[Endothelial corneal dystrophies (CD) - diagnosis and therapy]

Clinical, histological, and genetic definitions of the four endothelial corneal dystrophies (CD) are presented. Of these, Fuchs endothelial CD is one of the most common corneal dystrophies in Europe and North America. Beside bullous keratopathy, Fuchs CD represents the most frequent indication for posterior lamellar keratoplasty that is currently termed "Descemet stripping endothelial keratoplasty" or abbreviated, "DSEK". A comparison of the advantages and disadvantages of DSEK against the established Excimer laser-assisted penetrating keratoplasty is given. The often simultaneous occurrence of Fuchs CD and cataract should be treated by phacoemulsification and implantation of a posterior chamber lens before the keratoplasty. There are many comparative studies concerning the different surgical techniques to evaluate their intra- and postoperative advantages and results. Many years will be necessary before we can get a scientific and definitive assessment.