Materiały źródłowe

• #1 Fight Against Fuchs’ Dystrophy

  https://www.reviewofcontactlenses.com/article/fight-against-fuchs-dystrophy

  Fuchs dystrophy, a progressive corneal ailment, is characterized by the gradual deterioration and eventual demise of endothelial cells, leading to a significant reduction in their number and functionality. […] While there is no cure, there are treatment options available to alleviate symptoms and manage the condition. First-line treatments include topical distillation of hypertonic saline, topical steroids or artificial tears. This helps to reduce corneal swelling and improve vision. Moderate-to-severe Fuchs may require corneal transplantation, which involves replacing the affected cornea with a healthy donor cornea. There are many different methods, including Descemets stripping automated endothelial keratoplasty (DSAEK), Descemets membrane endothelial keratoplasty (DMEK) and others. […] Antioxidant therapy is a promising approach to counteract oxidative stress in Fuchs dystrophy. These compounds neutralize reactive oxygen species, reducing oxidative damage and preserving cellular function. Topical application of antioxidant agents to the cornea may help protect endothelial cells from oxidative stress.

• #2 Fuchs’ Dystrophy: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/23438-fuchs-dystrophy

  Fuchs dystrophy treatment […] A healthcare provider can treat Fuchs endothelial dystrophy, but they cant cure it. Your provider may choose observation during the early stage. Other Fuchs dystrophy treatments may include: […] Ointments and eye drops. For mild symptoms, these medications reduce swelling of your cells by helping to dry up excess fluid. The improvement is usually temporary. […] Corneal transplant. When Fuchs starts to limit your vision, surgery is the definitive treatment. You may get a partial corneal transplant (endothelial keratoplasty) or a full corneal transplant. […] Descemets stripping only (DSO). A newer procedure involves stripping away the diseased cells in the center to allow your own, healthier cells from the sides to replace them. […] With treatment, your expected outcome is much better. Your vision may improve to 20/20 within days of surgery (with glasses). That’s why it’s important to work with your provider to find the right treatment for you.

• #3

  https://www.aao.org/eye-health/diseases/what-is-fuchs-dystrophy

  Fuchs’ Treatment […] There is no cure for Fuchs dystrophy. However, you can control vision problems from corneal swelling. Your treatment depends on how Fuchs dystrophy affects your eyes cells. […] Here are treatments for early Fuchs dystrophy: […] Use an eye drop medicine or ointment to reduce swelling of the corneas cells. […] Use a hair dryer, held at arms length, to blow warm air on your face. This helps dry the surface of your cornea. […] For very poor vision or scarred corneas, you may need a corneal transplant. This surgery could be one of two types: […] Endothelial keratoplasty (EK): Healthy endothelial cells are transplanted into your cornea. […] Full corneal transplant: The center of your cornea is replaced with a healthy donor cornea. […] Your ophthalmologist will discuss what treatments are best for your condition.

• #4 Fuchs Endothelial Dystrophy Treatment & Management: Medical Care, Surgical Care, Diet

  https://emedicine.medscape.com/article/1193591-treatment

  Patients who have Fuchs endothelial dystrophy and clear corneas need no treatment. It is only when the corneal decompensation starts that medical treatment becomes necessary. This treatment is necessary until it is not possible to preserve good vision; at that point, keratoplasty is necessary. […] Lowering the intraocular pressure (IOP) is useful when it is even mildly raised. It occasionally helps even when the pressure is normal, especially in borderline cases of corneal decompensation. Topical carbonic anhydrase inhibitors should be avoided as it hinders the activity of endothelial pump. […] Failing vision or pain in the presence of epithelial edema and stromal haze, which cannot be treated by the instillation of 5% sodium chloride drops and ointment, necessitates recourse to surgery.

• #5 Fuchs’ Endothelial Dystrophy – EyeWiki

  https://eyewiki.org/Fuchs%E2%80%99_Endothelial_Dystrophy

  Fuchs dystrophy is often inherited in an autosomal dominant manner. This means if you have an inherited form of Fuchs endothelial dystrophy there is a 50% chance you will pass it on to your children. […] Medical treatment of Fuchs dystrophy begins once patients notice fluctuations in vision. The early treatment is usually in the form of hypertonic saline (such as Muro 128 or sodium chloride) eye drops and/or ointments. Use of the hypertonic saline may stabilize or improve vision by drawing extra water out of the cornea. […] As Fuchs dystrophy progresses, medical treatment may fail, and surgical management becomes necessary. […] For many years, the only option for patients with visually significant Fuchs dystrophy was a full thickness corneal transplant or penetrating keratoplasty (PKP).

