Fuchs’ endothelial dystrophy (FED) causes loss of corneal clarity bilaterally and is the most common indication for corneal transplantation. Not all patients with FED are symptomatic; however, more advanced disease results in decreased vision and pain. Cataract surgery may hasten progression of this disease.
Fuchs’ endothelial dystrophy (FED) is a genetic condition that manifests bilaterally and affects the innermost layer of the cornea. It causes a reduction in the number and function of the endothelial cells. Endothelial cells, which lie on their basement membrane (Descemet’s membrane) pump fluid out of the cornea and into the anterior chamber. This process is critical to maintain deturgescence and clarity of the cornea, which has a tendency to imbibe fluid. FED is the most common indication for corneal transplantation worldwide, with an incidence of around 4% and a slight female preponderance. The pattern of inheritance is most commonly sporadic, although autosomal dominant variants do occur.1,2