Pseudophakic bullous keratopathy. Relationship to preoperative corneal endothelial status

Pseudophakic bullous keratopathy is one of the complications of intraocular lens implantation. A knowledge of the preoperative status of corneal endothelium may help to minimize the incidence of this complication. The preoperative corneal endothelial status of 118 eyes of 102 patients who received Worst-Medallion intraocular lenses more than five years ago was analyzed retrospectively. This data was then correlated with the postoperative clinical status of the cornea. Twelve eyes (10%) underwent penetrating keratoplasty for irreversible corneal edema, and 28 of the remaining eyes (22%) had clinical evidence of peripheral corneal edema. No correlation was found between the preoperative endothelial cell density or the degree of postoperative cell loss and the development of corneal edema. Significant correlation was found between variation in cell size (pleomorphism) and the development of postoperative corneal edema. Greater density of precipitates on endothelium and abnormality in cell shape postoperatively were also frequently seen in corneas that developed edema subsequently.