: This is the first case report documenting an idiosyncratic unilateral madarosis and facial alopecia as adverse side effects presumed secondary to botulinum A toxin injections.

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DSAEK provides an alternative both to PK and to a repeat PK in patients with failed grafts because of endothelial cell dysfunction. The advantages DSAEK surgery can offer are a quicker visual recovery, a more stable refraction, a tectonically more stable globe, and fewer ocular surface defects associated with corneal sutures or the surface graft host interface. The limitations associated with DSAEK include donor button dislocation and endothelial cell loss and dysfunction. Whether DSAEK or PK offers the best visual outcome and graft survival over the long term is unknown. Caution is advised until multicenter trials confirm the optimal procedure.

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