Cataract surgery and intraocular lens placement in patients with Fuchs corneal dystrophy: a review of the current literature

Purpose of review Late-onset Fuchs endothelial corneal dystrophy (FECD) is seen in approximately 4% of individuals over the age of 40. With the growing population of adults over the age of 65, ophthalmologists need to be aware of the preoperative, perioperative, and postoperative considerations involved in cataract surgery in Fuchs patients. Recent findings Management of cataract patients with FECD requires preoperative assessment of endothelial cell size, density, and morphology. Considerations for perioperative endothelial cell loss include patients with hyperopia and shallow anterior chambers, phacoemulsification technique, transfer of ultrasonic energy to the cornea, corneal-protective perioperative agents, as well as thermal and mechanical damage. Ophthalmologists performing cataract surgery on patients with FECD must carefully consider the risks of endothelial cell loss during surgery and minimize the risk of corneal decompensation after surgery. Preoperative management should evaluate the severity of the FECD as well as individual factors such as cataract density, the health and thickness of the cornea, and the anterior chamber depth. Perioperative techniques, adjustments to biometry calculations, and intraocular lens (IOL) selection may help optimize visual outcomes and recovery time.

Automated summary

Late-onset Fuchs endothelial corneal dystrophy (FECD) is a condition that affects approximately 4% of individuals over the age of 40. Ophthalmologists need to consider various factors before, during, and after cataract surgery in FECD patients, including evaluation of endothelial cell size and density, as well as minimizing the risk of corneal decompensation. Preoperative management involves assessing the severity of FECD and individual factors, while perioperative techniques and lens selection can optimize visual outcomes.