Fuchs' endothelial corneal dystrophy (FECD) is characterized by endothelial guttae and progressive endothelial cell loss. The modern surgical treatment that selectively replaces the diseased endothelium is:

• A Penetrating keratoplasty (PKP)
• B Deep anterior lamellar keratoplasty (DALK)
• C Descemet membrane endothelial keratoplasty (DMEK) ✓
• D Conjunctival autograft

Explanation

FECD affects only the endothelium and Descemet's membrane; the stroma and epithelium are normal. DMEK (Descemet Membrane Endothelial Keratoplasty) selectively replaces only the diseased Descemet's membrane and endothelium with a donor tissue ~15 μm thick, preserving all host corneal stroma. This provides faster visual rehabilitation, superior optical quality, and lower rejection risk compared to DSEK/DSAEK (which includes posterior stroma), and far superior outcomes to PKP (full-thickness). DALK replaces the stroma but spares the endothelium — the opposite of what FECD requires.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.