Keratoplasty for bullous keratopathy with intraocular lens.

The presence of a pseudophakos does not appear to introduce any greater hazard when keratoplasty is required because of corneal edema. This, together with the histories obtained from patients requiring such keratoplasty, strongly suggests that the insult to the corneal endothelium takes place at the time of placement of the intraocular lens in the great majority of cases. Of possible further significance is the fact that five of the sixteen patients who underwent keratoplasty had had secondary procedures to stabilize or to reposition the lens following the original lens implantation. The increased trauma inherent in the intraocular lens operation has been pointed out by many authorities. The fact that twelve of the sixteen patients requiring keratoplasty had been operated by experienced, nationally known intraocular lens surgeons further emphasizes this. The immediate problem appears to be the development and refinement of surgical techniques to avoid some of the complications which have been described. The prognosis for keratoplasty in cases of bullous keratopathy with an intraocular lens has been found to be at least as good as in cases without an intraocular lens.