• #6 Fuchs dystrophy Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/fuchs-dystrophy

  Eye drops or ointments that draw fluid out of the cornea are used to relieve symptoms of Fuchs dystrophy. […] If painful sores develop on the cornea, soft contact lenses or surgery to create flaps over the sores may help reduce pain. […] The only cure for Fuchs dystrophy is a corneal transplant. […] A newer technique called endothelial keratoplasty (DSEK, DSAEK, or DMEK) has become the preferred option for people with Fuchs dystrophy. […] For people with Fuchs dystrophy that have mostly guttata and not much swelling, stripping off a small central disk of the endothelium containing the guttata can be helpful.

• #7 Therapeutic future of Fuchs endothelial corneal dystrophy: An ongoing way to explore

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11034696/

  Fuchs endothelial corneal dystrophy (FECD) is one of the most common corneal diseases that causes loss of visual acuity in the world. Currently, the mainstay of FECD treatment is surgery. However, limited sources of corneal graft and postsurgical complications remain problematic. In recent years, with advances in medical science and technology, there have been a few promising trials of new treatment modalities for FECD. In addition to new surgical methods, novel modalities can be classified into pharmacological-associated treatment, cell therapy-associated treatment, and gene therapy-associated treatment. […] Today, despite numerous treatment options available, a considerable proportion of patients with FECD eventually require a corneal transplant. […] After visual symptoms begin, FECD patients usually receive hypertonic saline as first-line therapy. However, hypertonic saline only reduces symptoms but does not halt the progression of FECD. Currently, the mainstay and only definitive treatment for FECD is surgery. It is indicated in patients with severe symptoms after conservative, nonsurgical treatments fail to provide satisfactory relief.

• #8 Fuchs Dystrophy | Treatment | Atlanta | Eye Exam

  https://www.omnieyeatlanta.com/services/corneal-care/fuchs-dystrophy/

  Fuchs dystrophy cannot be cured. Doctors are unable to treat the endothelial cells to make them work better or to become more numerous. However, blurred vision resulting from the corneal swelling can be controlled with medication. Salt solutions containing sodium chloride (Muro 128 drops or ointment, 2% or 5%) are often prescribed to draw fluid from the cornea and reduce swelling. Steroid eye drops may be helpful in specific situations. […] Corneal transplantation is considered when vision deteriorates to the point that it interferes with daily activities and impairs a persons ability to function normally. This surgery replaces the full thickness of the cornea, including the endothelium, with healthy layers. The cloudy cornea is replaced with clear corneal tissue. […] When patients with Fuchs dystrophy develop cataract, it is important to carefully evaluate the status of the endothelium to decide whether the cornea is likely to continue to function well following cataract surgery. A recommendation may be made to combine cataract surgery with corneal transplantation. One combined surgery can achieve what would otherwise require two separate surgeries with a longer post-operative recovery.

• #9 Fuchs Dystrophy | Treatment | Grand Forks ND | Thief River Falls MN

  https://www.northdakotaeyeclinic.com/services/corneal-services/fuchs-corneal-dystrophy/

  Fuchs dystrophy cannot be cured. Doctors are unable to treat the endothelial cells to make them work better or to become more numerous. However, blurred vision resulting from the corneal swelling can be controlled with medication. Salt solutions containing sodium chloride (Muro 128 drops or ointment, 2% or 5%) are often prescribed to draw fluid from the cornea and reduce swelling. Steroid eye drops may be helpful in specific situations. […] Another simple technique that reduces moisture in the cornea is to hold a hairdryer at arms length, blowing air towards the face with the eyes open. This warm air flow increases evaporation of water from the cornea, temporarily decreases swelling, and may improve vision. […] Corneal transplantation is considered when vision deteriorates to the point that it interferes with daily activities and impairs a persons ability to function normally. This surgery replaces the full thickness of the cornea, including the endothelium, with healthy layers. The cloudy cornea is replaced with clear corneal tissue. […] A recommendation may be made to combine cataract surgery with corneal transplantation. One combined surgery can achieve what would otherwise require two separate surgeries with a longer post-operative recovery.

• #10

  https://umiamihealth.org/en/bascom-palmer-eye-institute/specialties/corneal-and-external-diseases/fuchs%E2%80%99-dystrophy

  Fuchs dystrophy progresses slowly, usually in both eyes. The disease is more common in women than men and in people with a family history of the disease. Although this condition starts in the 20s and 30s, most people do not experience symptoms until their 50s or 60s. […] When you have a vision-impairing disease, you need a knowledgeable eye care team to provide a fast, accurate diagnosis and effective treatment plan. Preserving your eyesight through excellent care is the goal of every eye care professional at Bascom Palmer Eye Institute, part of the University of Miami Health System. […] Eye Drops and Ointments – If your disease is not severe, your eye doctor may recommend eye drops or ointment to reduce the swelling in your eye. […] Contact Lenses – Specialized soft contact lenses help alleviate pain associated with this disease.

