Cornea guttata and Fuchs dystrophy

The human cornea is a transparent tissue consisting of five layers that are 550 microns thick (0.55mm), which closes the eyball, behind the iris and the pupil. It has multiple functions: as the eye's transparent window it allows images to pass through and acts as a powerful lens to focus on the retina. It corresponds to the first lens of the eye's optical system.

Cornea guttata and Fuchs dystrophy are two conditions of the most profound layer of the cornea; the endothelium, the cells of which are reponsible for corneal transparency. In the so-called cornea guttata the cells of the endothelium are destroyed and deposits or drops appear their the place, which, over time, make the cornea swell and lose its transparency and opacify. We then talk about Fuchs dystrophy, which is a consequence of developing cornea guttata.

• Corneal thickening with loss of transparency and oedema.
• Pain, in some cases. 
• Compromised vision in the most severe cases, with a loss of acuity in the perception of images, which is more prevalent in the morning. 

In many cases, cornea guttata is a coincidental finding, however, Fuchs dystrophy can be inherited from our parents or come about spontaneously. A full eye exam is recommended on an annual basis. In addition, special care is required in the planning of cataract surgery should these two pathologies exist at the same time. 

The symptoms can be treated with an anti-oedema ointment or eyedrops, but when the disease has advanced, the solution is a posterior lamellar transplant in which a healthy donor endothelium is transplanted (DMEK or DSAEK). Thus, a new cellular layer is placed in the posterior part of the cornea, which, when it performs its biological functions properly, restores transparency to the corneal tissue.