Penetrating keratoplasty in aphakic eyes is indicated most frequently in cases of corneal edema of varying degree following cataract extraction. This edema may appear as an aggravation of a preexisting endothelial-epithelial (Fuchs') dystrophy of the cornea, or as a consequence of endothelial damage from a complicated cataract extraction or later impaction of vitreous against the endothelium. Other indications in aphakic eyes have been corneal edema resulting from chronic uveitis, opacity due to explosion or chemical injuries, opacified corneal grafts, opacity associated with familial aniridia and various degenerations. Lamellar transplants seldom achieve satisfactory therapeutic and visual results in most of these because the underlying disease is in the endothelium.
Since the early days of corneal transplantation aphakia has been considered a very unfavorable condition for penetrating keratoplasty, and the results of keratoplasty in aphakic eyes have, until recently, been reported as very poor. In the panel discussion of keratoplasty of the
FINE M. Penetrating Keratoplasty in Aphakia. Arch Ophthalmol. 1964;72(1):50–56. doi:10.1001/archopht.1964.00970020052012
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