Woo JH, Arundhati A, Chee SP, et al. - Researchers conducted this retrospective comparative cohort study to characterize the long-term outcomes of Descemet stripping automated endothelial keratoplasty (DSAEK) with an anterior chamber intraocular lens (ACIOL) compared with secondary posterior chamber (PC) IOL. Clinical results were examined for 82 eyes of 82 consecutive pseudophakic (PBK) or aphakic bullous keratopathy (ABK) patients who either had DSAEK with retained or secondary ACIOL (n = 23) or DSAEK with IOL exchange and/or secondary PCIOL (retropupillary iris-claw IOL, n = 25; intrascleral-fixated IOL, n = 29; or sulcus IOL, n = 5). Compared with those with secondary PCIOL, eyes which underwent DSAEK with ACIOL in situ had poorer long-term graft survival. Findings suggested no association of intraocular lens exchange with a higher complication rate. In ABK or PBK eyes with ACIOL, IOL exchange and/or secondary PCIOL implantation combined with endothelial keratoplasty is recommended.