Fuchs Endothelial Dystrophy

The cornea is the clear front window of the eye that accounts for about two thirds of the focusing power of the eye. To maintain its clarity, there is a thin layer of special pump cells (called endothelium) which operate continuously to keep the cornea clear and not waterlogged. In Fuchs dystrophy, these pump cells don’t work properly, the corneal “window” starts to swell with water and this causes blurring of vision.

In early stages of the disease, patients can be asymptomatic and the disease may only be found on incidental routine check-up at their optometrist or because they may have a family history.

In the mid-term stages, patients may complain of hazy vision in the morning that clears over the course of the day or they may describe seeing haloes around bright light sources.

In severe cases, vision can be blurry all day and blisters on the surface of the eye can form - these can pop and cause severe pain and stinging. These open blisters can also be a potential area of infection if not treated appropriately.

When the disease is early, the cornea can be observed over time. Increasingly though, we are recognizing that this pump layer of cells has regenerative potential and suitable candidates who are experiencing symptoms may choose to have a small central area of the disease removed to allow the healthy area to “fill” in, aided by special eye drops to encourage cell re-distribution. The opportunity to avoid a corneal transplant is beneficial, but visual recovery can take up to three months on average.


In the vast majority of moderate to severe cases however, patients will require an operation called an endothelial keratoplasty and this is classified as a corneal transplant. Transplantation techniques for Fuchs endothelial dystrophy are some of the most advanced techniques in the area of corneal transplantation. Dr Trinh has extensive experience in the entire range of corneal transplantation and offers DMEK surgery for these types of patients where they are not suitable candidates for the “stripping only” procedure. Long term outcomes of this type of transplant are excellent, with good evidence behind them, and offer a quite rapid recovery of vision in the postoperative period.