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January 1987

Penetrating Keratoplasty for Pseudophakic Corneal Edema With Exchange of Intraocular Lenses

Author Affiliations

From the Department of Ophthalmology, Emory University, Atlanta.

Arch Ophthalmol. 1987;105(1):58-62. doi:10.1001/archopht.1987.01060010064032

• 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 flexibleloop anterior chamber lens or a posterior chamber lens sutured to the iris.