Decreased corneal sensitivity and abnormal corneal nerves in Fuchs endothelial dystrophy

Area of Science:

• Ophthalmology
• Corneal Science
• Nerve Physiology

Background:

• Fuchs endothelial dystrophy affects corneal clarity and function.
• Corneal sensitivity and nerve structure are crucial for ocular health.
• Keratoplasty aims to restore corneal function but may impact nerve integrity.

Purpose of the Study:

• To quantify corneal sensitivity in Fuchs dystrophy patients.
• To assess changes in corneal nerves before and after keratoplasty for Fuchs dystrophy.
• To compare corneal sensitivity and nerve status with age-matched controls.

Main Methods:

• Central corneal sensitivity measured using Cochet-Bonnet esthesiometer.
• Corneal nerves examined via confocal microscopy.
• Evaluations performed pre- and post-keratoplasty (including DSEK) and in controls.

Main Results:

• Corneal sensitivity was significantly lower in Fuchs dystrophy patients compared to controls.
• Sensitivity decreased post-keratoplasty, gradually returning to near preoperative levels by 24 months but remaining subnormal.
• Confocal microscopy revealed sparse and abnormally branched subbasal nerves, correlating with reduced sensitivity.

Conclusions:

• Corneal sensitivity is diminished in Fuchs dystrophy and remains subnormal long-term after endothelial keratoplasty.
• Persistent loss and abnormal morphology of corneal nerves contribute to reduced sensitivity.
• These findings highlight the impact of Fuchs dystrophy and keratoplasty on corneal innervation.