Case Report: Fuchs Dystrophy after Corneal Transplantation

Abstract

Fuchs Endothelial Corneal Dystrophy (FECD) consists of a progressive loss of corneal endothelial cells, with subsequent development of subepithelial connective tissue objectively leading to severely impaired vision. Generally, the time interval between the asymptomatic stage, with only the presence of guttates on biomicroscopy, to the most advanced stage, associated with chronic edema that causes corneal opacity and scarring, can vary between 20 to 30 years of evolution. Eye bank donor cornea selection includes FECD screening based on macroscopic and specular microscopyfindings. However, this screening may not be sensible enough to detect the disease in its earlier stages. We report 2 cases of FECD in corneal grafts in which the donor corneas eye bank screening was negative for FECD. These two cases highlight the importance of a meticulous evaluation of donor corneas candidates for corneal transplant. Traditional evaluation was not sensible enough to detect early phases of FECD. Additional screening methods, such as genetic testing, would improve the accuracy to detect FECD and other diseases present in donor corneas used in corneal transplants.