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Pseudophakic Corneal Edema: A Review of Mechanisms and Treatments

Narayanan, Raja MD*; Gaster, Ronald N MD, FACS*†; Kenney, M Cristina MD, PhD*

doi: 10.1097/01.ico.0000214225.98366.83

Purpose: To review the pathological mechanisms and treatments for pseudophakic corneal edema (PCE), one of the most common indications for penetrating keratoplasty.

Methods: The literature was examined for the molecular biology associated with PCE and for the surgical and medical treatments for this disorder.

Results: The incidence of PCE has recently been decreasing because of improved surgical instrumentation, including improvements in intraocular lens designs that cause less trauma to the corneal endothelium. Extracellular matrix and growth factor abnormalities occur in PCE corneas and recently, the role of aquaporins, which are involved in the regulation of fluid movement across cells, has been investigated.

Conclusions: Although newer treatment options have been suggested, penetrating keratoplasty still remains the most definitive treatment and has the highest success rate.

From the *LV Prasad Eye Institute, Banjara Hills, Hyderabad, India, and the †Department of Ophthalmology, Veterans Affairs Medical Center, Long Beach, CA.

Received for publication March 18, 2005; revision received October 19, 2005; accepted October 21, 2005.

Reprints: M. Cristina Kenney, MD, PhD, Department of Ophthalmology, University of California Irvine, Medical Center, 101 The City Drive, Orange CA 92868 (e-mail:

© 2006 Lippincott Williams & Wilkins, Inc.