Abstract
A retrospective analysis of 198 eyes with pseudophakic bullous keratopathy undergoing penetrating keratoplasty with or without intraocular (IOL) exchange was performed over an 11-year period. The 198 eyes evaluated consisted of 86 anterior chamber (AC), 27 iris fixated (IF), and 85 posterior chamber (PC) lenses. Patients were followed up for an average of 3.2 ± 1.3 years. The mean intervals between initial cataract surgery and penetrating keratoplasty were 38 ± 4, 44 ± 3, and 3 ± 1.2 months with AC, IF and PC lenses, respectively. Pre-existing endothelial changes in fellow eyes were present in 56% of cases. Anterior vitrectomy was performed in 93% of AC, 54% of IF, and 35% of PC lenses. More than half of the PC lenses (58.8%) were retained as opposed to 1.7% of AC lenses and 0% of IF lenses. Maximum grafts remained clear with posterior chamber implants (83%) at the time of mean follow up. Visual acuity of 6/18 or more was achieved in 15% of eyes with AC, 17% with IF, and 45% PC with implants respectively. The most common cause of graft failure was raised intraocular pressure with all types of pseudo- phakos. The leading causes of non-improvement of vision in the presence of clear graft were cystoid macular edema (40%) and glaucomatous optic atrophy (37.1%).
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
R.E. Smith, McDonald, H.R., Nesburn, A.B., and Minckler, D.S., P.K., Changing indications 1947 to 1978. Arch. Ophthalmol. 98:1226 (1980).
J.B. Robin, Gindi, J.J., Koh, K., et al., An update of the indications for keratoplasty 1979 through 1983 Arch. Ophthalmol 104(1):87 (1986
D.M. Taylor, Atlas, B.F., Romanchuk, K.G., and Stern, A.L., Pseudophakic bullous keratopathy. Ophthalmology 90(1): 19 (1983).
P. Haaman, Jensen, O.M., and Schmidt, P., Changing indications of penetrating keratoplasty. Acta Ophthalmol. 72(4):443 (1994).
F.W. Price, Whitson, W.E., Collins, K.S., and Marks, R.G., Five year corneal graft survival. A large, single-center patient cohort. Arch. Ophthalmol. 111(6):799 (1993).
R.F. Meyer, and Sugar, A., P.K. in pseudophakic bullous keratopathy 90:677 (1980).
K.H. Charlton, Binder, P.S., and Perl T., Visual prognosis in pseudophakic corneal transplants. Ophthalmic Surg. 12(6):411 (1981).
J.J. Arentsen, and Laibson, P.R., Surgical management of pseudophakic corneal edema: complications and visual results following penetrating keratoplasty. Ophthalmic Surg. 13(5):371 (1982).
W.R. Fagadau, Maumenee, A.E., Stark, W.J., and Datiles, M., Posterior chamber intraocular lenses at the Wilmer Institute: a comparative analysis of complications and visual results. Br. J. Ophthalmol. 68(1): 13 (1984).
E.J. Cohen, Brady, S.E., Leavitt, K.L., et al., Pseudophakic bullous keratopathy. Am. J. Ophthalmol. 106:264 (1988).
G.N. Rao, Aquavella, J.V., Goldberg S.H., and Berk, S.L., Pseudophakic bullous keratopathy. Relationship to pre-operative endothelial status. Ophthalmology 91(10):1135 (1984).
S.B. Koenig, and Schultz, R.O., Penetrating keratoplasty for pseudophakic bullous keratopathy after extra-capsular cataract extraction. Am. J. Ophthalmol 105:348 (1988).
M. Lugo, Cohen, E.J., Eagle, R.C., et al., The incidence of preoperative endothelial dystrophy in pseudophakic bullous keratopathy. Ophthalmic Surg. 19:16 (1988).
S.R. Waltman, Penetrating keratoplasty for pseudophakic bullous keratopathy. Visual results. Arch. Ophthalmol. 99(3):415 (1981).
M. Busin, Arffa, R.C., McDonald B., and Kaufman, H.E., Intraocular lens removal during penetrating keratoplasty for pseudophakic bullous keratopathy. Ophthalmology 94:505 (1987).
P.W. Smith, Wong, S.K., Stark, W.J., et al., Complications of semiflexible, closed loop anterior chamber intraocular lenses. Arch. Ophthalmol. 105:52 (1987).
G.O. Waring, Stulting, R.D., and Street, D., Penetrating keratoplasty for pseudophakic corneal edema with exchange of intraocular lenses. Arch. Ophthalmol. 105:58 (1987).
D.J. Apple, and Olson, R.J., Closed loop anterior chamber lenses. Arch. Ophthalmol. 105:19 (1987).
A.M. Kozarsky, Stopak, S., Waring, G.O., et al., Results of penetrating keratoplasty for pseudophakic corneal oedema with retention of intraocular lens. Ophthalmology 91(10):1141 (1984).
M.S. Insler, Craig, J., Helm, B.S., and Kaufman, B.E., Visual results after keratoplasty in patients with P/C IOL. Am. J. Ophthalmol. 106:72 (1988).
G.O. Waring, Welch, S.N., Cavanagh, H.D., and Wilson, L.A., Results of penetrating keratoplasty in 123 eyes with pseudophakic or aphakic corneal edema. Ophthalmology 90(1):25 (1983).
S.G. Kramer, Cystoid macular edema after aphakic penetrating keratoplasty. Ophthalmology 88(8):782 (1981).
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1997 Springer Science+Business Media New York
About this chapter
Cite this chapter
Panda, A., Sharma, N., Angra, S.K. (1997). Penetrating Keratoplasty for Pseudophakic Bullous Keratopathy. In: Lass, J.H. (eds) Advances in Corneal Research. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-5389-2_19
Download citation
DOI: https://doi.org/10.1007/978-1-4615-5389-2_19
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4613-7460-2
Online ISBN: 978-1-4615-5389-2
eBook Packages: Springer Book Archive