Penetrating keratoplasty in pseudophakic bullous keratopathy

We studied 25 consecutive patients who underwent penetrating keratoplasty for pseudophakic bullous keratopathy. Follow-up time averaged 20 months. Ten patients required postimplantation surgical procedures because of complications after lens implantation. The time from lens implantation to onset of corneal edema averaged 18 months in patients without postimplantation surgical procedures and five months in patients with postimplantation procedures. The lens implants were removed in 11 patients at keratoplasty. Corneal clouding caused by graft rejection occurred in three patients, while 22 grafts remained clear. Final visual acuities were 6/6 (20/20) to 6/12 (20/40) in 13 patients, 6/15 (20/50) to 6/30 (20/100) in four patients, and 6/60 (20/200) or less in eight patients. We found no difference in final visual acuity between patients with lens implants removed at keratoplasty and those with lens implants left in place. Significant retinal pathology included cystoid macular edema, macular degeneration, and retinal detachment.