I specialise in cornea surgery and did the first no-suture cornea transplant in the UK in 2003. This article explains how I perform modern partial cornea transplantation for Fuchs and how this has greatly improved the outcome of treatment.
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Fuchs Endothelial Dystrophy (Fuchs) is a disease of the cornea named after the German ophthalmologist who first described it about a century ago. The cornea is the transparent ‘front window’ of the eye. It is important because it is the main focusing structure of the eye and so any change in its shape or transparency will reduce vision. The cornea is composed of several layers the innermost of which, called the ‘endothelium’, is needed to keep the cornea transparent by constantly removing fluid from it.
In Fuchs’ the cells of the corneal endothelium are gradually lost, a process which usually takes many years. Unfortunately the process may be speeded up after cataract surgery. The patient notices gradually worsening vision, usually in both eyes. Vision may be worse in the mornings, improving as the day progresses. Eye pain and redness only occur at a very late stage in the disease.
Fuchs’ is a fairly common disorder. It usually affects both eyes and begins in later life. The cause is completely unknown. It sometimes runs in families, although this is unusual.
A Fuchs cornea photographed using a camera that shows the endothelium. The stippled orange appearance is abnormal and characteristic of this disease.