Endothelial Corneal Dystrophy

Authors

  • Danielle Cadieux, MD, MHPE, FRCSC Dalhousie University, Halifax, NS
  • Rami Darwich, MDCM, MSc, PhD Dalhousie University, Halifax, NS

DOI:

https://doi.org/10.58931/cect.2024.3242

Abstract

Fuchs endothelial corneal dystrophy (FECD) was first described by Ernst Fuchs in 1910. It is a bilateral corneal endothelial dystrophy characterized by progressive loss of corneal endothelial cells and formation of excrescences at the level of Descemet’s membrane called guttae. The diseased endothelium leads to corneal edema and loss of corneal clarity. FECD typically manifests in the fifth and sixth decade of life coinciding with the development of cataracts. Careful preoperative evaluation and surgical technique allows for selection of patients who can safely undergo cataract surgery alone. Some patients, however, would benefit from both cataract surgery and endothelial transplantation (EK). This can be done as a staged surgery (cataract surgery then EK or vice versa) or in combination as a single procedure. This review evaluates the management strategies for individuals with cataract and FECD to help guide surgical decision-making and planning. 

Author Biographies

Danielle Cadieux, MD, MHPE, FRCSC, Dalhousie University, Halifax, NS

Dr. Dani Cadieux is an Associate Professor at Dalhousie University currently practicing as a Cornea and External Eye Disease specialist in Halifax, Nova Scotia. She completed her medical degree at Western University in London, Ontario, followed by an ophthalmology residency in Halifax. During residency, she completed a concurrent Master’s in Health Profession Education through the University of Maastricht, The Netherlands. She then completed fellowship training in Cornea and External Eye Disease in Melbourne, Australia. In addition to her clinical practice, Dr. Cadieux is the Program Director for the ophthalmology residency training program at Dalhousie University. 

Rami Darwich, MDCM, MSc, PhD, Dalhousie University, Halifax, NS

Dr. Darwich completed his MDCM degree at McGill University and is currently an ophthalmology resident at Dalhousie University. He will be completing a glaucoma fellowship at Mayo Clinic in Rochester, Minnesota. Dr. Darwich is actively engaged in research and has published in various peer‑reviewed journals and presented at numerous international conferences.

References

Ali M, Cho K, Srikumaran D. Fuchs Dystrophy and Cataract: Diagnosis, Evaluation and Treatment. Ophthalmol Ther 2023;12(2):691-704. doi: 10.1007/s40123-022-00637-1 [published Online First: 2023/01/14] DOI: https://doi.org/10.1007/s40123-022-00637-1

Elhalis H, Azizi B, Jurkunas UV. Fuchs endothelial corneal dystrophy. The ocular surface 2010;8(4):173-84. doi: 10.1016/s1542-0124(12)70232-x [published Online First: 2010/10/23] DOI: https://doi.org/10.1016/S1542-0124(12)70232-X

Weisenthal RW. Basic and Clinical Science Course. Section 08: External Disease and Cornea. 2020-2021 ed: American Academy of Ophthalmology 2018:24.

Sun SY, Wacker K, Baratz KH, et al. Determining Subclinical Edema in Fuchs Endothelial Corneal Dystrophy: Revised Classification using Scheimpflug Tomography for Preoperative Assessment. Ophthalmology 2019;126(2):195-204. doi: https://doi.org/10.1016/j.ophtha.2018.07.005 DOI: https://doi.org/10.1016/j.ophtha.2018.07.005

Patel SV, Hodge DO, Treichel EJ, et al. Predicting the Prognosis of Fuchs Endothelial Corneal Dystrophy by Using Scheimpflug Tomography. Ophthalmology 2020;127(3):315-23. doi: https://doi.org/10.1016/j.ophtha.2019.09.033 DOI: https://doi.org/10.1016/j.ophtha.2019.09.033

Arnalich-Montiel F, Mingo-Botín D, De Arriba-Palomero P. Preoperative Risk Assessment for Progression to Descemet Membrane Endothelial Keratoplasty Following Cataract Surgery in Fuchs Endothelial Corneal Dystrophy. American journal of ophthalmology 2019;208:76-86. doi: https://doi.org/10.1016/j.ajo.2019.07.012 DOI: https://doi.org/10.1016/j.ajo.2019.07.012

Wacker K, Cavalcante LCB, Baratz KH, et al. Hyperopic Trend after Cataract Surgery in Eyes with Fuchs’ Endothelial Corneal Dystrophy. Ophthalmology 2018;125(8):1302-04. doi: https://doi.org/10.1016/j.ophtha.2018.03.060 DOI: https://doi.org/10.1016/j.ophtha.2018.03.060

Yokogawa H, Sanchez PJ, Mayko ZM, et al. Astigmatism Correction With Toric Intraocular Lenses in Descemet Membrane Endothelial Keratoplasty Triple Procedures. Cornea 2017;36(3):269-74. doi: 10.1097/ico.0000000000001124 [published Online First: 2016/12/22] DOI: https://doi.org/10.1097/ICO.0000000000001124

Price MO, Pinkus D, Price FW, Jr. Implantation of Presbyopia-Correcting Intraocular Lenses Staged After Descemet Membrane Endothelial Keratoplasty in Patients With Fuchs Dystrophy. Cornea 2020;39(6):732-35. doi: 10.1097/ico.0000000000002227 [published Online First: 2019/12/17] DOI: https://doi.org/10.1097/ICO.0000000000002227

Eisenbeisz HC, Bleeker AR, Terveen DC, et al. Descemet Membrane Endothelial Keratoplasty and light adjustable lens triple procedure. American journal of ophthalmology case reports 2021;22:101061. doi: 10.1016/j.ajoc.2021.101061 [published Online First: 2021/03/16] DOI: https://doi.org/10.1016/j.ajoc.2021.101061

Hsiao CW, Cheng H, Ghafouri R, et al. Corneal Outcomes Following Cataract Surgery Using Ophthalmic Viscosurgical Devices Composed of Chondroitin Sulfate-Hyaluronic Acid: A Systematic Review and Meta-Analysis. Clin Ophthalmol 2023;17:2083-96. doi: 10.2147/opth.s419863 [published Online First: 2023/07/31] DOI: https://doi.org/10.2147/OPTH.S419863

Chuckpaiwong V, Muakkul S, Phimpho P, et al. Incidence and Risk Factors of Corneal Endothelial Failure after Phacoemulsification in Patients with Fuchs Endothelial Corneal Dystrophy: A 13-Year Retrospective Cohort. Clin Ophthalmol 2021;15:2367-73. doi: 10.2147/opth.s315436 [published Online First: 2021/06/12] DOI: https://doi.org/10.2147/OPTH.S315436

Romano V, Passaro ML, Bachmann B, et al. Combined or sequential DMEK in cases of cataract and Fuchs endothelial corneal dystrophy—A systematic review and meta-analysis. Acta Ophthalmologica 2024;102(1):e22-e30. doi: https://doi.org/10.1111/aos.15691 DOI: https://doi.org/10.1111/aos.15691

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Published

2024-06-18

How to Cite

1.
Cadieux D, Darwich R. Endothelial Corneal Dystrophy. Can Eye Care Today [Internet]. 2024 Jun. 18 [cited 2024 Jul. 24];3(2):10–15. Available from: https://canadianeyecaretoday.com/article/view/3-2-cadieux_et_al

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