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Corneal sensitivity in Fuchs’ dystrophy remains low after keratoplasty
Central corneal sensitivity remained below normal in patients with Fuchs’ endothelial dystrophy 3 years after endothelial keratoplasty, a study found.
“Corneal stromal nerves were abnormally tortuous in Fuchs’ dystrophy, and this appearance persisted through 3 years after DSEK,” the study authors said. “Whether stromal nerve tortuosity is the result of damage to the distal subbasal nerves and epithelial nerve endings, or is a direct effect of chronic stromal edema, is unknown.”
The authors analyzed 69 eyes before and after various keratoplasty procedures for Fuchs’ dystrophy and compared them with 35 age-matched normal corneas. Eyes underwent penetrating keratoplasty, Descemet’s stripping endothelial keratoplasty or deep lamellar endothelial keratoplasty. In 42 eyes that underwent DSEK, confocal microscopy was used to examine corneal nerves.
At baseline, corneal sensitivity was 4.61 ± 1.42 cm in the eyes with Fuchs’ dystrophy and 5.74 ± 0.48 cm in the age-matched controls (P < .001).
At 1 month after DSEK, sensitivity was 2.98 ± 2.01 cm (P < .001). At 24 months, it was 4.5 ± 1.63 cm, and at 36 months, it was 4.5 ± 1.48, which was still lower than control corneas (P < .001).
At 36 months after PK, sensitivity was 1.46 ± 1.98 cm, below preop levels (P < .001).