Cataract Surgery for 76 YOM 20/30 Vision Fuchs Dystrophy Guttata 1100 Corneal Thickness 560 MM

May 20, 2009

I would appreciate an opinion regarding undergoing cataract surgery with the following criteria:

1. I am 76 years old.
2. Have Fuchs Dystrophy.
3. Corneal thickness of approx 560 Microns in each eye.
4. Guttata count at 1100. No morning edema.
5. 20/30 vision

I have all the symptoms of cataracts.




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37 Responses to “Cataract Surgery for 76 YOM 20/30 Vision Fuchs Dystrophy Guttata 1100 Corneal Thickness 560 MM”

  • ari

    a crstalens in an eye with fuchs is, in my opinion, inappropriate. if your fuchs is a 7, there is a decent chance you will need a transplant sooner or later after surgery. but its kinda irrelevant- if you have significant cataract, what choice do you have but have it removed and hope for the best, and if you need dsaek (special corneal transplant surgery for diseases like fuchs), so be it- the prognosis is very good.

  • At 71, I have been diagnosed with Fuchs by two doctors, one wanting to implant Crystalens, and seeing what happens with Fuchs. Second doctor said I have “advanced Fuchs” (7 on 1-10 scale) and said my corneas would most likely never survive cataract surgery. The first doctor stands his ground. Which is the least riskiest?
    Even if I had the cataract surgery, is the corneal transplant probably inevitable in the long run?

  • Thank you, Ari, for your comment. I appreciate it. I realize that my ‘best bet’ is not to be ‘resistant’ against any more surgery and just go with the flow, intend my best, and know the best thing will happen with and for me. The more I stress or the ‘harder I try’ the worse my vision is.
    Again, thank, I have appreciated all the posts you have written.

  • ari

    subtle pre-fuch’s can be overlooked pre-op. typically, it would not cause problems after routine cataract surgery. it looks like you were not so lucky. you should definitely get dsaek cornea transplant consultation- very good chance you will get your vision back

  • I regret having cataract surgery in my left eye. NO diagnosis of Fuchs Dystrophy was made in that eye (that I was TOLD) until AFTER the surgery. If I could go back in time I would NOT have the surgery in my left eye. Now I am stuck with constant blurriness, discomfort…and even though I realize I have to “let it go” I am still angry with the eye dr’s for not making a diagnosis…AFTER the surgery and the blurriness continued, I was told by the surgeon that I had a ‘mild case’ of Fuchs Dystrophy. I am taking Muro128 drops and the ointment. If only I would have known that the surgery would ‘bring the Fuchs to life) ((before it never bothered me in the least)) I never, ever would have chosen to have the surgery. Now its like I am looking through several layers of white gauze with my Left eye. Please think TWICE before having cataract surgery…unless your cataracts are SO bad that you barely have ANY vision.

  • Jeanne Adam

    Now, 3 1/2weeks post-op for IOL implant. I have had lots of edema which led to blisters on the cornea, very painful. Still scheduled for DSAEK on 5/11. Muro is the only drop giving me relief from edema, also in between using other eye meds by doc’s advice. Will still post after DSAEK on 5/11.
    Great to hear from others on this subject!

  • Jeanne Adam

    I have just had cataract surgery on R. Eye by the DSAEK Specialist in FT. Myers…he is the innovator for DSAEK, Dr.M.Gorovoy. Surgery was 5 days ago, I cannot see anything but cloudiness in the eye. I have full confidence in him, I am going back for transplant of cornea lining in May…I pray I will see better after that heals. Fuch’s snuck up on me, I knew I had it but it caused blurry distance vision very quickly. His office is so efficient and the Dr. seems very knowledgeable. I will post after DSAEK surgery.

  • ari

    again, which iol did you choose?

  • Joy

    Well, 2 weeks plus 2 days after my cataract surgery. I was so excited at my ability to see without glasses (surgery eye). But this past week, my vision seems to be gradually deteriorating. Big disappointment that my distant vision isn’t more improved. Can’t recognize characters on TV (I wear my glasses and cover the surgery eye so I can see). Follow-up in a week. Torn between calling dr and waiting for follow-up. Oh my. Is the Fuchs’ terrorizing me?

  • ari

    thats wonderful to hear!
    which iol did you choose?

