Glaucoma, Fuchs Dystrophy and Cataract Surgery

September 13, 2009

I am 87 years old. I have glaucoma, and have lost almost all of the sight in my right eye. The optic nerve in my left eye is still healthy, but I found out yesterday that I have Fuch’s dystrophy. I am a candidate for a corneal transplant but I am concerned about the recovery time. Can you explain a bit further the reduced recovery time that you have referenced before. 6 months vs. weeks.

As a side question, I had cataract surgery 30 years ago. About 4 years ago I had laser surgery to deal with the blisters on my cornea. From what I have read, it appears that the laser surgery would aggravate the Fuch’s. It also appears that the cataract surgery also aggravated the Fuch’s long before it was diagnosed. Is this true?

If you have not been diagnosed with Fuch’s but have a genetic predisposition for it, should you ever have cataract surgery?




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One Response to “Glaucoma, Fuchs Dystrophy and Cataract Surgery”

  • Dr. Ari Weitzner

    In dsaek, the recovery time takes a few weeks, as there are no stitches, and only a thin layer of the cornea is being transplanted, so it is performed through a very small incision.

    If your cornea is scarred from the fuch’s (which is what it sounds like from your description of blisters and laser), then that will limit your vision- your surgeon can give you a better idea of what your potential is (depends on how dense the scar and whether it obstructs the visual axis).

    Cataract surgery aggravates fuch’s, but the cataract has to come out sooner or later- so it’s a matter of explaining to the patient the limits of the cataract surgery. leaving a cataract in the eye is not really an option- how can a patient see well with a significant cataract in the eye? the trick is to do the cataract surgery as carefully and delicately as possible to avoid aggravating the fuch’s. if the patient needs a dsaek after the cataract surgery- so be it.

    Laser to the cornea really has nothing to do with the fuch’s- although theoretically, the shock wave of the laser could aggravate it, but again, extremely unlikely.