The occurrence of pseudophakic bullous keratopathy following anterior chamber intraocular lens implantation is well documented. At the time of penetrating keratoplasty and anterior chamber intraocular lens removal, we attempt to reimplant a posterior chamber lens whenever possible because of the complications associated with anterior chamber lenses. We developed a technique to exchange an anterior chamber lens with a posterior chamber lens during penetrating keratoplasty. The intraocular lens loops are inserted in the ciliary sulcus and the optic is sutured to the iris.