Ibrahim O, et al. - In this prospective consecutive study, authors analyzed 74 cases to examine the consequence of iris damage on endothelial cell loss in the early phase after penetrating keratoplasty (PKP). They observed a decline in graft endothelial cell density (ECD) from 2674 ± 329 cells/mm² to 2114 ± 570 at 1 month, 1907 ± 629 at 3 months, 1669 ± 738 at 6 months, and 1404 ± 792 at 12 months. They found an association of ECD at 12 months was associated with the iris damage scores (IDSs), graft ECD, and history of graft failure. They concluded a relationship of severe iris damage with a rapid decrease in ECD and graft endothelial failure after PKP.