Fuchs’ dystrophy is an inherited condition that affects the inner layer of the cornea. This layer contains small pump cells (endothelial cells) that constantly remove fluids from the cornea in order to maintain its clarity. In patients with Fuchs’ dystrophy, premature loss of these pump cells results in corneal swelling, clouding and decreased vision. Fuchs’ dystrophy affects both eyes and is slightly more common among women than men. It generally begins at 30-40 years of age and progresses gradually with time.
In early stages, vision may seem blurred in the morning and sharper later in the day but as the conditions worsen, vision becomes continuously blurred. Other symptoms include hazy vision and glare when looking at lights. Fuchs’ can be detected during a routine eye examination. The health and number of endothelial cells can be evaluated and monitored by an instrument known as specular microscopy.
Fuchs’ dystrophy cannot be cured, though, with certain medications, the blurred vision resulting from corneal swelling can be improved. A corneal transplant is indicated when the vision deteriorates to the point that it impairs the patient’s ability to function.
New techniques including Descemet’s Stripping Endothelial Keratoplasty (DSEK) and Descemet's Membrane Endothelial Keratoplasty (DMEK) have evolved in corneal transplant surgery and accomplishes the goal of replacing only the endothelial cell layer. This new technique offers significant advantages over the standard corneal transplant such as a smaller surgical incision, fewer sutures, and faster visual recovery.