Amar Agarwal, MS, FRCS, FRCOphth, performs pre-Descemet's endothelial keratoplasty during the Intraocular Implant and Refractive Society (IIRSI) meeting in Chennai, India, on July 5, 2014. The video on PDEK showcases the separation of the pre-Descemet's layer along with DM-endothelial complex by creation of typical type 1 bubble which spreads from the center to the periphery. In this 'Live surgery' video on PDEK in PBK eye various challenges were encountered. Intraoperative hyphema occurred due to a trickling of blood from the side port incision following descemetorrhexis. The coagulated blood was removed with the vitrectomy probe, and the AC was cleared of blood. The AC was observed to be shallow, so a trocar was introduced and dry vitrectomy was performed. This led to an increase in the AC depth, which is ideal for implanting the graft. The donor graft was then loaded and injected inside the eye followed by gentle unrolling of the graft with air and fluid.