Penetrating keratoplasty in aphakic and pseudophakic bullous keratopathy.

Abstract

Pseudophakic and aphakic bullous keratopathy is becoming the prime indication for penetrating keratoplasty. Corneal edema in these cases is often associated with other complications of the anterior segment. We describe our observation of 46 consecutive corneal transplants performed between 1982 and 1984 for this condition with regard to preoperative condition, surgical technique, management of intraocular lens, and results. Twenty-six patients were pseudophakic and 20 were aphakic. Of those, 18 had glaucoma, 12 vitreous touch, and 10 synechiae. We exchanged all 14 iris-supported lenses, some of the anterior chamber lenses, retained all posterior chamber lenses, and implanted a lens in half of the aphakic eyes. There was no difference in the anatomical success rate between grafts in these pseudophakic and aphakic eyes as compared to those grafts in phakic eyes. The rate of complications including incidence of graft rejection was not affected by the presence of an intraocular lens. Postoperative elevation of intraocular pressure was not seen in those who had no glaucoma preoperatively.