Fuchs’s dystrophy is a disease of the corneal endothelial cells which leads to premature cell loss. Endothelial cells are specialist cells that line the inner surface of the cornea and spend their life keep the cornea transparent. If the number of endothelial cells decreases the cornea becomes water logged and loses its transparency. Patients with Fuchs’ dystrophy may notice glare and halos around bright lights, difficulty with driving at night and blurry vision in the mornings. As the disease progresses vision becomes permanently blurred and in advanced cases there may be pain caused by water blisters forming on the surface of the cornea.
The treatment for Fuch’s dystrophy is a corneal transplant. The latest technique for this is called DMEK (Descemet’s Membrane Endothelial Keratoplasty) which is a minimally invasive cell transplant technique performed through a 3mm small incision. The main benefit of DMEK is a very low rejection risk of less than 1%. Visual recovery is also rapid due to the absence of corneal stitches. DMEK can be combined with cataract surgery avoiding two separate surgeries. Full thickness corneal transplants (penetrating keratoplasty) are no longer the gold standard of surgery for Fuch’s dystrophy.