Descemet\u27s stripping endothelial keratoplasty (DSEK) is a good alternative to penetrating keratoplasty in eyes with endothelial dysfunction due to faster healing, better refractive outcomes, absence of suture-related complications, and better wound security. The complications usually encountered after DSEK are graft dislocation, detachment, and rejection, secondary glaucoma, epithelial downgrowth, retrocorneal fibrous membrane, aqueous misdirection, cataract development and other minor non-vision threatening complications.[1–3] Wrinkles or folds after endothelial keratoplasty can cause poor visual outcome.[4] We report a case of macrostriae and Descemet\u27s membrane folds in a DSEK graft. A 63-year-old woman with a 4-year history of Fuchs\u27 endothelial dystrophy in both eyes (OU) presented with floaters in her left eye (OS). She had undergone uncomplicated cataract surgery with posterior chamber intraocular lens implantation OS 3 years ago. One year later, she developed blurred vision in the same eye. Visual acuity was 20/200 OU. Increasing corneal edema was noted OS. The intraocular pressure (IOP) was 15 mm Hg in the right eye (OD) and 18 mm Hg OS. Central corneal thickness was 575 mm OD and 630 mm OS. Pseudophakic bullous keratopathy and progressive Fuchs’ dystrophy OS was diagnosed and DSEK OS was performed
