title: Long-term evaluation of endothelial cell changes in Fuchs corneal dystrophy: the influence of phacoemulsification and penetrating keratoplasty.
abstract: OBJECTIVE
  To evaluate the natural course of the long-term endothelial cell changes in Fuchs corneal dystrophy (FCD) patients and investigate the effects of phacoemulsification on the annual rate of change in endothelial indices in FCD patients.
  
  
  METHODS
  Thirty-four patients diagnosed with FCD at Seoul National University Hospital from 1994 to 2010 were retrospectively reviewed. Sixteen patients who had been followed up for more than 1 year were selected and classified into 3 groups: group A, patients with no ocular surgery; group B, patients who had undergone phacoemulsification only; and group C, patients who had undergone penetrating keratoplasty with cataract surgery. Endothelial cell density, polymegethism, pleomorphism, and pachymetry were measured and the exponential rates of endothelial cell and pachymetry change were analyzed.
  
  
  RESULTS
  A non-linear mixed model of non-operated FCD patients showed that only pachymetric data tended to increase with statistical significance (p = 0.001) with a mean follow-up period of 4.15 years. Using an exponential regression analysis fitting curve, the mean rates of annual endothelial cell loss were 0.82%/yr, 20.39%/yr, and 29.27%/yr in groups A, B, and C respectively, and statistical significance was seen only in group C (p < 0.05).
  
  
  CONCLUSIONS
  Retrospective long-term follow-up data showed that changes in endothelial density did not significantly decrease over at least 4 years in middle-aged FCD patients. The changes in pachymetric corneal thickness appeared to increase over the same period. Considering that no exponential changes were aggravated after performing cataract surgery alone, cataract surgery would be a preferable option in FCD patients compared to an approach of "wait-and-do" penetrating keratoplasty combined with cataract surgery.
authors: Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. ; Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea.
authors: Yong Woo
authors: YW
authors: Kim
authors: Mee Kum
authors: MK
authors: Kim
authors: Won Ryang
authors: WR
authors: Wee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000150:complications* / Q000473:pathology; D002452:Cell Count; D063171:Corneal Pachymetry; D018450:Disease Progression; D004728:Endothelium, Corneal / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D005642:Fuchs' Endothelial Dystrophy / Q000150:complications / Q000473:pathology* / Q000601:surgery; D006801:Humans; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011184:Postoperative Period; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult
keywords: Endothelial cell density; Fuchs corneal dystrophy; Pachymetry; Phacoemulsification