[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-374328-105":59,"doc-detail-374328-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","pseudophakic-bullous-keratopathy-introduction","Pseudophakic Bullous Keratopathy - Introduction","","Pseudophakic bullous keratopathy (PBK) is an irreversible corneal stromal edema caused by injury to the corneal endothelium, most often after cataract surgery. The document explains how loss of endothelial barrier and impaired transport mechanisms disrupt deturgescence, leading to stromal swelling, corneal scarring, reduced transparency, and progressive functional decline. It also summarizes key pathophysiologic changes, from Na+/K+ATPase alterations to bullae formation, epithelial rupture, pain, infection risk, and histologic findings.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/pseudophakic-bullous-keratopathy-introduction/374328/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/pseudophakic-bullous-keratopathy-introduction/374328.png","ImageObject",300,407,{"name":92,"@type":93},"Bulrr","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",12,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What defines pseudophakic bullous keratopathy (PBK)?","Question",{"text":113,"@type":114},"PBK is irreversible stromal edema resulting from injury to the corneal endothelium, most commonly after intraocular surgery such as cataract surgery.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How does corneal endothelial dysfunction lead to edema?",{"text":118,"@type":114},"The endothelium normally pumps fluid out of the corneal stroma via transport mechanisms; when barrier function or the metabolic pump is disrupted, fluid accumulates and the cornea loses deturgescence.",{"name":120,"@type":111,"acceptedAnswer":121},"What are common causes of endothelial damage in bullous keratopathy?",{"text":122,"@type":114},"The document highlights surgical trauma, including factors such as prolonged/high-energy phacoemulsification, toxic or pH/osmotic-altering agents, mechanical contact, and other intraocular procedures or medications.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},374328,1790740054,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":146},5909892115043,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","# Pseudophakic Bullous Keratopathy\n\nRoma B.Pegany,Richard D.Stutzman,Afshan A.Nanji,and Winston D.Chamberlain  \n## 12.1 Introduction\n\nPseudophakic bullous keratopathy(PBK)is irreversible stromal edema in the cor-nea,resulting from injury to the corneal endothelium,most commonly occurringafter intraocular surgery.Aphakic bullous keratopathy(ABK)refers to cornealedema that develops in the absence of an intraocular lens(IOL).While any intraocu-lar surgery can potentially cause endothelial damage,PBK most commonly occursafter cataract surgery [1].Approximately 26 million cataract surgeries are per-formed worldwide each year [2].From 1980 to 2014,PBK or ABK was the leadingindication for a penetrating keratoplasty(PKP)in the United States,representing28%of the cases during this period [3].While the advancement of modern phaco-emulsification techniques,viscoelastic devices,and IOL design have reduced theincidence of PBK since the 1960s,it still remains a significant cause of vision loss[1].The corneal edema and corneal scarring that develop in PBK compromise therefractive and transparency properties of the cornea,which are critical to the func-tion of the human optical system.  \n## 12.2 Pathophysiology of Corneal Edemain Bullous Keratopathy\n\nCorneal transparency is maintained through intact epithelial and endothelial barri-ers and transport mechanisms.The endothelium lines the posterior surface ofthe cornea.It is a highly specialized monolayer mosaic of hexagonal cells with a  \nNa+/K+ATPase ion transport system that actively pumps fluid out of the cornealstroma into the aqueous humor,keeping the stroma in a relative state of deturges-cence(78%water content)[4].The mechanisms leading to edema and PBK are notfully understood,but exposure to mechanical trauma and other forms of cellularstress during and after intraocular surgery can disrupt this barrier and the metabolicpump.Human corneal endothelial cells have a low proliferation rate and damagedcells are replaced by the enlargement of neighboring cells and their centripetalmigration into an injured region [5,6].Corneal epithelial cells have tight junctionalcomplexes between cells that normally prevent penetration of fluid from the precor-neal tear film into deeper layers of the cornea.  \nIn bullous keratopathy,epithelial Na+/K+ATPase function may be altered,andthere may also be increase aquaporin 3 levels,and abnormal integrin patterns [1].In advanced bullous keratopathy,aqueous fluid can enter and accumulate under theepithelium from the stroma and form small vesicles(bullae).Eventual epithelialrupture and corneal nerve exposure lead to ocular pain [1].Bullae may becomesecondarily infected from surface toxins and microbes,further complicating thecondition.Histological studies of PBK reveal bullous separation of the epithelialcell layer from Bowman's membrane,separation of stromal collagen fibrils withincreased interstitial fluid,thickening of Descemet's membrane,and decreasedendothelial cell number [7].  \n## 12.3 Mechanisms of Bullous Keratopathy\n\n### 12.3.1 Surgical\n\nSurgical trauma is the most common cause of endothelial decompensation in bul-lous keratopathy.Before the 1980s,PBK was a common complication because ofthe high rate of intracapsular cataract extraction and anterior chamber IOL place-ment [8].Modern,less-traumatic,phacoemulsification techniques and foldable pos-terior chamber IOLs have resulted in a decline in pseudophakic corneal edema.However,corneal edema following cataract surgery remains a common indicationfor corneal transplantation in the United States [9,10].Endothelial damage canoccur from prolonged or high-energy phacoemulsification,which is associated withthe production of free radicals that induce oxidative stress [6],as well as from theuse of high fluidic parameters and intraocular irrigating solutions [11]or drugs thatalter the pH and osmotic balance of the endothelium [1].Mechanical contactbetween the endothelium and surgical instruments or lens fragments ","cbCaimAM5XmlE67x","https://ap.wps.com/l/cbCaimAM5XmlE67x","pdf",2026246,11,"English","# 12.1 Introduction\n# 12.2 Pathophysiology of Corneal Edema in Bullous Keratopathy\n# 12.3 Mechanisms of Bullous Keratopathy\n## 12.3.1 Surgical\n## 12.3.2 Other Predispositions","[{\"question\":\"What defines pseudophakic bullous keratopathy (PBK)?\",\"answer\":\"PBK is irreversible stromal edema resulting from injury to the corneal endothelium, most commonly after intraocular surgery such as cataract surgery.\"},{\"question\":\"How does corneal endothelial dysfunction lead to edema?\",\"answer\":\"The endothelium normally pumps fluid out of the corneal stroma via transport mechanisms; when barrier function or the metabolic pump is disrupted, fluid accumulates and the cornea loses deturgescence.\"},{\"question\":\"What are common causes of endothelial damage in bullous keratopathy?\",\"answer\":\"The document highlights surgical trauma, including factors such as prolonged/high-energy phacoemulsification, toxic or pH/osmotic-altering agents, mechanical contact, and other intraocular procedures or medications.\"}]","Pseudophakic Bullous Keratopathy - Introduction | PDF",1790201465,28]