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”

  • Joy

    I have Fuchs’ Dystrophy. My most recent cell count was about 1600 in my worst eye. I have cataracts. My vision worsens each year. Can’t read street signs; cars on the highway are fuzzy around the edges, etc. Definitely don’t drive at night. I’m seeing a reputable corneal specialist who says my corneas aren’t that bad, but the cataracts need removal. I’m pretty confident that he can remove the cataracts without too much damage to the endothelial cells. My confusion is his recommendation that I have premium (prescription) lenses implanted as opposed to the clear lenses. I’ve read about side effects of the premium lenses, and they are some of the same problems I have now. My reasoning is, If the cataracts are causing my poor vision, won’t just removing them and implanting clear lenses improve my vision? By the way, the premium lenses cost $2,500 each and I just can’t see that they’re worth it. Opinions please.

  • I am a 77 yr old female and I was told I had Fuch’s about 5 yrs ago. I have been told my cataracts are ready to be removed, but I fear that the operation will cause my eyesight to get worse. The opthamalogist tells me they are ready to be removed, but I am fearful of it causing my eyesight to get worse. I see well enought to drive, but sometimes driving at night is difficult. I have no other symptoms and still see to read, but the distance in my glasses is not as good ,and I do better taking them off. I am not sure where I should go to have it done. The Dr I am seeing claims to be a corneal specialist, but I have heard pro’s and con’s on his abilities. I live in NW Florida and would appreciate being given a name of someone who is qualified to do surgery on Fuch’s patients. I was told I have no swelling and he has been seeing me for yrs and did not find it until 5 yrs ago. Are there special instruments for causing less trauma to the eye, as I read an anticle that they have come up with an instrument to use instead of the ultra-sound “jack-hammer” method. It was called a torsional mode that removes the tissue by shearing. It said by reducing the ultrasound power, it caused less tissue damage.. I believe Alcon was the company who introduced it in 2006. Should I get a 2nd opinion in another location? Thank you for you time.

  • ari weitzner

    if the surgery was uncomplicated, then you should be seeing normally by now. so, either the cornea is swollen from the fuch’s- and there’s a chance it won’t get better (but i would wait about 2 months to see if the cornea gets clearer), or, the surgery was complicated, and the cornea got damaged and/or some other issue.
    ask your doctor if the delay is due to the fuch’s. if so, then consider dsaek or related procedures to improve your vision.

  • I had cataract surgery almost 2 weeks ago. I have Fuchs Dystrophy and so far my eyesight has not improved since the day of surgery. I am getting worried about this and wonder if it will come back. My eye surgeon tells me it will take 2 weeks – to one month, but I keep thinking it should gradually be getting a little better – – however remains the same every day. I can see big objects but no details at all – mostly light objects also. The blurriness is difficult to take and it makes me feel a little sick and also I have headaches from it.

  • ari

    the fuch’s can create symptoms suddenly- not so unusual.
    i advise doing cataract surgery first, then the partial transplant (dlek/dsaek), not doing them at the same time- unless the fuch’s is very bad.
    do the cataract surgey when your ophthal feels they are ready and will improve your vision.

  • ari

    mk- i would not advise lasik on a cornea that is already symptomatic from fuch’s. in fact, i think lasik on fuch’s without symptoms is bad. technically, its true that the lasik affects the superficial cornea, and the fuch’s affects the inner. but the whole idea behind lasik and spending $5000 is to get good vision without glasses. if your cornea is affecting your vision due to the fuch’s, the quality of your vision will still be affected regardless of the lasik.

    i strongly, strongly advise against the lasik.

    best bet is to consider dlek/dsaek when it gets worse.

  • MK

    I am 52 and have Fuchs dystrophy. I have striae of my left eye and intermitant haziness of vision on the left which can last hours. I can now afford LASIK surgery but since the Fuchs is at a noticeable point ( on the left anyway), is it OK to proceed? An optometrist has advised against it, but today I consulted with a LASIK surgeon who said that the surgery would not affect the Fuchs because the issue is the inner corneal layer, and not where the LASIK treatment would be occurring. He described my dystrophy as a stage 3 on the left and a 2-3 on my right. The optometrist descibed it as moderate dystrophy occuring midline to temporally in both eyes.
    What do you think? It would be so nice to go back to single vision glasses again. I was just thinking of having my right eye corrected and going with monovision.

  • Meg

    I was just told I have Fuchs’ dystrophy, & that once my cataracts are “ready” for surgery, that I will also need to have corneal implants, hopefully the newer surgery using just a partial cornea. (?) How can this crop up so suddenly? While I have symptoms it seems they mimic those of cataracts I thought, except for the eye pain, but my Dr. did extensive testing & said in 6 mos. she’ll do the same tests again to see if my cataracts are at the right stage for surgery. I will seek a second opinion in the meantime, but will they do both surgeries at same time (she indicated this) and will they do both eyes at same time? I was sort of shocked, and didn’t ask these questions then. I am nearly 62, & also am developing glaucoma. (I am beginning to feel extremely old…no fun at all!)

