We report on 29 consecutive patients with pseudophakic bullous keratopathy who underwent in one eye penetrating keratoplasty with an exchange of the original intraocular lens for a Pearce tripod posterior chamber lens, and who were available for a follow up of at least 12 months. The average interval between cataract extraction with lens implantation and the appearance of bullous keratopathy was five and a half years (range 10 months to 16 years). The mean follow-up period after penetrating keratoplasty was 36 months (range 12 to 56 months). The corneal graft remained clear in 22 (76%) eyes. One year after the operation 45% of the eyes had a vision of 20/40 or better, and 20% had visual acuities between 20/40 and 20/100. The remaining 31% had a vision of 20/100 or less (one unknown). Nine eyes (31%) had cystoid macular oedema or macular degeneration. 45% of the eyes had a refraction within approximately 2 dioptres of emmetropia. In patients with pseudophakic corneal oedema we continue to exchange the intraocular lens by a Pearce tripod posterior chamber lens sutured to the iris when it is necessary to remove the lens.
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