• #11

  https://link.springer.com/article/10.1007/s40123-022-00637-1

  Corneal endothelium plays an important role in maintaining hydration homeostasis and clarity of the cornea. Fuchs endothelial corneal dystrophy (FECD) affects the corneal endothelium resulting in edema and characteristic excrescences on the Descemets membrane known as corneal guttae. Descemet membrane endothelial keratoplasty (DMEK) has evolved to become the standard of care for patients with FECD with excellent visual acuity outcomes. […] While newer therapeutic options are being investigated, Descemet membrane endothelial keratoplasty (DMEK), which involves replacing the diseased corneal endothelium and Descemet membrane with healthy donor endothelium and Descemet membrane, is the current standard therapeutic option for patients with FECD. […] Currently, no medical therapy is available to interfere with the progression of FECD. Hyperosmotic drops may temporarily improve symptoms in earlier stages. However, a recent randomized trial has revealed that the drops might not offer much benefit and might result in more adverse events compared to a placebo. Netarsudil, a rho kinase inhibitor, is approved for treatment of glaucoma. Netarsudil was associated with reduction of corneal edema and improvement in scotopic corrected distance vision of FECD patients in a randomized clinical trial on 26 eyes. However, currently for more advanced disease keratoplasty is the main modality for treatment.

• #12 Therapeutic future of Fuchs endothelial corneal dystrophy: An ongoing way to explore

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11034696/

  ROCK inhibitors are initially used to treat glaucoma, but their ability to increase adhesion, promote proliferation, and inhibit apoptosis of corneal endothelial cells have been demonstrated, making them potential treatments for other corneal endothelial disorders. […] Clinical trials have been carried out to assess the potential benefits of adding ripasudil (Kowa Company Ltd, Nagoya, Japan), a ROCK inhibitor, to postoperative treatment since ripasudil was believed to accelerate postsurgical endothelial cell healing and elimination of corneal edema. […] The efficacy of netarsudil, another ROCK inhibitor, in reducing corneal edema and central corneal thickness has been established in various trials. […] Currently, there are 19 trials exploring pharmacological-associated treatment options for FECD.

• #13

  https://journals.lww.com/tjop/fulltext/2024/14010/therapeutic_future_of_fuchs_endothelial_corneal.3.aspx

  Currently, there are 24 trials on potential nonsurgical treatment, of which 19 are treatments associated with pharmacology, 4 are treatments associated with cell therapy, and 1 is treatment associated with gene therapy. […] The efficacy of netarsudil, another ROCK inhibitor, in reducing corneal edema and central corneal thickness has been established in various trials. […] Cell therapy is effective in replacing damaged cells or tissues. It can be used alone or in combination with other treatment modalities. […] One pathogenesis pathway of FECD is the expansion of the CTG triplet in the TCF4 gene of chromosome 18. […] With more novel therapeutic approaches being developed in clinical trials, surgery may not remain the only standard for treating FECD. […] In general, nonsurgical measures should be used as first-line treatments for patients with mild FECD.

• #14 Redefining the Management of Fuchs Dystrophy | NYU Langone Health Physician Focus

  https://d1pv6k8x0ig2x3.cloudfront.net/redefining-the-management-of-fuchs-dystrophy/

  Interest in ROCK inhibitors for DSO has been growing since a 2017 study found that ripasudil, a ROCK inhibitor approved as a therapy for glaucoma in Japan, rescued two patients who had Fuchs dystrophy that was slow to clear. […] Additional research has shown that administration of topical ripasudil after DSO for Fuchs dystrophy results in earlier corneal restoration. […] Preliminary data from the phase 2 trial indicates improvements in the speed of healing and the final endothelial cell count, and a reduction in the failure rate for DSO, she says. […] The ongoing phase 3 trials will each evaluate an additional 100 participants.

• #15 Fuchs Endothelial Dystrophy Treatment & Management: Medical Care, Surgical Care, Diet

  https://emedicine.medscape.com/article/1193591-treatment

  Despite the lack of an accurate estimate of the prevalence of Fuchs endothelial dystrophy, it remains one of the most common indications for corneal transplantation, accounting for up to 29% of cases. […] Penetrating keratoplasty (PK) with or without cataract surgery had been the standard treatment for Fuchs endothelial dystrophy since the past 100 years. PK involves replacement of whole cornea, although only endothelial layer is defective. In last few years, major advances in this field have made replacement of endothelial layer possible without disturbing normal anterior structures of cornea using endothelial keratoplasty. Hence, the treatment of choice for FED has now become endothelial keratoplasty. […] Patients who undergo DSEK regain early and more superior visual acuity than patients who undergo PK due to lack of surface sutures.

