Corneal endothelia dystrophy is an inherited, alteration of the delicate inner lining of the cornea (endothelium). Fuchs’ presents itself in the first few decades of life and usually effects both eyes. The delicate inner lining of the cornea called the endothelium functions as a pump mechanism to keep the cornea clear. Decompensation or failure of the pump system leads to edema or swelling of the layers of the cornea resulting in reduced vision. At first, edema occurs only in the morning resulting in poor vision that clears later in the day. Sometimes the use of Sodium Chloride drops during the day and Sodium Chloride ointment in the evening can help in clearing the vision. When the vision has deteriorated to the point that reading, driving, hobbies or work are difficult, a corneal transplant is indicated and is successful nearly 90% of the time.
Cataracts are common in patients with Fuchs’ dystrophy. Patients with excessive corneal swelling will benefit from combined corneal transplant and cataract extraction, while those with minimal corneal swelling, a cataract extraction alone is usually successful.