Myerscough J, et al. - In this prospective observational interventional study, experts aspired to explore if autologous Descemet stripping endothelial keratoplasty is technically feasible and if it eliminates the risk of endothelial rejection in “only eyes” at high risk of immunological rejection. After endothelial rejection in the context of chronic panuveitis, a 25-year-old woman with failed penetrating keratoplasty and a blind fellow eye due to retinal detachment had autologous Descemet stripping automated keratoplasty. During the 2-year follow-up duration, no endothelial rejection was observed. Stable improvement in best spectacle-corrected visual acuity from 0.2 to 0.4 (decimal Snellen) has been noted. At the final follow-up, endothelial cell density of 1,465 (cells/mm²) was recorded. Using this repeatable technique to harvest and transplant an autologous DSAEK graft in high risk eyes eliminates endothelial rejection.