• #16 An Alternative Treatment Option for Fuchs Corneal Dystrophy | CollaborativeEYE

  https://collaborativeeye.com/articles/2020-nov-dec/an-alternative-treatment-option-for-fuchs-corneal-dystrophy/

  Fuchs endothelial corneal dystrophy is the most common indication for keratoplasty in the United States. Endothelial keratoplasty (EK) is the current standard of care when the disease causes problematic visual symptoms. Descemet stripping endothelial keratoplasty (DSEK) is the version of EK most frequently performed, but Descemet membrane endothelial keratoplasty (DMEK) has been growing in popularity over the past 10 years due to its lower risk of rejection, faster recovery rate, better visual acuity outcomes, and lower induction of refractive error. […] Endothelial keratoplasty is the current standard of care when Fuchs endothelial corneal dystrophy causes problematic visual symptoms. […] Descemet stripping only (DSO) is a technique in which dysfunctional central corneal endothelium and Descemet membrane are removed, allowing healthier peripheral cells to migrate into the area.

• #17 What Are the Causes and Treatment for Fuchs’ Dystrophy?

  https://www.oclvision.com/knowledge-base/fuchs-dystrophy-causes-symptoms-and-treatment-options/

  Fuchs dystrophy is primarily caused by genetic mutations that affect the endothelial cells. Over time, these cells deteriorate faster than they should, leading to a reduction in their number and function. The condition can occur with no family history or may be inherited in some cases. […] In the early stages, treatment may involve using sodium chloride (salt) drops or ointments to draw excess fluid out of the cornea through osmosis. While this approach can delay the need for surgery, it does not cure Fuchs dystrophy. […] DSAEK (Descemets Stripping Automated Endothelial Keratoplasty): This procedure involves replacing the damaged endothelial layer with a thin layer of donor tissue. Performed through small incisions, DSAEK does not require stitches and involves positioning an air bubble to keep the graft in place. It is generally performed under local or general anaesthesia.

• #18 Fight Against Fuchs’ Dystrophy

  https://www.reviewofcontactlenses.com/article/fight-against-fuchs-dystrophy

  Advances in the genetic understanding of Fuchs dystrophy offer potential for gene therapy approaches aimed at reducing oxidative stress in endothelial cells. […] Several pharmacological agents targeting oxidative stress and cellular protection are being explored. Rho-kinase inhibitors have shown promise in promoting endothelial cell survival and reducing oxidative damage, which may enhance endothelial cell resilience and improve corneal clarity in patients with early-stage disease. […] DMEK is the preferred technique, replacing the diseased Descemets membrane and endothelium with a healthy donor graft. This method offers excellent visual outcomes and faster recovery with low rejection rates. DSAEK replaces a slightly thicker layer of the cornea and may be suitable for patients who aren’t ideal candidates for DMEK. Penetrating keratoplasty, a full-thickness corneal transplant, is rarely used for Fuchs dystrophy now, and comes with the longest recovery time. […] Treatment of Fuchs dystrophy. As a topical therapy, the complex could help protect corneal endothelial cells from oxidative damage, potentially slowing disease progression and reducing the need for corneal transplantation.

• #19 What Are the Causes and Treatment for Fuchs’ Dystrophy?

  https://www.oclvision.com/knowledge-base/fuchs-dystrophy-causes-symptoms-and-treatment-options/

  DMEK (Descemets Membrane Endothelial Keratoplasty): DMEK involves transplanting a sheet of pure endothelial cells, which is thinner and results in faster visual recovery compared to DSAEK. It also has a lower rejection rate. This procedure is highly specialised and may not be suitable for all individuals. […] Routine cataract surgery can sometimes accelerate corneal failure in individuals with Fuchs dystrophy. Careful surgical techniques, such as the soft shell technique or femtosecond laser cataract surgery, can minimise endothelial cell damage. In more advanced cases, cataract surgery may be combined with endothelial corneal transplantation.

• #20 Improved Treatment Technique for Fuchs’ Dystrophy Shows Promise

  https://news.cuanschutz.edu/ophthalmology/improved-treatment-technique-for-fuchs-dystrophy-shows-promise

  A newer technique for preparing corneal tissue for transplantation has been shown to be safe and effective, while providing a faster and smoother process than the traditional technique, according to researchers in the Department of Ophthalmology at University of Colorado School of Medicine. […] In recent years, partial-thickness corneal transplantation, or Descemets membrane endothelial keratoplasty (DMEK), has emerged as an effective treatment for patients with Fuchs dystrophy, a condition in which endothelial cells which line the inner layer of the cornea die off. […] It can really restore vision-related quality of life for patients who suffer from symptoms of Fuchs’ dystrophy, and our research shows we can do this more successfully now than ever before. […] The EndoGlide technique preserves the tissue in a tiny capsule and forceps are later used to pull the tissue into the eye during surgery; it performed comparably to the modified Jones tube technique, which has been used for DMEK surgery for many years. […] Christopher says this is the first direct comparison of Jones tube with the EndoGlide technique, which she says provides more control for the surgeon during the transplantation, leading to faster and more regulated tissue implantation and likely better long-term outcomes.

