Results of keratoplasty for aphakic or pseudophakic corneal edema with intraocular lens implantation or exchange.

This paper reports the results of 99 penetrating keratoplasties for aphakic and pseudophakic corneal edema using a single-piece, semielastic anterior chamber lens. There were 24 patients with aphakic corneal edema and 75 with pseudophakic corneal edema. Most cases had history compatible with macular disease. A Cilco-Kelman multiflex anterior chamber lens was used in all cases. All intraocular lenses were removed from pseudophakic eyes (38 iris supported lenses and 37 anterior chamber lenses). Preoperative glaucoma was present in over 20% of all cases. Grafted eyes were followed from 1 to 5 years. There were 24 clear grafts in aphakic eyes (87%) and 72 in pseudophakic eyes (96%). Visual improvement occurred in 30% of aphakic eyes and in 10% of pseudophakic eyes. In 50% of both groups, vision improved to better than 20/100. The study shows that the use of this type of anterior chamber lens did not affect the outcome of corneal grafts, and that there were no differences in graft results between the two groups. Visual acuity results were related to retinal changes.