A patient with Fuchs dystrophy recently consulted me for possible laser eye surgery and was delighted to be able to undergo treatment. However, not all patients with Fuchs can have laser eye surgery. If the Fuchs is advanced, endothelial cell counts are low and already causing corneal swelling the patient should not have surgery. If on the other hand Fuchs dystrophy is still mild, there is a reasonable cell count, no appreciable corneal swelling, and no cataract the patient can have laser surgery with good results.
When choosing the technique of laser surgery the best choice is to perform a surface procedure such as LASEK or transPRK surgery. LASIK surgery may be complicated by flap slippage in the early post-operative period if there is anomalous endothelial function. Fuchs patients who have laser eye surgery who may subsequently have cataract surgery years later should remember to tell there surgeon that they have had previous laser so that accurate lens calculations can be made with this previous surgery in mind.
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