Results of penetrating keratoplasty with posterior chamber intraocular lens implantation in the absence of a lens capsule.

We studied 21 consecutive cases of posterior chamber intraocular lens implantation in the absence of an intact lens capsule performed during penetrating keratoplasty. Twenty patients had iris sutures to support the posterior chamber intraocular lenses (one required no suture). Twelve patients had closed-loop anterior chamber intraocular lenses, and five patients had other types of intraocular lenses explanted at the time of surgery. Postoperative follow-up time averaged 10 months, ranging from 2 to 19 months, with ten eyes having at least 1 year follow-up. All 21 grafts remained clear at their latest examinations. Seven eyes (33%) had 20/50 or better visual acuity, nine (43%) had a visual acuity from 20/60 to 20/150, and five (24%) had a visual acuity of 20/200 or worse at their latest examinations. All patients had improved vision postoperatively, and nine eyes (43%) achieved an improvement in vision of five lines or better. Of the ten eyes with at least 1 year follow-up, all had their sutures removed and four (40%) had 20/40 or better visual acuity. Of the remaining six patients (60%) with visual acuity worse than 20/40, all had significant retinal disease and/or glaucoma.