- What is it?
- Causes and Risk Factors
- Symptoms
- Diagnosis
- Treatment
- Disease progression
- Research
Treatment of Fuchs’ endothelial dystrophy
Eye drops or ointments that draw fluid from the cornea are used to relieve the symptoms of Fuchs’ dystrophy. If painful ulcers develop on the cornea, soft contact lenses or surgery may help reduce the pain.
The only cure for Fuchs’ dystrophy is a corneal transplant.
Until recently, the most common type of corneal transplant was penetrating keratoplasty. In this type of transplant, a round part of the cornea is removed, leaving an opening in the front of the eye. A similar piece of cornea from a donor is then sutured.
A newer type of endothelial keratoplasty (DSEK, DSAEK, or DMEK) is now the option of choice for people with Fuchs’ dystrophy. In this procedure, only the inner layers of the cornea are replaced, rather than all the layers. The patient recovers more quickly after this operation and has fewer complications.
Patient follow-up
Most patients are monitored for the first few weeks after surgery to ensure the surgery is successful and to prevent infection.
Sometimes, sutures have to be removed to minimise astigmatism. Full-thickness (PKP) and partial thickness (DSAEK, DMEK) transplants may be rejected, just like any other organ transplant. Corneal transplant rejection may occur years after the initial surgery.
Complications of surgical treatment
Surgical complications include infection, poor wound healing, transplant rejection and suture-related complications. With a full-thickness transplant (PKP), a high refractive error (graduation) can be observed.
Long-term topical steroids are required to prevent rejection, but can induce cataracts and glaucoma.
When undergoing a partial thickness transplant (DSAEK/DMEK), the most common initial complication is detachment of the endothelial cell membrane, which may require repeated air bubble placement or, more rarely, replacement of the endothelial transplant.
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