Cataract surgery can still be suitable with corneal disease, but planning is more complex and sometimes the cornea needs treatment first.
Situations where surgery can proceed
Mild, stable corneal changes may allow standard or modified techniques.
- Early Fuchs or mild dystrophy with good clarity and cell counts
- Old scars that are off‑centre and do not dominate the visual axis
- Regular astigmatism that can be addressed with toric lenses
- Use of careful incisions and viscoelastics to protect the endothelium
- Close monitoring of corneal clarity after surgery
When combined or staged procedures are needed
Advanced corneal pathology may require grafting or other surgery.
- Significant oedema or scarring already limiting vision
- Very low endothelial cell counts with high decompensation risk
- Plan for endothelial keratoplasty combined with or following cataract surgery
- Expectation that final clarity depends on corneal as well as lens status
- Referral to a corneal specialist for detailed assessment
