Although cataract surgery alone carries a risk of iatrogenic endothelial damage, IOL implantation will further increase the risk of endothelial compromise and resulting bullous keratopathy. PBK is an important consideration in the differential diagnosis of corneal disease in the pseudophakic eye and with proper treatment visual loss due to PBK is usually reversible. While seen most frequently with iris clip implants, all pseudophakes are susceptible to PBK and should be carefully observed for this disease entity.