Predicting Prognosis of Fuch’s Endothelial Corneal Dystrophy using Common Machine in eyeMds offices.

Fuch’s Endothelial Corneal Dystrophy is an abnormality of the cornea’s endothelial cells that line the inner cornea (or window of the eye). Malfunction of these cells can cause vision loss by turning the clear cornea into white-looking sclera: they are the same tissue but the endothelial cells pump water out of the tissue to keep it clear. 

We have Scheimflug Tomography machines which most eyeMds offices have now. This machine may now help us give a better prognosis of vision loss before and after cataract surgery. 

The interesting thing will be to see if Femtosecond Laser-Assisted Cataract Surgery, which appears to be the best method to remove a cataract currently, will improve outcome scores in patients with Fuchs as we suspect it will help. 

Here is a simplified version: Reference is below.

Here are the key features to look for according to Patel, et. al, below.
1. Loss of regular Isopachs
2. Displacement of the thinnest point of the cornea
3. Focal Posterior Depression

5-year risk of disease progression or needing corneal surgery: (I remember it roughly as 7, 50, 90%)

If no features present = 7% risk over 5 years

If 1-2 features present = 48%

If all 3 present =89%

Most eyeMDs try to tell patients of the risk of Fuch’s Dystrophy which includes needing a corneal surgery after cataract surgery. This paper helps define this risk. 


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