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I have a thickened cornea and need cataract surgery—is this a problem because of the thick cornea?
If the corneal thickening is due to a disease like Fuchs' dystrophy, then that can be a problem. Some patients just have thicker corneas just as some people are taller than others—that is not pathologic. However with diseases of the cornea such as Fuchs', the inner layer of the cornea does not work well to keep fluid out of the cornea which allows it to thicken and this can impair vision. Corneas like this are more likely to get edematous and thicken more after cataract surgery and can limit vision. Hypertonic saline drops and anti-inflammatory drops can reverse this in many cases. If all else fails, the inner portion of the cornea can be replaced in a relatively short procedure known as DSEK which can bring vision back to a much better state. I always recommend removing cataracts at an earlier stage in patients with this condition when the cataract is easier to remove and there is less chance of swelling.
Answered by: Jeffrey Whitman, MD
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