• #21 Therapeutic future of Fuchs endothelial corneal dystrophy: An ongoing way to explore

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11034696/

  To date, four surgical procedures are available, including penetrating keratoplasty (PKP), Descemet stripping endothelial keratoplasty (DSEK), Descemet membrane endothelial keratoplasty (DMEK), and Descemets stripping only (DSO). […] In the early 2000s, DSEK was performed as an improved procedure involving the removal of the dysfunctional corneal endothelium and transplantation of the donors partial thickness corneal graft consisting of the stroma, Descemets membrane, and functional endothelium, which can effectively prevent the cornea from accumulating excessive fluid. […] In recent years, DSO that features microscopic removal of centrally located dysfunctional endothelium has been developed, allowing the healthy endothelium of peripheral regions to migrate and repair defects. […] Currently, there are 24 trials on potential nonsurgical treatment, of which 19 are treatments associated with pharmacology, 4 are treatments associated with cell therapy, and 1 is treatment associated with gene therapy.

• #22 An Alternative Treatment Option for Fuchs Corneal Dystrophy | CollaborativeEYE

  https://collaborativeeye.com/articles/2020-nov-dec/an-alternative-treatment-option-for-fuchs-corneal-dystrophy/

  DSO uses no donor tissue, so there is no rejection risk and no need for long-term steroid use. […] Descemet stripping only (DSO), sometimes also called descemetorhexis without EK (DWEK), is a technique in which dysfunctional central corneal endothelium and Descemet membrane are removed, allowing healthier peripheral cells to migrate into the area. […] The adjunctive use of rho kinase (ROCK) inhibitors has been shown to speed the resolution of corneal edema after DSO. […] This case and the published literature support the use of DSO as an alternative to keratoplasty for selected patients with Fuchs corneal dystrophy. Appropriate surgical candidates have visually significant central corneal involvement with a relatively clear corneal periphery. […] DSO has demonstrated encouraging short-term outcomes for appropriate candidates, but long-term results are still being investigated.

• #23 ESCRS – Cell therapy for Fuchs’ dystrophy

  https://www.escrs.org/eurotimes/cell-therapy-for-fuchs-dystrophy

  Cell therapy for Fuchs dystrophy […] Injection of cultured human corneal epithelial cells (hCECs) supplemented with a rho-associated protein kinase (ROCK) inhibitor into the anterior chamber may offer a potentially groundbreaking new treatment for corneal endothelial dysfunction, according to Shigeru Kinoshita MD, PhD. […] This injected cell therapy holds a lot of promise for corneal endothelial cell disorders such as Fuchs endothelial corneal dystrophy. […] Our research has led us to understand that mature fully differentiated cells hold the key to a successful and safe treatment, he said. […] The results at 24 weeks showed that the injection therapy was effective, with repopulation of CECs on Descemets membrane and the posterior surface of the corneal stroma, attainment of normal corneal thickness and resolution of corneal epithelial oedema. […] The visual acuity of many of the patients also improved significantly and the corneas were still transparent up to two years after surgery, added Dr Kinoshita.

• #24 Fuchs Endothelial Dystrophy Treatment & Management: Medical Care, Surgical Care, Diet

  https://emedicine.medscape.com/article/1193591-treatment

  Most recent surgical technique being explored is of Descemetorrhexis without endothelial keratoplasty (DWEK), where only the central Descemet membrane with the diseased cells is stripped to promote corneal endothelial recovery by sliding of the remnant healthy endothelial cells from the periphery. This may or may not be augmented by using ROCK Inhibitors. […] Cataract surgery alone should be considered in patients with Fuchs endothelial dystrophy who have good endothelial cell density and corneal pachymetry less than 600-640 m. If precautions are taken to protect the endothelium during surgery with endothelium coating viscoelastics and controlled phacoemulsification parameters, most cases of confluent guttata, without corneal symptoms, do well with cataract and lens implant surgery alone.

