Results of penetrating keratoplasty for pseudophakic bullous keratopathy with the exchange of an intraocular lens

We report on 29 consecutive patients with pseudophakic bullous keratopathy who underwent in one eye penetrating keratoplasty with an exchange of the original intraocular lens for a Pearce tripod posterior chamber lens, and who were available for a follow up of at least 12 months. The average interval between cataract extraction with lens implantation and the appearance of bullous keratopathy was five and a half years (range 10 months to 16 years). The mean follow-up period after penetrating keratoplasty was 36 months (range 12 to 56 months). The corneal graft remained clear in 22 (76%) eyes. One year after the operation 45% of the eyes had a vision of 20/40 or better, and 20% had visual acuities between 20/40 and 20/100. The remaining 31% had a vision of 20/100 or less (one unknown). Nine eyes (31%) had cystoid macular oedema or macular degeneration. 45% of the eyes had a refraction within approximately 2 dioptres of emmetropia. In patients with pseudophakic corneal oedema we continue to exchange the intraocular lens by a Pearce tripod posterior chamber lens sutured to the iris when it is necessary to remove the lens.