Cataract surgery fuchs dystrophy is often referred to as Feothelial dystrophy (FED) as an article writing material to understand progressive diseases affecting the corneal endothelium
Cataract Surgery Fuchs Dystrophy
Cataract is the leading cause of blindness in the world. Cataracts occur when the natural lens is foggy in your eyes. Once the cataract is formed, the lens becomes more opaque because the cataract interferes with the light coming into your retina. Cataracts are a natural process. In the Indonesian dictionary, cataracts is a disease in the eye that cause the lens of the eye becomes turbid. With the opacification of the lens inside the eye, cataracts can cause decreased vision. The eyepiece is responsible for clearly focusing the object, if the lens is turbid, then the vision that was obvious becomes blurred and difficult. You can have cataracts in one eye or both. Cataracts can occur at any age, but in general cataracts are considered part of the aging process. The incidence of cataracts is even higher in those aged over 75 years. However, the good news is that cataract treatments are very successful with the latest surgical techniques.
Cataract surgery fuchs dystrophy often referred to as Feothelial dystrophy (FED)
FED was first described in 1910 by Vienna ophthalmologist Ernst Fuchs, who reported epithelial and stromal edema in a group of 13 patients, which he described as’ dystrophia epithelialis corneae ” now known as FED. Feothelial dystrophy (FED) is a progressive disease that affects the corneal endothelium, which can significantly affect vision, and may occur simultaneously in cataract patients. There are three stages of FED, namely stromal and epithelial edema, and identify gutta as an early sign of FED. Gutta usually begins to center and then extends to include the peripheral cornea. When endothelial cells undergo apoptosis, the remaining cells stretch to cover areas of non-cells that produce varying endothelial cell size (polymegathism) and varied cell morphology (pleomorphism). This process is at least to the second stage, the stromal edema, which arises from the endothelium’s ability to pump out fluid from the stroma resulting in reduced visual symptoms. Epithelial edema is the result of anterior movement of fluid in the stroma driven by intraocular pressure. As disease develops, there is an increase in fluid accumulation and blisters and bullae that can cause pain as it erupts, forming epithelial erosion. The third stage of advanced FED is characterized by sub-epithelial connective scarring and peripheral cornea neovascularization. Therefore, FED is a Descemet membrane disease and endothelial cells, while changes in the corneal and epithelial stroma are secondary to endothelial dysfunction.
FED is a progressive bilateral primary disorder of the corneal endothelium. The FED process may occur sporadically or inherited. In the hereditary case, inheritance proved autosomal dominant with 30% of patients known to have a family history of the disease. This happens because the density of endothelial cells is the highest at birth and decreases non-linearly in the first few years due to rapid corneal growth. Endothelial cell density is a measure of endothelial function, although it is not always correlated with corneal thickness.
Cataract surgery in the Fuchs dystrophy setting can be done successfully, especially when the surgeon is aware of preoperative and intraoperative factors that affect the number of functioning endothelial cells. All patients should be aware of the progressive nature of the disease and the possibility of keratoplasty at some point in their lives. Routine cataract surgery has been shown to induce endothelial cell density loss of 6.3% – 12.8% due to ultrasound strength during phacoemulsification. However, in patients with endothelial disease, greater cell loss may lead to ‘pseudophakic bullous keratopathy’ (PBK), which is a complication of cataract surgery especially in patients with FED. If there is FED awareness, surgeon skills, surgical skills and techniques can minimize the loss of endothelial cell density.
As reference cataract surgery with fuchs dystrophy please read on Wikipedia about the Fuchs’ dystrophy (FED)