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Cataract Surgery with Fuchs Disease

Posted , 10 users are following.

jar16
jar16

I had cataract surgery in my left eye about 3 wks ago. My vision is still very blurred. Let me add that I have fuchs disease,but my surgeon advised me to go ahead with the surgery. I've had all kinds of eye drops but know luck at all. I'm afraid that my fuchs disease was excellerated. and thats why I still can't see. Very depressed. Anyone out there with this type of problem. I'm a 67 year old male who had 2 vitrectomies last year.

2 likes, 9 replies

9 Replies

  • robert93685
    robert93685 jar16

    Posted

    This is a challenge.  Fuchs' endothelial dystrophy is a problem affecting the cells lining the inner side of your cornea.  The cells are miniature pumps removing water from the cornea to make it transparent. With Fuchs' there are not enough cells to perform this dehydration action and so the cornea swells = corneal oedema and goes cloudy.  The problem with cataract surgery is that it causes a further loss of endothelial cells due to inevitable surgical trauma. 

    I am an experienced cataract surgeon and in practice the cornea may actually improve with less oedema after surgery but I always warn my patients of the risks.  The endothelila cells can migrate after surgery to cover up bare areas.  Unfortunately they do not multiply. Some surgeons advise waiting until cataracts are really bad.  Personally I don't advocate this because dense mature cataract require more energy and trauma to mrove than early/moderate cataracts.

    It is worth being patient because gradual improvement can continue up to 3 months after surgery. In severe cases further surgery might be required to graft endothelial cells from donor cornea.  You have already had lots of eye surgery and it would not be advisable to have another op for many months!

    Time is the main factor here.  FML drops might help in the future.  Some doctors advocate 1% sodium chloride ophthalmic ointment to dehydrate the cornea. This may help remove water by osmotic action but ointment severely blurs vision so I don't recommend messy ointments.  Soft bandage contact lenses may help with comfort if you are get a lot of sharp pain.

    It can take several weeks for vision to clear. These are still early days and I hope your vision improves.

    • jar16
      jar16 robert93685

      Posted

      Robert,thanks so much for responding.I had my cataract surgery on May 12th. On my second visit after the surgery on May 22nd. I was convinced that it would not get better. I was very pessimistic. My doctor told me to be patient and she assured me she would do all she could and make me well.At that visit she gave me an injection directly in my eye. It improved slighty,I was hopeful.She also advised me to increase my dossage of prednisolone to 8 drops a day,along with 2 drops a day of diclofenac,one drop of timolol,and the sodium chloride. I have tried to educate myself and do have a general understanding of all that is going on. After a while I started to get headaches and my neck was hurting . At that time I didn't have the timolol it was on order. I called Bascom Palmer. and after many phone calls a docter called me back,not my doctor. I told her I decreased the prednisolone to 4 drops a day. I reasoned that was causing the problem. It seemed to work. A couple of days later I started to use the timolol. As you know it reduces the eye pressure. Before the surgery I was quite concerned, but she told me she would use the latest technology so as to cause the least stress on my eye. My next appointment is June 8th. I live in Port St. Lucie Fl. Bascom Palmer is in Palm Beach Gardens about 50 miles from my house. I was told to get my eye pressure checked locally I never did because the pressure seemed to decrease with the timolol and the reduced prednisolone. So currently I'm taking just one or two drops of prednisolone,one or two drops of diclofenac,one drop of timolol,and muro 4 times a day. Honestly nothing has really improved. I think I made the right choices about my dosages,I realize I'm certainly not a doctor but after talking to Bascom Palmer I think I'll be allright. i know I'm probably leaving something out,but, be assured I'm being very diligent. Again, thank you so much for your response. It means so much. Can't wait for my next visit June 8th
    • robert93685
      robert93685 jar16

      Posted

      Fair enough and I cannot grumble with your treatment. I work in Australia so not sure of Muro but I understand it is 5% sodium chloride.

      My only comment is the pressure in your eye should be kept low to say 10 mm of mercury instead of the more average 17mm to help the endothelial cells doing all the pumping. 

      You cannot know the pressure in your eye by a sense of comfort or headache, however a local optician can easly check the pressure. 

      Occasionally steroid/ prednisolone drops can make the pressure go unexpectedly high even beyond 30 mm. Your headache and neck ache is almost certainly due to worry and tension headache. The best remedy for that is a combined back and neck massage!

    • jar16
      jar16 robert93685

      Posted

      Yes,the Muro is 5% sodium chloride. If I remember correctly my pressure reading on May 22nd was 17mm. Actually the headache was on the top of my head down my neck on the side of my eye surgery. I've had sinus headache and stress headaches before,this was different. I think I will take your advice and look for a local optician and get my pressure checked tomorrow. I did some research on prednisolone and  it says can cause elevation of eye pressure,optic nerve damage, and delay of healing and that was also why I reduced the dosage. Diclofanac info said it may also delay healing and can cause cornea thinning. Any way'I feel pretty good now, except I can't hardly see out of my left eye.

      Thanks

      Joe

    • cathy34670
      cathy34670 robert93685

      Posted

      Was reading about what you said about fuchs dystrophy and cataracts

      Are you a physician that deals with this?

  • tigitigi72
    tigitigi72 jar16

    Posted

    Hello, very sorry to hear of your eye problem.  What happened after your 2 vitrectomies last year?
    • jar16
      jar16 tigitigi72

      Posted

      After my first vitrecomy about a year ago the macular hole did not close,it failed. I waited about 3 months and had the second vitrectomy per my doctors advice. It did close and after about 6 months I was advised to have my cataracts removed. I don't know if you re familar with a macular hole but the rehab is a killer. You have to lay face down for the majority of the day after surgery. When you have a vitrectomy it excellerates the cataract. So here I am in pretty bad shape. Trying not to feel sorry for myself,but,regreting my surgery. I probably should have waited. Thanks for your concern.

      Take Care

      Joe

  • tigitigi72
    tigitigi72 jar16

    Posted

    Hi, thanks for your quick response. No, I don't know anything about macular holes or the re-hab involved.  Can understand when you say that you wish that you had'nt had anything done .  I feel the same. I am awaiting an E.R.M (membrane peel) but am still nervous.

    Hope you feel better soon.

    Take care.

  • kea61151
    kea61151 jar16

    Posted

    I guess i have not had Fuchs disease, and maybe on the wrong page, but i understand the feeling of having operations on your eyes, and they not only are not better when done, but they are worse then they have ever been..  I had my eyes done a week apart 2 years ago, and Still having problems..  I feel like there is glop in my eyes a lot, and they burn and get tired easy.  Can't see as well as i used to before surgery for doing computer work and paper work.  I still wear glasses because i feel naked without them, as i wore them since 1 year old... I am cross eyed too, and they straighten out eyes when people look at me.  I had an opthomologist do the eye exam and give prescription, and an assistant who also made a prescription after their exam...  One is a minus, the other prescription is a plus.  both different but was told that they are close in there prescriptions.  I am 63 and really don't need extra problem.... but i guess no one does, i am just sick of it...  I feel i made the wrong decision.  They say, oh, you just have dry eye..  No.... I feel i have to Much liquid in eye...  So going to a new eye doctor, hopefully she will be able to see why the burning, and bad vision still..  Also being cross eyed, VERY hard to use drops and i don't use them.  They Never go in.     I sure hope your time for drops is past and you are actually getting better sir!!  No fun not being able to see right..  Sorry to You, cause as i said, it is very hard to put up with..

    Bless you in your search for a clearer look at things..  Patience is a key too with this, i know that..

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