What are the latest advances in Fuchs dystrophy?

Conservative therapy for early Fuchs’ dystrophy still involves the use of 5% sodium chloride solution throughout the day (e.g., Muro 128 [Bausch + Lomb] every two to six hours) and 5% sodium chloride ointment at bedtime. For more symptomatic cases, NSAIDs such as ketorolac, bromfenac or nepafenac may be helpful in managing patients with painful bullae. It is important to note, however, that NSAIDs merely provide analgesia. Additionally, corneal melts have been associated with excessive and prolonged use of certain NSAIDs, so they should be dosed judiciously.4

Bandage soft contact lenses also may serve to alleviate patient discomfort in cases of advanced Fuchs’ dystrophy. A flatly fit, high water content lens helps to mask the irregular astigmatism and diminish pain associated with epithelial bullae.2,5 SiHi lenses also have been used in this capacity with some success.6

Prior to 2000, penetrating keratoplasty remained the last recourse for most patients with advanced Fuchs’ dystrophy. However, with the advent of deep lamellar keratoplasty, patients now have a surgical option that is less invasive and painful, necessitates a shorter recovery time, and results in fewer instances of rejection.7

DMEK surgery is the Gold Standard for treatment of Fuch's. Gerrit Melles, MD, PhD developed it and continues to improve the procedure. I have had DMEK in both eyes over a period of 44 days and am extremely satisfied...okay...'giddy' with the results!