Penetrating keratoplasty for the treatment of pseudophakic corneal edema associated with posterior-chamber lens implantation.

Abstract

POSTERIOR CHAMBER (PC) LENS INIPLANTATION IS A RELATIVELY NEW TECHNIQUE. The incidence of pseudophakic bullous keratopathy (PBK) following extracapsular cataract extraction with PC lens implantation has been reported at less than 1%. ' If we compare this figure with the incidence of PBK in iris fixated and anterior chamber (AC) intraocular lenses, which is as high as 6.2%, this represents an advantage in the use of PC lenses.", 2 Nevertheless, long-term follow-up of corneal edema in PC lens implantation is not available to confirm that the lower incidence of PBK with this technique can presently be compared with that in other types of lenses. The functional capacity of the endothelium depends primarily on its action as a barrier at the level of the tight junctions and on the metabolic pump action of the enzymatic systems in the cellular membrane. Both can be affected by multiple factors during or after the surgical implantation of an intraocular lens. Among the factors that can possibly decompensate the endothelial function, we should consider surgical trauma, glaucoma, lowgrade uveitis, chronic endothelial microtrauma due to the intraocular lens, and the attrition of the endothelium that follows any type of surgery.3 At present we cannot predict how these different factors affect the