Surgical management of coexisting pseudophakic bullous keratopathy and glaucoma

This technique is a 1-step surgical management approach for patients with p seudophakic bullous keratopathy, glaucoma, and an unsatisfactory intraocula r lens (IOL). The outcome of 4 consecutive patients who had penetrating ker atoplasty, IOL removal, vitrectomy, transscleral sutured IOL implantation, and trabeculectomy by the same surgeon were reviewed. All patients had had intracapsular cataract extraction with anterior chamber IOL implantation an d were on antiglaucoma therapy. Main outcome measures were Snellen visual a cuity and intraocular pressure. A 1-stage quintuple procedure can achieve r elatively rapid visual rehabilitation in these high-risk eyes. The role of filtration surgery is controversial, but it was partially successful in con trolling postoperative intraocular pressure. (C) 1999 ASCRS and ESCRS.