Patients with Fuchs endothelial dystrophy experience residual corneal haze after DSEK

Research conducted in the Department of Ophthalmology at Mayo Clinic in Rochester, Minn., has determined the changes in anterior corneal cells in Fuchs endothelial dystrophy before and after Descemet stripping with endothelial keratoplasty (DSEK). The study also quantified corneal light scatter (that is, haze) and its relation to vision after DSEK.

"This study indicates that visual function after DSEK is affected by residual haze in the anterior host cornea more so than in the surgical interface," says Sanjay V. Patel, M.D. "Haze, which contributes to glare disability, partially improves after surgical intervention and does not affect visual acuity. Haze improves more in younger patients, an outcome that is associated with improvement in forward light scatter."

The research abstract, "Cellular Changes in the Anterior Cornea Before and After Descemet Stripping Endothelial Keratoplasty for Fuchs Endothelial Dystrophy," was presented at The Association for Research in Vision and Ophthalmology annual meeting in May 2012. Related papers were published in Archives of Ophthalmology and Cornea.

In the study, 49 eyes of 42 patients with Fuchs dystrophy (mean age, 67 years; range, 41-87 years) were examined before and at one, two and three years after DSEK and were compared with 35 healthy eyes that did not have Fuchs. Outcome measures were high- and low-contrast visual acuity and forward light scatter. Corneal haze, keratocyte density and corneal nerves were assessed through use of in vivo confocal microscopy.

For more information

"Confocal Microscopy of Fuchs Endothelial Dystrophy Before and After Endothelial Keratoplasty" was presented in part at The Association for Research in Vision and Ophthalmology annual meeting in May 2012 and will be published in an upcoming issue of Archives of Ophthalmology.

"Corneal Haze Determined by Confocal Microscopy 2 Years After Descemet Stripping With Endothelial Keratoplasty for Fuchs Corneal Dystrophy" was published in the July 2012 issue of Archives of Ophthalmology.

"Decreased Corneal Sensitivity and Abnormal Corneal Nerves in Fuchs Endothelial Dystrophy" was published in the November 2012 issue of Cornea.

Points to remember

• A study of 49 eyes with Fuchs dystrophy compared with 35 healthy eyes indicates that visual function after Descemet stripping with endothelial keratoplasty is affected by residual haze in the anterior host cornea more so than in the surgical interface.
• Outcome measures were high- and low-contrast visual acuity and forward light scatter.
• Results show that haze partially improves after surgical intervention and does not affect visual acuity. Haze also improved more in younger patients.