• #25

  https://link.springer.com/article/10.1007/s40123-022-00637-1

  For patients with both a visually significant cataract and FECD, either a DMEK triple procedure or a staged procedure can be considered. The DMEK triple procedure provides rapid visual recovery and limits the risks and costs associated with two separate procedures. […] Surgical techniques to reduce EC loss such as tri-soft shell technique (TSST), Phaco-Chop technique and low-flow irrigation may be considered. […] For young patients with significant FECD, but without a cataract, phakic DMEK might be the preferred approach. […] While EK, with its excellent outcomes, remains the standard therapeutic option for patients with FECD, newer modalities are emerging and might be of interest in the near future. These therapies include DSO, rho-associated kinase inhibitor eye drops, synthetic DM transplant, injection cell therapy and gene therapy.

• #26 Fuchs’ Endothelial Dystrophy – EyeWiki

  https://eyewiki.org/Fuchs%E2%80%99_Endothelial_Dystrophy

  Since the early 2000s, there has been a trend to try and treat endothelial dystrophies by transplanting only the posterior, or endothelial, portion of the cornea. […] The next iteration of corneal transplant endothelial keratoplasty surgery is called DMEK. […] Also sometimes referred to as Descemet’s Stripping Only (DSO), DWEK is the latest surgical option for some patients with Fuchs’. […] Follow-up is essential after any form of corneal transplantation. Most patients will need to be seen often in the first few weeks after the surgery to ensure surgical success and monitor for infection. […] The prognosis for patients with Fuchs’ endothelial dystrophy is excellent. The various surgical treatments available today have very good success rates.

• #27 Tratamiento de la distrofia endotelial de Fuchs | PortalCLÍNIC

  https://www.clinicbarcelona.org/en/assistance/diseases/fuchs-dystrophy/treatment

  Eye drops or ointments that draw fluid from the cornea are used to relieve the symptoms of Fuchs dystrophy. If painful ulcers develop on the cornea, soft contact lenses or surgery may help reduce the pain. […] The only cure for Fuchs dystrophy is a corneal transplant. […] A newer type of endothelial keratoplasty (DSEK, DSAEK, or DMEK) is now the option of choice for people with Fuchs dystrophy. In this procedure, only the inner layers of the cornea are replaced, rather than all the layers. The patient recovers more quickly after this operation and has fewer complications. […] Full-thickness (PKP) and partial thickness (DSAEK, DMEK) transplants may be rejected, just like any other organ transplant. Corneal transplant rejection may occur years after the initial surgery. […] Long-term topical steroids are required to prevent rejection, but can induce cataracts and glaucoma. […] When undergoing a partial thickness transplant (DSAEK/DMEK), the most common initial complication is detachment of the endothelial cell membrane, which may require repeated air bubble placement or, more rarely, replacement of the endothelial transplant.

• #28 Corneal Transplantation for Fuchs’ Dystrophy

  https://www.allan.vu/procedures/corneal-transplantation-for-fuchs-dystrophy/

  If you experience Redness, Sensitivity to light, Visual blurring, or Pain (RSVP) at any stage after corneal transplantation, you should reattend via the Casualty Service without delay to make sure that you do not have a graft rejection episode. […] […] We normally recommend that you continue to review your eye health once a year under the care of your local optometrist after you have been discharged from routine postoperative clinic review at Moorfields.

• #29 Fuchs dystrophy – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/fuchs-dystrophy/diagnosis-treatment/drc-20352731

  Some nonsurgical treatments may help relieve symptoms of Fuchs dystrophy. If you have advanced disease, an eye care professional may suggest surgery. […] People who have surgery for advanced Fuchs dystrophy can have much better vision and remain symptom-free for years. Surgical options include: […] A variety of new treatments are being investigated that could change how Fuchs dystrophy is managed in the future. Since the discovery of the genetic mutation associated with most cases of Fuchs dystrophy, there is a better understanding of how the disease might develop. This offers the potential for nonsurgical therapies in the future. Various eye drop treatments are being developed and may enter clinical trials in the future. Novel surgical treatments also are being studied to find if they might be helpful.

• #30 Gene therapy could treat eye disease without surgery – Futurity

  https://www.futurity.org/fuchs-dystrophy-cornea-vision-gene-therapy-2608012-2/

  A new gene therapy could eventually provide an alternative treatment for Fuchs endothelial corneal dystrophy, a genetic eye disease that affects roughly one in 2,000 people globally. […] Currently, the only treatment is corneal transplant, a major surgery with associated risks and potential complications. […] When you do a transplant you make a huge difference for that person, but its a big deal for the patient with lots of visits, lots of eye drops, lots of co-pays, and if you had a medical treatment that did not require surgery, that would be great, says Bala Ambati, a research professor at the University of Oregon who led an eight-year study involving the development of the gene therapy. […] We confirmed that (in mice who received it), our treatment was able to rescue loss of corneal endothelial cells, reduce guttata-like structures, and preserve the corneal endothelial cell pump function.

