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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7759
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I have fuchs corneal dystrophy and the start of cataracts.

Customer Question

I have fuchs corneal dystrophy and the start of cataracts. What are the considerations for cataract surgery for me?
Submitted: 3 years ago.
Category: Eye
Expert:  CamilleRN replied 3 years ago.
Welcome to JustAnswer Health...and thank you for your question. I am a verified Expert and am delighted to help you today. In a patient with Fuch's, a cataract surgery may hasten the need for a corneal transplant. In many cases a corneal transplant is often at the same time. When the surgeries surgeries are done in one procedure,recovery time is reduced. Here is an article regarding this:
FUCHS
Customer: replied 3 years ago.
OK. My strategy so far is to delay doing anything but keeping watch of the progress. At the point that I am forced to do something then you indicate that the solution is corneal transplant. What are the considerations accompanying this solution? Risks and benefits, long term medications and recovery prognosis.
Expert:  CamilleRN replied 3 years ago.
I am going to opt out and see if there is an Expert available that can address your additional questions. If so, one will answer your question in this same window.
Thank you:-)
Expert:  Dr. Rick replied 3 years ago.
Hi. I'm online and happy to answer your question today. I am an ophthalmologist and I am very familiar with Fuchs corneal dystrophy and how it relates to cataract surgery.

Would you like to continue working on your issues or has the above expert covered things well enough for you?
Customer: replied 3 years ago.
Dr. Rick, I would appreciate your input. Thanks, Gary
Expert:  Dr. Rick replied 3 years ago.
Oops! I just noticed I've forgotten to answer your question :(

If you are still there, and still would like an answer, please drop me a note and I'll get right with you...

Customer: replied 3 years ago.
Sorry, I was busy with other issues. Let me know when I can get with you.
Expert:  Dr. Rick replied 3 years ago.
We, really, are playing chat tag, eh? :o) Let me just give you some information about this issue and you can let me know if you would like to discuss it further. Sorry for all the delays in getting you the information you require
Expert:  Dr. Rick replied 3 years ago.
As you most likely already know, in Fuchs the endothelial cells, the 'little pumps' that keep your cornea thin and clear, are damaged and die off faster then in normal folks. You are born with all the endothelial cells you are going to ever have and you can think of this process of endothelial loss as a race: Will you die before you no longer have enough cells to keep your cornea healthy? In the vast majority of instances the answer to this race is, yes :)

In you case? Doubtful.

Everything, from infection, trauma, contact lens wear, aging and.....cataract surgery......cause loss of endothelial cells. Most cases this is not a problem and does not change the outcome of the race. In your case, it might. Notice the word choice? Might. Not will.... ;)

There are a number of precautions your surgeon can take during your cataract surgery to greatly minimize the loss of endothelial cells. There are special "coating" agents she can inject inside your eye prior to removing the cataract, she can also take extra care when using the phaco instrument to emulsify the cataract for removal and also coat the artificial lens in protective "goop" prior to inserting it in your eye.

With modern surgical techniques and being forewarned about your Fuch's dystrophy along with a preoperative evaluation of your endothelial cells you should be OK with having your cataract removed. It is NOT a given that surgery will tip you over into needing a corneal transplant and, in any case, there are other procedures to restore endothelial cells (DSEK) without having to resort to a full thickness transplant.

I do not see why your recovery process after cataract surgery will be much different then most folks. Sure, you might have a greater risk of getting some post-op corneal edema but, if your endothelial cell counts aren't too horrible, you should be ok.

And, now, the obligatory word from our sponsors: :o)

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Once again let me thank you for your patience! I feel bad that it took so long to get you an answer :(
Expert:  Dr. Rick replied 3 years ago.

Let me know if there is anything else you would like to discuss pertaining to this issue.

Did I ever mention that I am sorry you had to wait so long for an answer? =)

Customer: replied 3 years ago.
Thanks. That is the information I needed. My Mom, now 90+, had successful cataract surgery and has Fuchs but has not needed a corneal transplant. Her vision is poor and she complains about it but she is still reading large print books. So I guess my strategy is to wait with my yearly checks until cataract surgery is absolutely necessary. Now I don't drive after dusk. Then hopefully I can have the cataract surgery and not need the corneal transplant. I understand the 'race' between cataracts and Fuchs is still the issue. I have other eye issues like floaters, adhesions, blepheritis, etc. All a part of aging I guess. My eye clinic is part of WVU Medical Center and they should be able to take good care of the issues. I just needed a good explanation and second opinion. They diagnose but don't always reassure. Then I stress out worrying.
Expert:  Dr. Rick replied 3 years ago.
I can understand how you feel. You are correct -- the folks at WVU will take good care of you.

It is now safe to press that Pretty Green Button so that my poor, starving, barefoot, daughters can buy new shoes and, once again, feel safe from the mean, nasty snakes, as they walk through the tall Wisconsin grass.

Expert:  Dr. Rick replied 3 years ago.
Not sure why that last part posted in bold......I wonder if my girls have been messing around with my computer?!?
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7759
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and 2 other Eye Specialists are ready to help you

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