Demographic profile and clinical course of Fuchs endothelial corneal dystrophy in Mexican patients

Int Ophthalmol. 2022 Apr;42(4):1299-1309. doi: 10.1007/s10792-021-02117-0. Epub 2021 Nov 7.

Abstract

Purpose: To describe the demographic characteristics and clinical course of Fuchs endothelial corneal dystrophy (FECD) in a Mexican-mestizo population.

Methods: A retrospective observational and longitudinal study was performed in consecutive patients with the clinical diagnosis of Fuchs endothelial corneal dystrophy seen at our institution. Initial and last follow-up best-corrected visual acuity, slit-lamp findings, and specular microscopy endothelial morphometric parameters were analyzed.

Results: One hundred and two eyes belonging to 51 patients were included in the analysis. Median age at the time of diagnosis was 69 years (range, 25-87 years) with a female-to-male ratio of 3.3:1. Visual loss (40%) followed by glare (13.3%) and fluctuating matutine vision loss (13.3%) was the most common complaints at presentation. Regarding FECD staging, 65 (63.7%) were classified as stage-I FECD, 21 (20.6%) stage-II, and 15 (14.7%) as stage-III. A high percentage of eyes (44.1%) presented visual impairment ( ≤ 20/50) at presentation, and the presence of isolated corneal guttata was the most common stage of presentation (64%) at slit-lamp examination. While fifty-nine (57.8%) eyes did not require any medical or surgical management, 17 (16.7%) eyes were managed with hypertonic saline eyedrops alone or in combination with bandage contact lens, and 18 (17.6%) required corneal transplantation. Penetrating keratoplasty alone (8 eyes, 44.4%), or in combination with cataract extraction and intraocular lens implantation (3 eyes, 16.7%), was the most frequent surgical technique performed.

Conclusion: Demographical characteristics of Fuchs dystrophy regarding age at presentation, gender distribution, and clinical stage at the time of diagnosis did not differ significantly from other international reports. Almost 20% of these patients will require keratoplasty during the disease, emphasizing the need for safer and more reproducible keratoplasty techniques.

Keywords: Corneal endothelium; Fuchs endothelial corneal dystrophy; Guttae; Keratoplasty; Specular microscopy.

Publication types

  • Observational Study

MeSH terms

  • Demography
  • Descemet Stripping Endothelial Keratoplasty*
  • Endothelium, Corneal
  • Female
  • Fuchs' Endothelial Dystrophy* / diagnosis
  • Fuchs' Endothelial Dystrophy* / epidemiology
  • Fuchs' Endothelial Dystrophy* / surgery
  • Humans
  • Longitudinal Studies
  • Male
  • Retrospective Studies
  • Vision Disorders
  • Visual Acuity