Optical and Anatomic Changes in Fuchs Endothelial Dystrophy Corneas

Abstract

The advent of endothelial keratoplasty and improvements in corneal imaging have advanced our understanding of the optical and anatomic properties of corneas with Fuchs endothelial dystrophy before and after keratoplasty. Corneal changes appear earlier in the course of Fuchs endothelial dystrophy than previously considered, indicating disease chronicity, probably in response to a state of long-term subclinical corneal edema. These early changes increase optical aberrations and light scatter that decrease visual acuity and increase disability glare, respectively. Because many of the structural changes that contribute to aberrations and scatter originate in the anterior cornea, they persist in the host cornea after endothelial keratoplasty and even after corneal edema has resolved. These factors that originate early in the disease process probably determine the visual outcomes of endothelial keratoplasty for Fuchs endothelial dystrophy.