Management of pseudophakic corneal edema with reconstruction of the anterior ocular segment

The following surgical techniques were used to treat pseudophakic corneal edema in 13 consecutive eyes: penetrating keratoplasty (13 eyes), mechanical anterior vitrectomy (ten eyes), removal of intraocular lens (13 eyes), gonioplasty with opening of peripheral anterior synechiae using a dental mirror (seven eyes), iridoplasty using a round needle (six eyes), and insertion of a replacement intraocular lens (12 eyes). The most common intraoperative complication was hemorrhage in the angle. Although the angle was open 360 degrees to the ciliary body in 12 of the 13 eyes at the end of surgery, a few peripheral anterior synechiae recurred in six eyes at six weeks. Short-term results suggest that this technique can restore the structure of the anterior ocular segment, decrease progressive peripheral anterior synechiae and glaucoma, and possibly decrease cystoid macular edema.