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Presentation type	Oral presentation
Title	EndoArt Artificial Endothelial Implantation after Multiple Failed Keratoplasties: A Case Series

Purpose	To report outcomes of EndoArt in three patients with advanced corneal decompensation and multiple failed keratoplasties.
Methods	Three patients underwent EndoArt between 2022 and 2025 after repeated graft failure. They presented with corneal edema, pain and poor vision. Surgery was under general anesthesia with gas tamponade and OCT verification. Follow-up included slit-lamp biomicroscopy, Pentacam, anterior segment OCT, IOP, and best corrected visual acuity (BCVA).
Results	All procedures were completed without complications and implants remained stable. A 26- year-old monocular patient achieved marked improvement: astigmatism decreased from −9.7 D to −1.4 D, CCT reduced, and BCVA improved from hand movements to 0.05 at 6 months, with pain relief and high satisfaction. An 84-year-old with multiple PK and DSAEK failures obtained long-term stability: pachymetry decreased from 1005 µm to 600 µm and remained stable at 3 years, with BCVA ~0.1 and no need for re-intervention. A 64-year-old with glaucoma, Baerveldt tube, and steroid response underwent EndoArt as an alternative to PK; at 11 weeks the implant was stable, with one remaining suture, IOP 25 mmHg on therapy, symptoms improved, though uncorrected vision remained at hand movements.
Conclusion	EndoArt provided stability, pain relief, reduced edema, and functional rehabilitation in high-risk eyes. It may represent a valuable alternative for patients unsuitable for repeat donor keratoplasty.
Conflict of interest	No

Authors 1

Initials	K
Last name	Skafi
Department	UZ Brussel
City	Brussel

Authors 2

Initials	R
Last name	Van Schoor
Department	UZ Brussel
City	Brussel

Authors 3

Initials	S
Last name	Ní Dhubhghaill
Department	UZ Brussel
City	Brussel