Fuchs Dystrophy (cataract and corneal transplant)

It may or may not be caused by diabetes, but I’ve been diagnosed with Fuchs Dystrophy after some progressive vision loss in my right eye over the past couple of years.

Diagnosis was a bit circuitous. My retina-specialist opthamologist of course looks closely at the back of my eyes regularly. But it in the end it was my “regular eye doctor” who used a slit lamp to look at the front of my eyeball and saw that the reason the glasses were becoming increasingly useless was Fuchs Dystrophy, which was degrading the cornea cells.

So I went to a “front of the eye” doctor and with some different fancy tests they confirmed that yes I have Fuchs Dystrophy and they got me scheduled for cataract surgeries and corneal transplants (specifically DSAEK).

I had the right eye cataract surgery last Monday, and that seems super successful (followup checkup tomorrow), and in the middle of March I’ll be having the right eye corneal transplant. Then if that goes smoothly (a corneal transplant a much bigger deal) I’ll be having the cataract surgery done to left eye in April followed by the corneal transplant there in May.

I was super impressed by the eye surgery center and how they tested my bg prior to and during cataract surgery. Of course I also had my CGM with me.

Well that’s the story so far! Will follow up with more details in March I’m sure.

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Wow a cornea transplant. That sounds so incredibly invasive. Maybe it has become an everyday thing but it sounds tough
I hope it works out and you have good vision afterward.
So far my eyes are really good minus a small bit of presbyopia which is pretty expected for everyone. Please let us know how you are doing

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Good luck with successful eye surgeries. Corneal transplants are pretty serious business. Nancy50

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Thanks guys! At eye doc this morning, we discussed DMEK as an alternative corneal transplant method that has a potentially less lengthy recovery-to-normal-vision period at the cost having me lay flat in bed for a longer time after the surgery.

Corneal transplant on first eye was done yesterday and I am spending 3 days on my back to make sure it attaches properly. Postop appointment today it’s looking like it’s already mostly attached so will be spending 2more days looking even further behind and up.

In between the inactivity and steroid eye drops my insulin requirements have more than doubled but doing ok.

Nancy was right, corneal transplant is a big deal. The cataract surgery was a breeze in comparison.


Is that common for T1Ds ?

I have had many laser treatments, vitrectomy and cataract surgery in both eyes, but had not heard about corneal transplants.
Does diabetes (high bgs) contribute to the condition?

I have not found any research that says that diabetes or high bgs leads to Fuchs dystrophy.

Given the way my corneal cells were withering away I might think that Fuchs dystrophy could be caused by autoimmune attack. Like T1 diabetes and hypothyroidism are caused by autoimmune attack. But I haven’t found any research in this direction either.

I did find some research on corneal thickness being related to diabetes. But nothing like the famous DCCT and its charts showing how strongly retinopathy is strongly related to elevated A1C.

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Update to the update:

The corneal transplant in March didn’t do anything for me. It was in the right place, it was not being rejected, but it wasn’t doing its job.

So Monday this week went back in for a repeat corneal transplant, the previous transplant tissue was pulled out, and a new transplant tissue put in. (Actually an easier surgery than the first). It’s only two days later, but this new transplant is just obviously better and already seems to be working!

And another more diabetes related update: I had previously blamed it on the steroid (anti-rejection) eyedrops, but now have come to realize that both times in surgery they pumped me full of IV steroids during surgery and 8 hours later WOOMPH massively high insulin doses needed for several days. At least triple my usual insulin needs.

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So glad that the new transplant is working!