Primary cornea guttata in Japanese patients with cataract: specular microscopic observations

To evaluate the prevalence of primary cornea guttata (the first stage of Fuchs' dystrophy) in Japanese patients, we retrospectively examined specular photomicrographs of patients' cataracts. Primary cornea guttata in subjects without corneal inflammation was defined as dark areas, seen on specular microscopy, and irregular refractile dots, observed with slit-lamp microscopy. In 107 patients with cataract (211 eyes), primary cornea guttata was found in 4 women (7 eyes), aged 56 to 76 years. One eye of patient 4, who had a history of angle-closure glaucoma and laser iridotomy, had bullous keratopathy. We also examined 16 relatives (32 eyes) of these 4 affected patients (probands), and found 2 women (4 eyes) with primary cornea guttata. No hereditary influence was identified. We believe that the incidence of primary cornea guttata (Fuchs' dystrophy) in Japan is lower than that in North America.