Cataract Surgery with Fuch's Dystrophy

Question: I have Fuch's Endothelial Dystrophy and am having Cataract Surgery with astigmatism surgery on my left eye. What type of things should I be on the lookout for or should I even have the astigmatism part of the surgery done?


Answer: Fuch’s Dystrophy is a slowly progressive disease of the cornea in which the innermost layer of cells in the cornea, called the endothelium, tend to decrease in functioning and die, which makes the endothelium less efficient in maintaining the proper level of corneal hydration/dehydration through its normal metabolic pumping activity. This results in the cornea swelling and distorting vision and may be accompanied by glare, night vision problems, haloes and photophobia. You do not state what type of "astigmatism surgery" you are having with the Cataract Surgery. Presumably you are referring to the use of an astigmatism correcting toric lens implant and not Limbal Relaxing Incisions (LRI). The choice of a Toric Lens Implant rather than a Monofocal Lens Implant is generally not considered to pose any additional risk for a patient with Fuch's Dystrophy. One consideration is that although there are many experienced and excellent Cataract Surgeons, you may wish to consider have your surgery performed by a Cataract Surgeon who is also a Corneal Specialist. In this way, should it become necessary by using advanced corneal transplantation procedures that allow transplantation of the deep corneal layers called “endothelial keratoplasty” or “posterior lamellar keratoplasty” techniques it is often possible to help patients resume normal activities and lifestyles with minimal symptoms.

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