  • ari weitzner

    hi carol- dont be so panic-stricken from fuch’s- the latest surgical procedures in dsaek and related ones are very sucessful, if you get to that point- and you live in nyc, where great cornea surgeons practice.
    im not sure why you think you need a new ophthalmologist- when you need surgery, you should simply get a second opinion. otherwise, as long as your vision is stable, there is nothing to do anyway- we dont do any cataract or cornea surgery if the patient is satisfied with her vision and/or the vision is stable. (one small caveat- dont wait until your cataracts get too dense- it makes the surgery more difficult. )

  • carol opulski

    I have been told I have Fuchs. I have been followed by a Lasik eye surgon, from reading your articles, I can see that I need a new eye MD. Can anyone in NYC recommend a thoughtful, nice , excellent one?

    I have been totally afraid since my diagnosis, and stricken with panic attacks for fear of loosing my sight. Can anyone in my area help me? I also have diabeties, type ll and I am 51 years old woman.

    The MD I am currently being treated by says my Fuchs is not yet a problem, that the corneas are still normal.

  • Ginny

    Well after the cataract surgery on my left eye, I developed what the dr. called scar tissue which in reality was that the Fuch was upset. The dr. said he would do something about it when my vision got bad. Ny vision went wacky and I changed to a corneal specialist here in New Orleans. He said that there was so many things going on in my left eye that if I didn’t have surgery, I wouldn’t be able to drive. I had DSAEK surgery on my left eye Sept. 1, I am still dealing with that. I can hardly see out of my left eye, just globs. Hopefully eyerything works out. I go back next Tuesday and see if maybe the air bubble needs to be replaced or the whole procedure done over. We will see!

  • Dr. Ari Weitzner

    hi ginny
    20/30 vision is a great result- you are lucky. the floaters often appear worse after cataract surgery because your contrast vision is better, so you can see them better- that is typical.
    your difficulty with near vision may be due to astigmatism- get a prescription instead of over-the-counter readers. otherwise, it may be dur to the fuch’s- try using muro-128 drops when you read, as it may clear up the cornea a little.

  • Ginny

    Yes I am a member of both Fuch Groups. They are great.

  • Marielle

    Ginny, have you joined the help group called Fuchs’ Friends? It is not a medical site, but people with Fuchs’ share their information and it can be very reassuring and informative.

  • Ginny

    I recently had cataract surgery in both eyes (6/11/09 and 7/9/09) and i have Fuch also. Prior to the surgery, at an office visit, the thickness was measured at 693 in the left eye and 694 in the right eye. When I went in at each surgery the thickness was measured at 994 each time. The nurses were alarmed but the doctor wasn’t worried. I have had floaters before but now they are worse. My vision is 20/30 and I can see through the floaters pretty well for distance. Close up it is bad. I have so many readers glasses now, trying to find the right strength. Do I have any reason to be concerned.

  • ari weitzner

    when the cornea fails, i mean it loses clarity (the cornea has to constantly pump out fluid to keep it clear; otherwise, it gets waterlogged and thus cloudy).

    any surgery in the eye, including cataract surgery, causes turbulence in the eye. the cells (endothelium) that act as water pumps of the cornea are in the innermost layer. any turbulence will cause some of those cells to fall off. the cornea requires a minimum number of those precious cells. fortunately, we have many more than we need, so if we lose, say 20%, the cornea still functions normally. but in fuch’s, the patient has lost many of those cells, and even losing 1% can cause the cornea to fail.

  • Marielle

    I’m interested in your responses to cataract surgery if Fuchs’ is present. In what way does the “cornea fail” after cataract surgery ? And when you say that after cataract surgery “there is a very decent chance the cornea will remain clear,” how does surgery affect the corneal clarity?

  • ari weitzner

    i think dsaek concurrently is too aggressive. there is a very decent chance the cornea will remain clear. if the fuch’s were worse, then i would agree.

  • MD

    DSAEK concurrently with cataract surgery an option?

  • Dr. Weitzner

    those corneal numbers are not bad. if your surgery is done very carefully by an excellent surgeon, chances are very good your cornea won’t fail and you’ll see well. if the cornea fails, you won’t see well.

    With 20/30 vision, do you really want to take chances? i suppose that is something you have to think carefully about- how unhappy you are with your vision, and whether it’s the worth the small risk. if you decline surgery for now, make sure you are followed closely, for we don’t want the cataract to become too dense, as that will increase the surgery’s risk to the cornea. also, with time, your fuch’s might get worse, increasing the risk of surgery.

    Your general health and life expectancy play an important role, too.

    Lastly, if your corneal does fail, all hope is not lost- we now have much better cornea transplant techniques where recovery can take weeks instead of 6 months-year, and vision is much better than traditional techniques.

    i hope this helps!