  • Joy

    See my post in September. I had the cataract only surgery on my left (worse) eye 2 days ago with an IOL implant. Wow is all I can say. My vision in that eye is so improved I find it hard to believe. I’m typing this without glasses. Everything is so clear, even colors are more pronounced. I have a lot of healing to come, but at this point I am overjoyed. Haven’t had my glasses on since the patch came off. Do close my right eye on occasion to focus. I’m so ready to have the cataract removed from the right eye. I realize the Fuchs’ is still there and will have its way with me, but am hopeful it will progress very slowly and I’ll never need DSAEK or corneal transplant. My doc here in San Antonio is wonderful. I’ll try to post again in 3 weeks after my check-up. Life is good.

  • ari weitzner

    if the cornea is nice and clear, and the retina exam was negative for fluid (was an oct done, or just angiogram?- angiogram could possibly miss subtle fluid), perhaps something happened to the optic nerve. do you have any risk factors for ischemic optic neuropathy like hypertension/diabetes/high cholesterol? do you have any glaucoma?
    you need to get a second opinion.
    i assume your surgeon is a cornea specialist and would detect subtle fluid between your cornea and the graft.- that could degrade the vision.

  • Penny

    I am 53 years old. I was diagnosed with Fuchs in both eyes when I was 18. On the advise of Edward Isbey of Asheville Eye I had a combination surgery of DSAEK as well as cataract with an IOL implant. Prior to surgery my uncorrected vision in my left eye was 20/50 early morning; 20/40 late morning and 20/30 late afternoon. My surgery was on November 16, 2010. The following day my vision was 20/100. Two days later my vision was 20/80. During the surgery Dr. Isby found it necessary to place a contact in my eye. This contact was removed after the exam where my vision was 20/80. Since then my vision has declined. It has been 20/200. It has not improved since before Thanksgiving. My question is….does anyone know if this is unusual. Last Monday Dr. Isbey referred me to a retina specialist to see if I had developed fluid behind my retina due to the surgery. No fluid was found. My impression from Dr. Isbey is he is somewhat confused why my vision has not improved.

  • ari weitzner

    you have to ask your surgeon what percentage of your vision loss is due to fuch’s and how much to cataract. that will determine whether you should have cataract alone, first, or in combination with corneal transplant. if you need transplant, you need to go to someone who is familiar with the new technique of dsaek/dlek. a conventional transplant is inferior to this and should not be done. this technique has a difficult learning curve, and you need to go go to someone who is very familiar with it. for straight cataract surgery, you should stick to your regular ophthalmologist. after the transplant, the vision may be foggy for a few weeks- you know best how this may affect your dental procedures. after simple cataract surgery, you can go back to work in a couple of days, unless the cornea gets swollen from the fuch’s- then it can stay foggy for weeks, or even longer if the swelling doesn’t resolve.

  • Jamesoh

    I went a few months ago to see why my vision was getting foggy. My opthalmologist says I also have some cataract. I was told I have Fuchs and have a thickness number of 625. I am a dentist and worried a little about how soon I will be able to work again after surgery. I have always had alot of floaters starting at around 35y/o. This is mostly my left eye that is in question at this point. I can get by working alright at this point but if I wait maybe they could do a corneal transplant at the same time? I think I generally heal kind of slowly too. Should I be seeing a corneal specialist or just a local guy that does 10 cataract surgerys a week?

  • ari

    the torsional is simply a slightly different ultrasound. i use it and i think it is easier on the eye.
    the rand institute in florida has a good reputation. bascom palmer is a world-class eye hospital. consider those if you have second thoughts about surgery. waiting for the cataract to ripen may be a bad idea- requires more ultrasound to remove, and thus more risk to the fuch’s cornea.

    offering a fuch’s patient a multifocal is very aggressive, and i disagree with it. most ophthal’s dont want to implant multifocals (like alcon’s restor) in eyes with compromised corneas- the odds of you being unhappy are just too high. the crytalens works differently- would give you decent intermediate vision, but you will probably need glasses for reading. less controversial, but less bang for your buck. if you have astigmatism, i would get the toric lens.

  • Joy

    Forgot to mention, I am 73 yrs old and was diagnosed with Fuchs about 5 years ago. My corneal specialist and retina surgeon (I’ve had a retinal hole repair) feel that I may not need corneal or endothelial transplants for 10 or more years, if then.