The cornea is the first and most powerful lens of the eye, focusing light to produce the clear image we see. The cornea has special cells on its back surface called “endothelium” that keep it CLEAR, and these slowly deteriorate over time.
In Fuchs Dystrophy, there is accelerated loss of the endothelium. This means that the cornea becomes CLOUDY and SWOLLEN, blurring vision typically over months to years. Patients complain of fogging of vision, worse in the morning, and improving throughout the day.
Fuchs Dystrophy over time
The natural history of Fuchs Dystrophy is slow progressive visual deterioration over time.
Fuchs dystrophy cannot be stopped but the symptoms of Fuchs dystrophy can be treated. Lubricant drops may help with discomfort; lowering the eye pressure can reduce corneal swelling; anti-inflammatory eye drops can provide symptomatic relief for any inflammation that may occur. Ripasudil can temporarily halt or even reverse the condition.
The good news is that endothelium can be selectively replaced surgically, restoring sight. Damaged cells are selectively replaced with healthy new cells from donor human corneal tissue, using keyhole surgery. This minimally invasive transplant delivers rapid return of vision over days to weeks. No matching of transplant tissue is required.
When do I need surgery?
If your vision does not improve with drops or contact lenses are intolerable or unhelpful, a transplant is required. If you are in pain, the transplant should be done promptly. If the cornea deteriorates, it is harder to achieve success with DMEK.