Corneal Transplant for Fuchs’ Dystrophy
What Is Fuchs’ Dystrophy?
Fuchs’ dystrophy is a hereditary condition of a weak inside layer of the cornea. Fuchs’ dystrophy can be mild and never require intervention or it can advance, clouding vision.
It is hereditary. The endothelium (inside layer) is compromised by guttata, areas missing endothelial cells, whose purpose is to keep the cornea clear by pumping fluid out of it. The decrease and poorer function of these cells can lead to corneal swelling and clouding.
The first symptom may be increased glare. Decreased vision may be worse on awakening and then clear as the day goes on. This is because the eye is open, allowing for evaporation. Cloudy, misty vision, seeing halos at night and a foreign body sensation are all symptoms of corneal compromise due to swelling as it progresses.
When mild, eye drops consisting of sodium chloride are helpful to reduce the corneal swelling by osmotic relief. Muro 128 drops at five percent (available over the counter) two drops four times daily can be very effective. Steroid eye drops can also be helpful and delay surgical intervention. When the vision is bad enough, corneal transplantation is very effective.
Corneal transplantation has gone through significant changes over the past decade due to improvements in techniques. Full-thickness transplantation, which requires a longer healing period and leaves the eye with significant astigmatism, was all that was available in the past. Fortunately now only the inner layer is removed and replaced, restoring the exact anatomy of the eye and hence good vision. It is called endothelial keratoplasty or formally Descemet’s membrane endothelial keratoplasty (DMEK). Another type of transplant (DSAEK), which stands for Descemet’s stripping automated endothelial keratoplasty, proceeded DMEK and was a good option and easier to perform, but added extra layers in the transplant tissue, making the cornea thicker than usual preventing the best visual rehabilitation. In treating corneal problems, our eye doctors have found success with DSEK and DMEK surgical interventions to restore vision and comfort.
Contact San Diego Eye Care Center
To schedule a consultation to discuss your eye care needs, please contact our office at (760) 757-1144.