Cataract Surgery and Fuchs' Dystrophy
Routine cataract surgery in patient with Fuchs' dystrophy can accelerate corneal failure unless particular care and an alteration to the standard technique of surgery is made to minimise corneal endothelial cell damage (Soft shell technique). Ideally your surgery should be undertaken by a corneal surgeon that is familiar with the management of patients with Fuchs' dystrophy. Some patients may elect to have femtosecond laser cataract surgery which has the advantage of reducing energy levels used during cataract removal and results in less intra-operative endothelial cell damage. In moderate to advanced cases of Fuchs' dystrophy your surgeon may decide to perform cataract surgery and endothelial corneal transplantation at the same time.
Endothelial cell numbers can be assessed in the clinic pre-operatively by specular microscopy and will help guide the decision whether to perform cataract surgery alone or combined with DMEK/DSAEK.