Introduction:
Fuchs endothelial dystrophy (FECD) is a corneal endothelial disease characterized clinically by corneal endothelial dysfunction and guttae excrescences on the posterior corneal surface. FECD is characterized by dysfunctional corneal endothelium that deposits a posterior collagenous layer between the Descemet's membrane and the endothelial monolayer. In a healthy cornea, stromal hydration is maintained by the delicate balance between passive, inward diffusion of aqueous and active, outward transport of excess fluids by endothelium. FECD leads to impairment of the endothelial pump mechanism, resulting in corneal edema and its clinical sequelae.
Clinical manifestations of FECD may range from mild to severe. In mild FECD, patients are asymptomatic with no impairment of vision, and a diagnosis is most commonly made by incidental observations of corneal guttae during routine ophthalmologic examinations. In severe FECD, marked dysfunction of central endothelium with dense accumulations of central guttae, result in significant corneal edema, scarring and impairment of visual function.