Fuchs Dystrophy

corneaThe normal cornea has vital cells on it's inner surface, shown by the black dotted line on the image on the right. Fuchs Endothelial Dystrophy refers to a genetically predetermined failure of these vital cells on the inside of the cornea. These cells do not replicate, and their failure leads to gradual loss of vision. There is no prevention for this condition, and no identifiable cause. Early diagnosis and monitoring allow patients to plan for changes in vision. Eventually, when vision deteriorates, Endothelial Transplantation is required, and this cures the corneal problems. Prior to Endothelial Transplantation, full thickness transplantation of the cornea was the only treatment option.

fedWhat causes vision loss in Fuchs Dystrophy

The cells on the inner cornea keep the cornea clear. When the cells fail, their number is significantly reduced and the cornea then swells and becomes cloudy, causing vision to decline. Pain and inflammation may develop, and the eye may develop sight threatening infections or glaucoma. The image on the right shows a swollen cloudy cornea (shown in pale green), with marked reduction in number of vital cells on the inner cornea (shown as black dotted line). Similar changes may also occur in some patients after cataract surgery, and this is called Pseudophakic Bullous Keratopathy (PBK)

What is Endothelial Transplantation?

Endothelial transplantation is a more advanced small incision keyhole procedure performed by Dr Anthony Maloof to transplant the a layer of cells obtained from donor human cornea onto inner cornea. This restores the cornea with healthy vital cells, and allows a relatively rapid return of vision.


Endothelial transplantation returns vision rapidly from 3 days to 1 month on average. This surgery does not induce warpage (astigmatism) of the cornea nor significantly weaken the eye as occurs with full thickness transplantation. The eye is stronger, and vision may return to 20/20 if the eye is healthy.

Dr Anthony Maloof introduced DSEK and then Endothelial Transplantation to Australia in 2006, and was the first to perform this type of layered transplantation in Australia.



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