Cornea specialist visit

[JMWB]

I posted to you a few months ago re guttata and cataract surgery. I had just been diagnosed with guttata which I had never heard of, did some research and discovered about Fuchs' dystrophy! You  seemed to agree with the advice I had researched re cataract surgery and Fuchs which was to have a cornea specialist do it. I saw a specialist at the same hospital office where I see my opthalmologist, he is in private practice in Houston but lectures the residents locally every couple of weeks. He examined my eyes but did no further testing (my cornea thickness was within normal limits in June). He said I do need cataract surgery but when I asked if he would do the surgery he told me my opthalmologist was a good surgeon and he wouldn't do anything differently to her. When I asked if the guttata presented a problem he said even people without guttata sometimes had problems with the surgery.! I don't feel happy not having a  specialist do the surgery. Am I making a mountain out of a molehill ? That is how he made me feel !

[JMWB]

Many thanks ! I shall relax and go with the surgery next year !

[John C Hagan III, MD, FACS, FAAO]

Hello JMWB   I think it was mentioned in the discussion that you can have guttatta and not have Fuch's Dystrophy. It's a matter of how many are there. A "few" corneal guttatta is a normal finding. If your local ophthalmologist and this consultant both felt that the number you have does not warrant a diagnosis of Fuch's and your corneal thickness is normal and your family history negative then it would seem at present "not to worry" as you don't have Fuch's.

Even having Fuch's Dystrophy doesn't mean you need a corneal surgeon to do cataract surgery. The operation is done the same as regular surgery just a little shower and using more "visco-elactics" to shield and protect the cornea.

Your ophthalmologist is a "specialist" and in many cases a general ophthalmologist may have done more cataract surgeries than a corneal specialist.  If you're comfortable with your local ophthalmologist and he has a good reputation as a cataract surgeon there's likely no reason to not have him do th surgery.

JCH III MD Eye Physician & Surgeon