One year after DSAEK, the patient had progressive blurring of vision to hand movements. We observed total corneal decompensation with bullae and Descemet membrane folds. Therapy with prednisolone acetate, 10%, eyedrops (Pred Forte) 6 times a day, prednisolone pivalate, 5%, eye gel (Ultracortenol) 3 times a day, and preservative-free chloramphenicol, 0.4%, eyedrops 3 times a day proved to be unsuccessful. A penetrating posterior mushroom keratoplasty was performed. Six months after surgery, best-corrected visual acuity improved to 0.80 OD with –3.25 – 2.00 × 30°. The corneal graft in the right eye has remained clear.