Fuchs' endothelial corneal dystrophy (FECD) is characterized by which histopathological finding on Descemet's membrane and what is the current preferred surgical treatment?
- A Abnormal thickening of Descemet's membrane with guttata (excrescences) and progressive endothelial cell loss; Descemet membrane endothelial keratoplasty (DMEK) ✓
- B Thinning of Descemet's membrane with endothelial cell proliferation; penetrating keratoplasty
- C Subepithelial bullae formation due to IgG deposits; Bowman layer transplantation
- D Band keratopathy with calcium deposits; EDTA chelation
Explanation
Fuchs' dystrophy shows progressive corneal guttata — mushroom-shaped excrescences of abnormal collagenous Descemet's material secreted by abnormal endothelial cells, visible as beaten-metal or orange-peel appearance on specular microscopy. Progressive endothelial cell loss leads to bullous keratopathy. Current gold-standard surgical treatment is DMEK (Descemet Membrane Endothelial Keratoplasty), which transplants only the Descemet's membrane and endothelium, offering faster visual recovery (20/25 or better in >80%), less graft rejection, and better tectonic integrity than full-thickness penetrating keratoplasty.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.