• #31 Gene therapy could treat eye disease without surgery – Futurity

  https://www.futurity.org/fuchs-dystrophy-cornea-vision-gene-therapy-2608012-2/

  To test the safety of the treatment, the researchers examined surrounding tissues and other genes to make sure they had not been adversely affected by the therapy. Future research will examine the therapy in human donor corneas from eye banks and other animal models with an eye toward eventual clinical testing in humans.

• #32 Fuchs endothelial corneal dystrophy: for patients – Gene Vision

  https://gene.vision/knowledge-base/fuchs-endothelial-corneal-dystrophy-for-patients/

  One such therapy is called antisense RNA oligonucleotides (AONs). These are small molecules that are genetically engineered and subsequently injected into the eye to correct a disease-causing genetic mutation. […] The lack of suitable donor corneal grafts with healthy endothelium has made tissue-engineered endothelial grafts an attractive solution. […] Neuroprotective agents encompass a broad range of therapies that aim to promote cell survival and preserve function.

• #33 Fuchs Endothelial Dystrophy Treatment & Management: Medical Care, Surgical Care, Diet

  https://emedicine.medscape.com/article/1193591-treatment

  Some of the other future therapeutic options for Fuchs dystrophy (not yet in clinical practice but in experimental stages) include endothelial cell augmentation therapy which involves intracameral injection of cultured cells or Tissue Engineered Endothelial Keratoplasty. Work demonstrating the ability to culture human corneal endothelial cells ex vivo on several substrates, including denuded Descemet membrane and amniotic membrane, indicates promising areas of future research.

• #34 Hope for patients with Fuchs’ Endothelial Corneal Dystrophy: Innovations in treatment – Oligofastx

  https://oligofastx.com/hope-for-patients-with-fuchs-endothelial-corneal-dystrophy-innovations-in-treatment/

  In the case applied to the treatment proposed in OLIGOFASTX, the RNA oligonucleotide to be developed must be able to block miRNAs (small molecules that regulate a messenger RNA) related to the development of Fuchs Corneal Dystrophy disease. […] Cell therapy consists of introducing stem cells into the cornea to convert them into healthy endothelial cells and repair the existing damage; On the other hand, growth factors are substances that stimulate tissue growth and regeneration and are applied in the form of eye drops. Both techniques have been shown to be effective in improving vision and reducing symptoms of Fuchs’ Endothelial Corneal Dystrophy. […] In conclusion, Fuchs’ Endothelial Corneal Dystrophy is an eye disease that affects many people worldwide. Fortunately, treatment innovations are now being developed that offer an alternative to conventional corneal transplantation and are a step towards personalized and more effective medicine.

• #35 Fuchs Endothelial Dystrophy – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK545248/

  Fuchs endothelial dystrophy (FED) is a progressive, bilateral corneal disorder that leads to corneal endothelial dysfunction, fluid retention, and vision impairment. […] Management depends on disease severity, ranging from hypertonic saline and soft contact lenses for mild cases to endothelial keratoplasty for advanced stages with significant visual impairment. […] Advances in cell-based therapies and pharmacologic approaches are being explored to delay or prevent the need for corneal transplantation. […] Hypertonic saline serves as a first-line therapy for early-to-moderate FED by dehydrating the cornea and reducing morning swelling. […] Descemet membrane endothelial keratoplasty (DMEK) is the preferred surgical approach for significant corneal edema and visual impairment. […] Research into nontransplant alternatives for FED is ongoing, with several promising therapies emerging.

• #36 Fuchs Corneal Dystrophy & Scleral Lenses: Treatment Guide

  https://eyefreedom.com/fuchs-corneal-dystrophy-scleral-lenses/

  Currently, scleral lenses represent a safe, effective, and non-invasive alternative to traditional treatments. […] The future of Fuchs Corneal Dystrophy treatment is promising. With advancements in technology, we can expect even more personalized and effective treatment methods. […] If youre suffering from Fuchs Corneal Dystrophy, consider consulting with a qualified professional like Dr. Boshnick to see if scleral lenses could be a good option for you.

• #37 Managing Fuchs Dystrophy: From Diagnosis To Treatment And Beyond

  https://www.my-iclinic.co.uk/articles/managing-fuchs-dystrophy-from-diagnosis-to-treatment

  Following treatment, ongoing monitoring and management of Fuchs dystrophy are essential to ensure optimal outcomes and detect any potential complications or recurrence of symptoms. […] These treatment options may vary depending on the severity of the condition, the patient’s overall health and medical history, and their individual preferences and goals. […] Emerging therapies targeting the underlying pathophysiology of Fuchs dystrophy, such as corneal endothelial cell regeneration and modulation of cellular senescence, offer potential avenues for disease modification and tissue regeneration. […] Minimally invasive techniques, such as Descemet’s membrane endothelial keratoplasty (DMEK), offer improved visual outcomes, faster recovery times, and reduced risk of complications compared to traditional penetrating keratoplasty.

