TY - JOUR
T1 - Penetrating Keratoplasty for Pseudophakic Bullous Keratopathy
T2 - Management of the Intraocular Lens
AU - Speaker, Mark G.
AU - Lugo, Miguel
AU - Laibson, Peter R.
AU - Rubinfeld, Roy S.
AU - Stein, Raymond M.
AU - Genvert, Gail I.
AU - Cohen, Elisabeth J.
AU - Arentsen, Juan J.
N1 - Funding Information:
Supported in part by the Corneal Research Fund at the Wills Eye Hospital.
PY - 1988
Y1 - 1988
N2 - Management of the intraocular lens (IOL) at the time of penetrating keratoplasty (PK) for pseudophakic bullous keratopathy has been based on lens-related factors and coexisting anterior segment abnormalities. The authors reviewed the results of PK for 102 cases of pseudophakic bullous keratopathy (43 anterior chamber, 50 iris-supported, and 9 posterior chamber) with respect to: (1) the type of IOL, (2) coexisting abnormalities, and (3) management of the IOL at surgery. Graft failure after 2 years of follow-up was: (1) retained iris-supported IOLs, 9%; (2) retained anterior chamber IOLs, 60%; (3) retained posterior chamber intraocular lenses (PC IOL), 0%; (4) removed IOLs, 9%; and (5) exchanged IOLs, 20%. After 5 years of follow-up, 13 of 13 PKs with retained closed-loop anterior chamber IOLs had failed. Visual results were best in eyes with retained iris-supported, rigid anterior chamber or PC IOLs and when the IOL was removed without replacement. The authors recommend that closed-loop anterior chamber lenses and unstable lenses of any type be removed or exchanged and that well-fixated PC IOLs and iris-clip IOLs be retained at the time of PK for pseudophakic bullous keratopathy.
AB - Management of the intraocular lens (IOL) at the time of penetrating keratoplasty (PK) for pseudophakic bullous keratopathy has been based on lens-related factors and coexisting anterior segment abnormalities. The authors reviewed the results of PK for 102 cases of pseudophakic bullous keratopathy (43 anterior chamber, 50 iris-supported, and 9 posterior chamber) with respect to: (1) the type of IOL, (2) coexisting abnormalities, and (3) management of the IOL at surgery. Graft failure after 2 years of follow-up was: (1) retained iris-supported IOLs, 9%; (2) retained anterior chamber IOLs, 60%; (3) retained posterior chamber intraocular lenses (PC IOL), 0%; (4) removed IOLs, 9%; and (5) exchanged IOLs, 20%. After 5 years of follow-up, 13 of 13 PKs with retained closed-loop anterior chamber IOLs had failed. Visual results were best in eyes with retained iris-supported, rigid anterior chamber or PC IOLs and when the IOL was removed without replacement. The authors recommend that closed-loop anterior chamber lenses and unstable lenses of any type be removed or exchanged and that well-fixated PC IOLs and iris-clip IOLs be retained at the time of PK for pseudophakic bullous keratopathy.
KW - anterior chamber intraocular lenses
KW - corneal transplant failure
KW - intraocular lens complications
KW - intraocular lens exchange
KW - intraocular lens removal
KW - iris-supported intraocular lenses
KW - penetrating keratoplasty
KW - posterior chamber intraocular lenses
KW - pseudophakic bullous keratopathy
UR - http://www.scopus.com/inward/record.url?scp=0023723048&partnerID=8YFLogxK
U2 - 10.1016/S0161-6420(88)33037-X
DO - 10.1016/S0161-6420(88)33037-X
M3 - Article
C2 - 3062537
AN - SCOPUS:0023723048
SN - 0161-6420
VL - 95
SP - 1260
EP - 1268
JO - Ophthalmology
JF - Ophthalmology
IS - 9
ER -