We can do cataract surgery for patients with Fuchs’ corneal dystrophy, but we must weigh the relative risks of corneal endothelial decompensation. If the patients are barely hanging on in terms of endothelial function, even doing a perfect cataract surgery can push them over the edge and result in corneal edema. If the patient has a low corneal endothelial cell count and increased corneal pachymetry, is it a reasonable idea to implant a toric monofocal IOL? And if so, what would be the best refractive target? Does the corneal pachymetry help us predict the relative risk of corneal decompensation in the near future?
click to learn why I implanted a toric IOL in this patient with Fuchs’ corneal dystrophy: