Penetrating keratoplasty for pseudophakic corneal edema with exchange of intraocular lenses.
We studied one eye in each of 25 consecutive patients with pseudophakic corneal edema. Each patient underwent a penetrating keratoplasty with exchange of intraocular lenses and was followed up for 12 to 38 months (mean, 18.7 months). The corneal graft remained clear in 22 (88%) eyes, but only eight eyes (32%) had acuity of 20/40 or better; nine eyes (36%) manifested cystoid macular edema, and six eyes (24%) had degenerative maculopathy. Elevated intraocular pressure was present in 12 eyes after surgery, with three eyes manifesting visual field loss; in all eyes the condition was controlled medically. Peripheral anterior synechiae appeared postoperatively in two eyes. We now treat severe cases of pseudophakic corneal edema with a penetrating keratoplasty, meticulous anterior vitrectomy, gonioplasty, iridoplasty, and exchange of intraocular lenses, employing a flexible-loop anterior chamber lens or a posterior chamber lens sutured to the iris.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003316:Corneal Diseases / Q000209:etiology / Q000601:surgery*; D016039:Corneal Transplantation; D004487:Edema / Q000601:surgery*; D005260:Female; D006801:Humans; D007910:Lenses, Intraocular; D008875:Middle Aged; D012029:Refraction, Ocular; D012086:Reoperation; D012189:Retrospective Studies; D014785:Vision, Ocular; D014792:Visual Acuity