Slit-lamp examination of the left eye. (A) Corneal irregularity with marked thinning of the central cornea is observed in June 2008. (B) Slit-lamp examination of the left eye after penetrating keratoplasty revealed a diffuse cloudiness of the corneal graft with stromal oedema (June 2009). (C) Slit-lamp examination of the left eye in November 2009 showed an epithelial defect on the central cornea, which did not heal despite intensive topical therapy with autologous serum. (D) The corneal graft is clear after the second repeat keratoplasty, and there are no signs of infection (February 2011).