Corneal Dystrophy and Yag laser

Hello dr.

I went to an eye clinic last Thursday - I had cataract surgery two years ago (not at this clinic), and have had gradually deteriorating vision since. then. At a check up a year ago (different doctor) I was told I had the typical clouding that would require a Yag procedure. I have put this off because I knew I was at higher risk for retinal detachment as a former -10 myopic.I knew also that I had "guttata". However my vision is becoming increasinly problematic so I finally made the appointment. The doctor I went to see is highly regarded in the field (Germany) runs a Lasik clinic at a university hospital, and his other specialty is cataract surgery.He gave me the bad news that most of my vision problems are due to the advancing corneal dystrophy, and not the secondary cataract. However he still recommended that I have the Yag because it may give SOME improvement (he's really not sure how much, if at all). I asked if he thought the small possibility of improvement outweighed the risks and he said yet. So I've made the appointment which is in 2 weeks.

The doctor I saw a year ago (for various reasons I had decided not to go there for the Yag) had said that when I had the Yag, I would need to use eye drops for the week prior to the procedure, to reduce any edema. The current doctor
doesn't think this is necessary. I want to trust his judgement - but Ihey are my eyes and I have to live wth any mistakes! Should I be worried about this do you think?

Thanks for your help.

Carolyn

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

You should go with the recommendations of the surgeon you pick to do the yag capsulotomy.

Also there is a wonderful new operation for Fuchs corneal dystrophy called Descemet Stripping (automated) epetheial keratoplasty. It heals much faster than a traditional corneal transplant, is much safer and give much better results. Its often called by acronyms like DSAEK and DSEK.

Not all corneal surgeons can do this procedure. Be sure your coneal surgeon does the procedure and is experienced (> 20 procedures).  If not consider getting a second opinion from one that does it. Google the term and read about this wonderful new surgery.

JCH III MD