3067: your first surgery in Fuchs’ corneal dystrophy
Operating on an eye with Fuchs endothelial dystrophy presents a distinct challenge, especially when extensive corneal guttae compromise endothelial reserve and somewhat obscure the surgical view. In this milestone 350th case performed by a resident, navigating cataract surgery requires meticulous endothelial protection protocols. Employing a soft-shell viscoelastic technique with a dispersive agent coating the endothelium creates a crucial physical buffer against ultrasonic energy, fluidic turbulence, and nuclear fragments during emulsification. Working low in the capsular bag, minimizing cumulative dissipated energy, and maintaining stable fluidics are vital steps to avoid accelerating endothelial cell loss and precipitating post-operative corneal decompensation.
Watch the video to analyze the surgical maneuvers, viscoelastic maintenance, and fluidic strategies used to safely complete phacoemulsification in the setting of dense guttae. What is your primary dispersive OVD sequence or operative strategy when protecting the cornea in eyes with Fuchs dystrophy? Please comment your thoughts below.
