This paper describes the surgical results in 163 patients in whom intraocular lenses (IOL) had been implanted, exchanged, or removed during penetrating keratoplasty (PKP). They were divided into the following groups: PKP, cataract extraction, and IOL implant; PKP in aphakia and IOL implant; PKP and IOL exchange; PKP and IOL removal. In all groups clear transplants were obtained in over 92% of the cases, with best optical and visual results obtained in cases of Fuchs' dystrophy with cataract extraction and IOL implant (98% clear grafts and vision better than 20/40 in most cases). There were no significant differences in graft transparency and in the magnitude of visual acuity improvement between cases of pseudophakic edema with IOL replaced or removed at the time of surgery, and cases of aphakic edema with secondary IOL implant. Good surgical results are attributed to the use of young donor tissue with short time of storage, microsurgical techniques, and the use of sodium hyaluronate (Healon) for the protection of graft endothelium.
