A 55-year old male patient presented to our department complaining of sudden visual loss in his left eye, 28 years after an uncomplicated PK for keratoconus. The patient reported no history of trauma or eye rubbing. Upon presentation, best-corrected visual acuity (BCVA) was 20/40 in the right eye and hand movement (HM) in the left eye. Slit-lamp biomicroscopy showed a bulging, full-thickness graft with distorted curvature and marked peripheral thinning and steepening. Diffuse corneal stromal oedema was observed (9–6 o’clock) that spared the inferior nasal area of the graft. No signs of infection, graft rejection or failure were identified. Anterior segment optical coherence tomography (AS-OCT, DRI OCT Triton: Topcon Corporation, Tokyo, Japan) revealed a DM detachment, with no DM breaks, localized to the area of the marked oedema. We decided to proceed with corneal graft repositioning and re-bubbling. More specifically, a circumferential, full-thickness incision in the previous graft-host junction was made, using fine corneal scissors. The incision was extended for 270o degrees (9 o’clock hours), surrounding the area of the corneal oedema and the underlying detached Descemet membrane. Following this, the graft was repositioned and sutured into place using interrupted 10-0 Nylon sutures. Lastly, air was injected in the anterior chamber in order to achieve reattachment and promote adherence of the previously detached DM. On the first post-operative day, corneal oedema had resolved and DM was found reattached. Patient’s BCVA was 20/40 in the left eye. The postoperative course was uneventful and the graft remained clear after a follow-up of 3 months. AS-OCT showed successful graft repositioning and a fully attached DM.