Cataract Surgery in Eyes with Fuchs Endothelial Corneal Dystrophy

Clinical evaluation of the corneal endothelium is of high importance when screening patients for cataract surgery. Slit-lamp examinations should be accompanied by endothelial microscopy to exclude endothelial pathologies. Corneal guttae are the most common endothelial disorder in candidate cataract patients. The clinical significance of corneal guttae without edema is often underestimated. The quality of vision in early stages of Fuchs endothelial corneal dystrophy (FECD) with corneal guttae is impaired way before development of corneal edema. The first symptoms are glare, reduced contrast sensitivity, and color vision, mainly when the lighting conditions are bad. Several studies have confirmed that corneal guttae cause an additional decrease in contrast sensitivity, as well as an additional increase in stray light in cataract patients [1–3]. These parameters are not routinely tested in cataract patients. It is therefore crucial to inform patients before cataract surgery about the presence of corneal guttae, which may lead to inferior results after surgery.