Endothelial line associated with pseudophakic bullous keratopathy

Three patients undergoing uncomplicated cataract extraction with intraocular lens implantation developed an endothelial line, clinically appearing identical to that seen in allograft rejection following corneal transplantation. Both intracapsular and extracapsular surgery were involved. Three different intraocular lens types were implanted (pupillary supported, anterior chamber, and posterior chamber). Each case was associated with postoperative iritis and glaucoma. They were nonresponsive to steroid therapy and eventually resulted in total corneal decompensation. This clinical entity may represent an autoimmune phenomenon stimulated by chronic inflammation induced by the intraocular lens.