This paper studies the appearance and development of pseudophakic corneal edema (PCE) in a series of 840 patients referred for keratoplasty for corneal edema. There were no cases of PCE in 100 eyes with corneal edema studied between 1960 and 1970. In 200 cases of corneal edema studied between 1978 and 1980, there were 30 eyes with PCE (15%). The disease has gradually increased to 56% of all cases of corneal edema seen in 1986. A tendency of PCE to decrease has been noted in the last 2 years. The high incidence of PCE in recent years, which is the main reason for keratoplasty today, seems to be related to the use of closed loop anterior chamber lenses. Fuchs' dystrophy, which formed the bulk of cases of corneal edema, may be present in many cases of PCE. Results of keratoplasty with intraocular lens (IOL) removal or exchange provided better than 80% good results in a group of 230 cases followed from 1 to 7 years with visual improvement better than 20/100 in over 50% of cases. The removal of an intraocular lens causing progressive visual symptoms is advised even at the risk of causing corneal edema.
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