In patients with early Fuchs’ endothelial dystrophy, how do you determine whether to proceed with cataract surgery alone versus a combined endothelial keratoplasty?

If Corneal thickness is >640 or specular microscopy is lower than 1,000, those are indicative of poor outcome after cataract surgery and patients may benefit from combined procedure. However, some patients with Fuchs can be misleading as having a low corneal thickness but a dense central guttae that...

I consider there to be three categories of patients presenting with visually significant cataract and Fuchs' dystrophy.

• Category 1 patients have more severe Fuchs' dystrophy that is clearly visually significant with increased CCT and edema or Descemet folds on exam. These patients will almost certai...