Back to Freepaper Session

Does Fuchs" endothelial dystrophy exist?

Session Details

Session Title: Cornea Surgical II

Session Date/Time: Wednesday 09/10/2013 | 08:00-10:30

Paper Time: 09:08

Venue: Forum (Ground Floor)

First Author: : M.Dirisamer AUSTRIA

Co Author(s): :    R. Yeh   K. van Dijk   L. Ham   I. Dapena   G. Melles  

Abstract Details

Purpose:

To describe the potential role of the recipient corneal endothelium in re-endothelialization of the recipient posterior stroma, and corneal clearance after Descemet membrane endothelial transferral (DMET), i.e. a ‘free-floating’ donor Descemet-graft in the recipient anterior chamber after descemetorhexis, for treatment of Fuchs endothelial dystrophy.

Setting:

Non-randomized, prospective study, at a tertiary referral center. Netherlands Institute for Innovative Ocular Surgery, Rotterdam.

Methods:

Twelve eyes enrolled in our study, seven suffering from Fuchs endothelial dystrophy, and five had bullous keratopathy. The clinical outcome was monitored by biomicroscopy, optical coherence tomography, confocal microscopy, and endothelial cell density and pachymetry measurements.

Results:

All eyes operated on for Fuchs endothelial dystrophy, showed corneal clearance, with pachymetry values returning to normal (533 ±47 µm), and re-endothelialization of the denuded recipient posterior stroma, with an average endothelial cell density of 797 (±743) cells/mm2 six months after surgery. In contrast, none of the bullous keratopathy eyes showed any improvement throughout the follow-up period.

Conclusions:

If underlying pathology correlates with the occurrence of ‘spontaneous’ corneal clearance after DMET, this would indicate that the remaining rim of recipient endothelium (after descemetorhexis) is involved in the re-endothelialization of the recipient posterior stroma in eyes with Fuchs endothelial dystrophy. If so, the corneal endothelium may not be dystrophic so that Fuchs endothelial "dystrophy" may be a misnomer.

Financial Interest:

... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented