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Management of Fuchs endothelial corneal dystrophy (FECD): a case series



Abstract

Background: Fuchs endothelial corneal dystrophy (FECD) is the most common corneal dystrophy and often results in visual loss. This study aims to discuss the etiology, pathophysiology, diagnosis, and management of FECD.

Case presentations: We reported three cases of FECD. The first patient was 60 years old female diagnosed with corneal scar post-penetrating keratoplasty (PK) and pseudophakia in the right eye (RE) and FECD grade II in the left eye (LE). The right and left eye (RLE) visual acuity was 6/18 and 6/12, respectively. The patient was managed thrice a day with lubricant eye drops in the RE and Phacoemulsification and Descemet membrane endothelial keratoplasty (DMEK) in the LE. The second patient was 80 years old female with RLE FECD grade II, LE Pseudophakia, and RE Immature Cataract. Visual acuity was light perception in the right eye and 1/60 in the LE. She was managed with Siloxane eye drop 2x1, Oculenta gel 1x1 in RLE, and DMEK in LE. The third patient was 73 years old male with pseudophakia, FECD grade III, and corneal neovascularization in the RE. Visual acuity in RE was hand movement, and LE was 6/6. He was planned for PK on RE, Diquafosol sodium (Diquas®) eye drop twice a day, and eye fresh plus eye drops 4x1 in RLE.

Conclusion: FECD is the most common endothelial dystrophy and the main indication for corneal transplantation in the presence of visual disturbances. Medical therapy in the form of topical hyperosmotic agents can be given in the early phase and is useful for reducing corneal edema. The preferred management of FECD is currently Endothelial Keratoplasty (EK), such as DMEK, which has demonstrated excellent corneal clearance. Although the graft rejection rate in DMEK is low, there is a risk of rejection with the discontinuation of topical corticosteroids.

Keywords: FECD corneal endothelial cell corneal transplantation

References

  1. Cursiefen C, Jun AS, editors. Current Treatment Options for Fuchs Endothelial Dystrophy [Internet]. Switzerland: Springer Cham; 2017. Available from: https://doi.org/10.1007/978-3-319-43021-8
  2. Zhang J, Patel D V. The pathophysiology of Fuchs' endothelial dystrophy – A review of molecular and cellular insights. Exp Eye Res. 2015;130:97–105. Available from: http://dx.doi.org/10.1016/j.exer.2014.10.023
  3. Eleiwa T, Elsawy A, Özcan E, Abou Shousha M. Automated diagnosis and staging of Fuchs' endothelial cell corneal dystrophy using deep learning. Eye Vis (London, England). 2020;7:44. Available from: https://pubmed.ncbi.nlm.nih.gov/32884962
  4. Vedana G, Villarreal Jr G, Jun AS. Fuchs endothelial corneal dystrophy: current perspectives. Clin Ophthalmol. 2016;10:321–30. Available from: https://pubmed.ncbi.nlm.nih.gov/26937169
  5. Eghrari AO, Riazuddin SA, Gottsch JD. Fuchs Corneal Dystrophy [Internet]. Progress in Molecular Biology and Translational Science. Elsevier; 2015. p. 79–97. Available from: http://dx.doi.org/10.1016/bs.pmbts.2015.04.005
  6. Blitzer AL, Colby KA. Update on the Surgical Management of Fuchs Endothelial Corneal Dystrophy. Ophthalmol Ther. 2020/08/25. 2020;9(4):757–65. Available from: https://pubmed.ncbi.nlm.nih.gov/32840804
  7. American Academy Of Opthalmology. External Disease and Cornea. In: Weisenthal RW, Daly MK, Freitas D de, Feder RS, Orlin SE, Elmer Y. Tu, et al., editors. 2020-2021 Basic and Clinical Science Course. Ovid Technologies (Wolters Kluwer Health); 2020.
  8. Cunnusamy K, Bowman CB, Beebe W, Gong X, Hogan RN, Mootha VV. Congenital Corneal Endothelial Dystrophies Resulting From Novel De Novo Mutations. Cornea. 2016;35(2):281–5. Available from: https://pubmed.ncbi.nlm.nih.gov/26619383
  9. Soh YQ, Kocaba V, Pinto M, Mehta JS. Fuchs endothelial corneal dystrophy and corneal endothelial diseases: East meets West. Eye (Lond). 2019/07/02. 2020;34(3):427–41. Available from: https://pubmed.ncbi.nlm.nih.gov/31267087
  10. Patel S V, Hodge DO, Treichel EJ, Spiegel MR, Baratz KH. Predicting the Prognosis of Fuchs Endothelial Corneal Dystrophy by Using Scheimpflug Tomography. Ophthalmology. 2020;127(3):315–23. Available from: http://dx.doi.org/10.1016/j.ophtha.2019.09.033
  11. Kaup S, Pandey SK. Cataract surgery in patients with Fuchs' endothelial corneal dystrophy. Community eye Heal. 2019;31(104):86–7.
  12. Kiel M, Bu JB, Gericke A, Vossmerbaeumer U, Schuster AK, Pfeiffer N, et al. Comparison of DMEK and DSAEK in Eyes With Endothelial Decompensation After Previous Penetrating Keratoplasty. Cornea. 2021;40(9):1218–24.
  13. Nanavaty MA, Wang X, Shortt AJ. Endothelial keratoplasty versus penetrating keratoplasty for Fuchs endothelial dystrophy. Cochrane database Syst Rev. 2014;2(2):CD008420.

How to Cite

Wulandari, N. M. A., Siska, Kusumadjaja, M. A., Jayanegara, W. G., Juliari, I. G. A. M., Kusumadjaja, I. M. A. ., Pramita, I. A. A., & Safitri, P. D. M. (2023). Management of Fuchs endothelial corneal dystrophy (FECD): a case series. Intisari Sains Medis, 14(1), 439–444. https://doi.org/10.15562/ism.v14i1.1662
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Ni Made Ayu Wulandari
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Siska
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Made Agus Kusumadjaja
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Wayan Gede Jayanegara
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I Gusti Ayu Made Juliari
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I Made Agus Kusumadjaja
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Ida Ayu Ary Pramita
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Putu Dian Mega Safitri
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