What is Fuchs Corneal Dystrophy?

Fuchs Dystrophy is a corneal condition characterized by fluctuating or blurry vision. The cornea is composed of three layers. The inner endothelium layer is composed of thousands of small pump cells. These cells are responsible for pumping fluid out of the cornea so it can remain clear to provide good vision. If these cells become dysfunctional, damaged, or destroyed, the cornea becomes swollen and cloudy, causing blurred vision. These inner endothelial cells can be lost due to Fuchs or other conditions such as aging, diseases, trauma, or previous eye surgery. If a significant number of endothelial pump cells are lost, a corneal transplant operation may be indicated to allow for a clear cornea and restore vision.

Endothelial Keratoplasty

There are a variety of corneal transplant options available to treat Fuchs, however there have been recent advancements in this procedure to allow only the affected areas of the cornea to be transplanted. As mentioned above, the corneal endothelium is responsible for the loss of corneal transparency with Fuchs. This layer of the cornea is only one cell layer thick and makes up a very small percentage of the corneas overall thickness. Endothelial Keratoplasty (EK) is a procedure designed to transplant only the thin layer of tissue that is irregular in Fuchs. This allows for much of the patient’s cornea to remain untouched. These newer and less intrusive partial-thickness transplants are called Descemet’s Membrane Endothelial Keratoplasty (DMEK) and Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK).

Postoperative care and expectations

Surgery is usually performed as an outpatient procedure at a hospital or surgery center, under local anesthesia. If you also have a cataract, then cataract surgery can be performed at the same time as EK surgery. Routine post-op care includes visits at 1 day, 1 week, 1 month, and 3, 6, 12 and 24 months after the surgery. Several eye drops are used before and after the procedure. Sometimes patients will need to be on long term eye drops, but this is not always the case. Improvement in vision usually occurs after updating glasses prescriptions 1 to 3 months following the EK procedure.
EK is not for everyone. Some patients with corneal scarring or other conditions are not suitable candidates for EK. Your eye doctor can detect the presence of corneal dysfunction and where appropriate, will refer you to Dr. Phillips or Dr. Espandar for surgery consultation.