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A patient with Epidermolysis Bullosa and Keratoconus had a corneal ulcer in the left eye (OS), requiring a conjunctival flap. Vision was 20/150. One year later, VA was 20/250 OS with 4+ nuclear sclerosis. The flap was lifted for cataract surgery guided by endoillumination, then sutured back with an AMT and tarsorrhaphy. After 9 months, scleral lens fitting achieved VA of 20/30 OS.