Between July 1980 and March 1987 the authors performed pseudophakic penetrating keratoplasty in 56 eyes with bullous keratopathy following implantation of an intraocular lens. The postoperative results in 50 eyes (47 patients) are reported in this retrospective study. Average duration of follow-up after keratoplasty was 8.1 months. The intraocular lenses were either iris-supported (31), anterior chamber lenses (12), or posterior chamber lenses (7). The interval between implantation of the lens and performance of the keratoplasty ranged from three to 451 months (average 69.9 months). It varied considerably, depending on the type of lens used. Vision after penetrating keratoplasty improved in 44 of the 50 eyes and was unchanged in three. In ten eyes, improvement in vision was limited by persistent cystoid maculopathy (CMP). Postoperative complications occurred in five eyes and traumatic wound dehiscence in two. However, none of the transplants showed any signs of rejection during the follow-up period. The prognosis for penetrating keratoplasty following intraocular lens implantation is generally good; impaired vision is due to extracorneal factors, in particular CMP.