Fuchs Dystrophy and Cataract: Diagnosis, Evaluation and Treatment

Muhammad Ali, Kyongjin Cho, Divya Srikumaran

Research output: Contribution to journalReview articlepeer-review


Corneal endothelium plays an important role in maintaining hydration homeostasis and clarity of the cornea. Fuchs endothelial corneal dystrophy (FECD) affects the corneal endothelium resulting in edema and characteristic excrescences on the Descemet’s membrane known as corneal guttae. Descemet membrane endothelial keratoplasty (DMEK) has evolved to become the standard of care for patients with FECD with excellent visual acuity outcomes. Patients with FECD may have coexisting cataracts and therefore may require a cataract surgery, which increases the risk of corneal decompensation. The presence of FECD may not only influence the choice of intraocular lens but vision outcomes can also be affected by the corneal condition. The ability to combine the surgeries further raises important considerations regarding the timing and sequence of DMEK and cataract extraction for patients with FECD. This review provides a guide for corneal surgeons in choosing between endothelial keratoplasty and cataract surgery—alone, in combination or sequential—in their management of patients with FECD.

Original languageEnglish (US)
Pages (from-to)691-704
Number of pages14
JournalOphthalmology and Therapy
Issue number2
StatePublished - Apr 2023


  • Descemet membrane endothelial keratoplasty
  • Fuchs endothelial dystrophy
  • Triple procedure

ASJC Scopus subject areas

  • Ophthalmology


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