[Keratoplasty of pseudophakic eyes with posterior chamber lenses in Fuchs' dystrophy and secondary bullous keratopathy. Long-term outcome].
Penetrating keratoplasties in pseudophakia were added to a group with limited prognosis. This was especially valuable, if iris-supported and anterior chamber intraocular lenses were implanted. Since today mainly posterior chamber lenses are implanted, the question of the long-term prognosis in this type of lens is important.


METHODS
From 1985 to 1994, 62 penetrating keratoplasties in pseudophakic eyes with posterior chamber IOL were performed: group I: decompensated Fuchs dystrophy (26 patients), group II: secondary surgery-related bullous keratopathy (36 patients) exclusively. Minimal follow-up was 18 months, mean age was 73.7 years.


RESULTS
The mean follow-up period was 32 months. The mean visual acuity on delivery was 0.11. After 6 months it was 0.23, after 1 year 0.3, after 2 years 0.35 and after 3 years 0.41 without significant differences in either group. Two years after transplantation 52.8% gained a visual acuity (VA) of > or = 0.3, after 3 years 58.6% of which 41.1% had a VA of > or = 0.5. There was a visual improvement in 83.4%; the mean spherical equivalent was -0.29 D. Refractive errors within 2 D of emmetropia were found in 56.7%; 95.1% of the grafts remained clear. Five patients had a reversible graft rejection. Extracorneal factors of impaired vision were observed in 25 patients.


CONCLUSIONS
Despite a different VA before surgery, the visual outcome in the two groups was identical. Penetrating keratoplasty in Fuchs dystrophy and secondary bullous keratopathy with posterior chamber IOL have a much better long-term prognosis than those with iris-supported and anterior chamber IOL. Postoperative complications and graft rejections are rare.
Müller
M
M
Augenklinik Marienhospital, Osnabrück.
Meyer
H J
HJ
Meyer
C
C
D000368:Aged; D003316:Corneal Diseases / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005642:Fuchs' Endothelial Dystrophy / Q000601:surgery*; D006801:Humans; D015948:Keratoplasty, Penetrating; D007910:Lenses, Intraocular; D008297:Male; D011183:Postoperative Complications / Q000601:surgery*; D012086:Reoperation; D016896:Treatment Outcome