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To describe clinical properties of a patient with persistent interface fluid syndrome and clear graft, 3.5 years after Descemet stripping automated endothelial keratoplasty (DSAEK).Case report.A 69-year-old woman who had DSAEK in 2006 presented with a clear cornea (no corneal edema) and deep diffuse reticular haze in the right eye. Visual acuity was 20/40. Ultrahigh-resolution optical coherence tomography (UHR-OCT) imaging of the right eye demonstrated persistent interface fluid at the donor–recipient junction. The detachment between donor and recipient corneas was 70 μm at the center. There was no connection between the anterior chamber and the donor/recipient interface.Despite the persistent detachment of the donor cornea, the recipient cornea can remain clear in persistent interface fluid syndrome after DSAEK.