THE SIGNIFICANCE OF ANTERIOR-CHAMBER DEPTH IN FUCHS CORNEAL-DYSTROPHYAND CORNEA-GUTTATA

It is sometimes claimed that a relationship exists between Fuchs' dyst rophy and angle closure glaucoma and that this is an indication for th e simultaneous performance of keratoplasty and cataract extraction in patients with Fuchs' dystrophy. If such a relationship exists, then th e anterior chamber depth in Fuchs' dystrophy should resemble that in a ngle closure glaucoma and a significant degree of cornea guttata might be expected to be common in angle closure glaucoma. In 88 patients wi th angle closure glaucoma we found that the anterior chamber depth was significantly shallower than in cornea guttata or Fuchs' dystrophy fo r acute (p < 0.001), chronic (p < 0.002) or incipient angle closure gl aucoma (p < 0.001). Cornea guttata and Fuchs' dystrophy were very infr equent in these patients with angle closure, only two having cornea gu ttata and one Fuchs' dystrophy. These results do not support a relatio nship between angle closure glaucoma and Fuchs' dystrophy or cornea gu ttata and do not justify performing combined cataract surgery and kera toplasty in all cases of cornea guttata or Fuchs' dystrophy undergoing keratoplasty. Each case should be assessed on its merits and combined surgery should be reserved for patients shown to have a shallow anter ior chamber or significant cataract.