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A 66-year-old male who previously had therapeutic penetrating keratoplasty (PK) for uncontrolled infectious keratitis developed iridocorneal adhesion, posterior synechiae, and graft rejection. Repeat PK combined with cataract surgery was planned. After synechiolysis, phacoemulsification, IOL insertion and PK were performed. Uncorrected distant Visual Acuity improved from hand motion to 20/200.