Fuch’s Corneal Dystrophy

Fuchs’ corneal dystrophy is an inherited disorder that tends to affect patients during their 50s and beyond. Many patients who have this condition have minimal or no resultant impact on their best-corrected vision. However, some patients will suffer varying degrees of vision loss, and may go on to require either medical or surgical treatment. This may include special eye drops, or a partial or full-thickness corneal transplant.

This disease is characterized by the loss of cells from the inner layer of the cornea and by a decrease in function of the remaining cells. This cell layer, called the endothelium, is responsible for maintaining the fluid balance in the remaining layers of the cornea. Therefore, if it is not working properly, there is a risk of swelling because of an accumulation of fluid in the cornea. In a cornea that is already compromised by loss of and/or poorly functioning endothelium, surgery can put you at risk of developing irreversible swelling of the cornea. In this case, one may be required to undergo replacement of the inner layer of the cornea.

Corneal transplant surgery has undergone extraordinary advancements in recent years. Surgeons used to replace the entire cornea—a full-thickness corneal transplant. Now, transplant surgeons are instead able to replace only the inner layer of the cornea in most cases of Fuchs’ Dystrophy. This is significant, because in the event that you do require corneal transplant surgery, your recovery time will be much faster than it used to be. Also, you will not develop the same degree of astigmatism that is seen with full-thickness corneal transplants, so your uncorrected vision will be better than if you were to undergo a full-thickness procedure.

This advancement in corneal transplant surgery has revolutionized the treatment of Fuchs’ corneal dystrophy. Patients with cataracts and Fuch’s dystrophy are now able to undergo treatment of their cataracts at an earlier stage, with good postoperative results. In years passed, surgeons frequently delayed cataract surgery because of the risk of corneal swelling and the possible resultant need for a full-thickness corneal transplant. Now, the risk to the cornea is markedly reduced due to improvements in technology. In fact, most corneal transplant surgeons now will recommend having your cataract removed at an earlier stage, because there is less surgical trauma to the eye in the process of removing a small cataract than there is removing an advanced cataract. Therefore, by getting your cataract out early, you may actually prevent the later need for a corneal transplant.

© Vision Information Services, LLC, Mooresville, NC 2012