The long-term follow-up of patients undergoing penetrating keratoplasty for pseudophakic corneal oedema is reported. The cause and frequency of corneal decompensation following intracapsular cataract extraction with insertion of an iris supported lens was assessed and found to be unrelated to the implant in the majority of cases. The most common cause of decompensation was endothelial touch during the cataract extraction. In all eyes the intraocular lens was retained at the time of penetrating keratoplasty. The hazards of removal of the lens are discussed and the recommendations made that lenses be retained when penetrating keratoplasty is undertaken for pseudophakic corneal oedema, other than in exceptional cases.
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