In Fuchs’ dystrophy, an inherited problem with the pump layer of cells (those responsible for pumping fluid back into the eye) lining the inner aspect of the cornea (the corneal endothelium), causes the cornea to become waterlogged and cloudy.
Fuchs’ dystrophy is common, and normally affects people in middle age or later life. The typical early symptom is ‘morning misting’ – patients find that their vision is misty on waking, but clears during the day.
Good vision can be restored in patients with Fuchs’ dystrophy and other causes of corneal endothelial failure by corneal transplantation.
Since 2000, selective corneal transplantation techniques have been developed which allow surgeons to replace the damaged endothelial layer with healthy tissue through a small, sutureless incision in an operation similar to modern cataract surgery.Different versions of this operation called DSAEK or DMEK are available to suit different patients. These ‘keyhole’ corneal transplantation operations can be performed under local anaesthetic, can be repeated if necessary, and quickly improve vision.