Penetrating keratoplasty and intraocular lens exchange for pseudophakic bullous keratopathy associated with a closed-loop anterior chamber intraocular lens.
We reviewed the records of 20 consecutive eyes with pseudophakic bullous keratopathy associated with a closed-loop anterior chamber lens that underwent penetrating keratoplasty, total anterior vitrectomy, and anterior chamber intraocular lens exchange. On reexamination, all corneal grafts had remained clear during an average follow-up period of 15 months (range, four to 45 months). Seven eyes (35%) attained a visual acuity of 20/40 or better with spectacle correction; however, 15 of 20 eyes (75%) attained a best-corrected visual acuity of 20/40 or better using a pinhole and a gas-permeable contact lens. In five eyes visual acuity was 20/400 or poorer because of cystoid macular edema, as documented by fluorescein angiography, age-related macular degeneration, or optic atrophy. Localized, minimal peripheral anterior synechiae were present on gonioscopy in seven eyes. The one-piece flexible anterior chamber lens implants used for exchange appeared to be well tolerated in this series of patients.
Koenig
S B
SB
Medical College of Wisconsin, Eye Institute, Milwaukee 53226.
McDermott
M L
ML
Hyndiuk
R A
RA
D000368:Aged; D000369:Aged, 80 and over; D000867:Anterior Chamber; D003316:Corneal Diseases / Q000209:etiology / Q000601:surgery*; D016039:Corneal Transplantation; D004867:Equipment Design; D005260:Female; D006068:Gonioscopy; D006801:Humans; D007910:Lenses, Intraocular / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012086:Reoperation