In my previous prospective study of 132 eyes, the incidence of clinically significant cystoid macular edema was 42% in aphakic penetrating keratoplasty, 33% in combined keratoplasty and cataract extraction with vitrectomy, and only 4% in combined keratoplasty and cataract extraction without vitrectomy. In the present study we added 26 aphakic and 11 pseudophakic keratoplasties and 17 procedures combining keratoplasty with extracapsular cataract extraction. Grafts were clear in 94% of patients, and 43% had visual acuity of 20/40 or better. Clinically significant cystoid macular edema occurred in 35% of aphakic and 27% of pseudophakic keratoplasties. Cystoid macular edema did not occur in combined keratoplasty and extracapsular cataract extraction.