Fuchs’ endothelial corneal dystrophy
ICD-10 H18.5 · ICD-11 9A70.0

Fuchs’ Endothelial Corneal Dystrophy When Nonsurgical Corneal Dehydration Has Not Reduced Epithelial Edema

In Fuchs’ endothelial corneal dystrophy, a palliative nonsurgical approach to managing corneal epithelial edema is often used as an initial measure. When that approach does not achieve its goal, a different management pathway is indicated.

Previous Treatment — Insufficient Response

Prior therapy: palliative nonsurgical corneal dehydration — including the use of a hair dryer or topical hypertonic sodium chloride (eye drops or ointment).

Goal not reached: reduction of corneal epithelial edema. Failure to achieve this outcome is the indication for escalation to the next treatment line.

Next-Line Approach

At this stage, the structured protocol describes a surgical endothelial keratoplasty approach. The specific procedural options and the criteria for selecting among them are detailed in the full regimen.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1146/annurev-vision-091718-014852

For several decades, penetrating keratoplasty has been the only definitive treatment option for FECD.

However, the development of minimally invasive lamellar endothelial keratoplasty (EK) procedures has provided key benefits such as better and faster visual recovery, a tectonically stronger globe, decreased risk of bleeding and infection, less astigmatism, less corneal denervation, and lower rejection rates.

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