• #38 Hope for patients with Fuchs’ Endothelial Corneal Dystrophy: Innovations in treatment – Oligofastx

  https://oligofastx.com/hope-for-patients-with-fuchs-endothelial-corneal-dystrophy-innovations-in-treatment/

  The conventional treatment for Fuchs’ Endothelial Corneal Dystrophy is corneal transplantation, but this procedure has limitations. […] Fortunately, there are innovations in treatment that offer hope for patients with Fuchs’ Endothelial Corneal Dystrophy. Cell therapy and tissue engineering are in development and may provide an alternative to corneal transplants. In addition, gene therapy is also being investigated as a possible cure for this disease. […] These treatment innovations offer hope to patients and can significantly improve their quality of life. […] Fortunately, thanks to new innovations in treatment, such as the development of specific oligonucleotides or cell therapy with stem cells and growth factors, new hope has opened up for patients suffering from this disease. […] The OLIGOFASTX consortium has on its radar the development of oligonucleotide-based therapies to improve the quality of life of patients affected by this rare disease.

• #39 Fuchs’ Dystrophy – Symptoms, Causes & Treatment

  https://www.visioncenter.org/conditions/fuchs-dystrophy/

  While there is no cure for Fuchs dystrophy, treatment options are available to decrease swelling and improve vision. […] A licensed ophthalmologist will create a treatment plan based on the severity of symptoms and how the disease affects the corneal endothelium. […] Early-stage treatment may include nonsurgical interventions, such as: medicated eye drops or ointment to decrease swelling, using a hair dryer at arm’s length to dry the cornea surface (be careful to use a very low heat or cool setting), therapeutic soft contact lenses, sodium chloride eye drops. […] In late-stage Fuchs’ dystrophy, vision problems may affect the quality of life, and a corneal transplant may be needed. […] There are two types of corneal transplants, including: a full-thickness corneal transplant replaces the center of your cornea with a healthy donor, endothelial keratoplasty (EK) transplants healthy endothelial cells into the cornea.

• #40 Fuchs’ Dystrophy – Symptoms, Causes & Treatment

  https://www.visioncenter.org/conditions/fuchs-dystrophy/

  Complications from treating Fuchs dystrophy can include: cataracts or glaucoma from long-term use of topical steroids, astigmatism or refractive errors, the corneal transplant could lead to bleeding, tissue rejection, and infection. […] While there is no cure for Fuchs’ dystrophy, early detection can prevent vision problems with nonsurgical treatment, including medicated eye drops and ointment. […] A corneal transplant may be necessary if vision changes affect the quality of life.

• #41 Redefining the Management of Fuchs Dystrophy | NYU Langone Health Physician Focus

  https://d1pv6k8x0ig2x3.cloudfront.net/redefining-the-management-of-fuchs-dystrophy/

  Since its introduction in the United States in the mid-2010s, Descemet stripping only (DSO) has revolutionized the surgical management of Fuchs dystrophy. […] Further advancing the treatment, Dr. Colby currently serves as the U.S. chair for two ongoing phase 3 trials evaluating whether a topical Rho-associated protein kinase (ROCK) inhibitor administered in the weeks following DSO surgery or simultaneous cataract and DSO surgery may enhance the efficacy of the procedures for treating Fuchs dystrophy. […] If successful, the trials may lead to FDA approval of topical ROCK inhibitor administration as an adjuvant therapy to DSO. […] Adjuvant ROCK inhibitor eye drop use could become standard practice following DSO cases in the early postoperative period. […] New evidence suggests these agents can enhance final endothelial cell count after a tissue corneal transplantation as well.

• #42 Fuchs’ Corneal Endothelial Dystrophy Care and Treatment in NYC

  https://lasiknyc.com/fuchs-dystrophy

  Ideally, it is better to catch Fuchs early so treatment can be done before any scarring and permanent damage to the cornea occurs. Your ophthalmologist can screen for Fuchs dystrophy as part of an annual eye health exam. […] For many with Fuchs Dystrophy, special considerations need to be undertaken when it comes time for cataract surgery. In general, cataract surgery often exacerbates Fuchs dystrophy; sometimes to the point where the cornea may not fully recovery from the stress of cataract surgery. Other times, cataract surgery wont provide adequate improvement in vision because Fuchs dystrophy is also impacting quality of vision. For these reasons, many ophthalmologists will recommend undergoing an endothelial keratoplasty surgery (DSAEK or DMEK) at the same time as cataract surgery. […] Your ophthalmologist will recommend a treatment plan tailored to your needs based on a thorough evaluation.

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