Pseudophakic bullous keratopathy (PABK) is the second most common diagnosis leading to corneal transplant. These eyes are psuedophakic without other underlying corneal conditions. The "trauma" of cataract surgery or subsequent secondary anterior segment surgery leads to frank cornea decompensation from an insufficient number of endothelial cells . PABK can be acute after phaco from direct damage, or late-term from chronic endothelial loss typically seen with anterior chamber IOLs, nuclear chips , etc.
Pseudophakic Bullous Keratopathy OMD0610_A07_Fig02.jpg

PABK is often associated with the implantation of an anterior-chamber lens. It is prefered to replace that lens with a posterior sclera-sutured lens, followed by DSEK ( Descemet’s stripping with endothelial keratoplasty).