title: Penetrating keratoplasty for pseudophakic bullous keratopathy. Management of the intraocular lens.
abstract: Management of the intraocular lens (IOL) at the time of penetrating keratoplasty (PK) for pseudophakic bullous keratopathy has been based on lens-related factors and coexisting anterior segment abnormalities. The authors reviewed the results of PK for 102 cases of pseudophakic bullous keratopathy (43 anterior chamber, 50 iris-supported, and 9 posterior chamber) with respect to: (1) the type of IOL, (2) coexisting abnormalities, and (3) management of the IOL at surgery. Graft failure after 2 years of follow-up was: (1) retained iris-supported IOLs, 9%; (2) retained anterior chamber IOLs, 60%; (3) retained posterior chamber intraocular lenses (PC IOL), 0%; (4) removed IOLs, 9%; and (5) exchanged IOLs, 20%. After 5 years of follow-up, 13 of 13 PKs with retained closed-loop anterior chamber IOLs had failed. Visual results were best in eyes with retained iris-supported, rigid anterior chamber or PC IOLs and when the IOL was removed without replacement. The authors recommend that closed-loop anterior chamber lenses and unstable lenses of any type be removed or exchanged and that well-fixated PC IOLs and iris-clip IOLs be retained at the time of PK for pseudophakic bullous keratopathy.
authors.affiliation: Cornea Service, Wills Eye Hospital, Philadelphia, PA 19107.
authors.forename: M G
authors.initials: MG
authors.lastname: Speaker
authors.forename: M
authors.initials: M
authors.lastname: Lugo
authors.forename: P R
authors.initials: PR
authors.lastname: Laibson
authors.forename: R S
authors.initials: RS
authors.lastname: Rubinfeld
authors.forename: R M
authors.initials: RM
authors.lastname: Stein
authors.forename: G I
authors.initials: GI
authors.lastname: Genvert
authors.forename: E J
authors.initials: EJ
authors.lastname: Cohen
authors.forename: J J
authors.initials: JJ
authors.lastname: Arentsen
mesh_terms: D000368:Aged; D003316:Corneal Diseases / Q000209:etiology / Q000601:surgery*; D016039:Corneal Transplantation; D004487:Edema / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007430:Intraoperative Care; D007910:Lenses, Intraocular / Q000009:adverse effects; D008297:Male; D012189:Retrospective Studies; D014792:Visual Acuity