Corneal hydration control in Fuchs' dystrophy

Abstract

Corneal hydration control was tested in 22 patients with Fuchs' dystrophy, and eight subjects of similar age without the disease, by measuring the corneal thickness recovery from swelling induced by hypoxia or following overnight sleep. Measurement precision was enhanced by using a modified optical pachometer and conducting two test procedures which were analyzed by a coupled exponential model. We have identified three parameters of the recovery from corneal swelling which may be used to describe hydration control: percent recovery per hour (PRPH) (mean 25.4% for Fuchs' and 34.2% for normals), time for 95% of corneal thickness recovery (mean 10.2 hr for Fuchs' and 7.1 hr for normals), and the open-eye steady-state thickness (mean 562 microns for Fuchs' and 537 microns for normals.) A PRPH of 17.1%/hr was identified as the minimum below which the cornea could not regain its open-eye steady state during the entire day and approaches decompensation. Our test procedure quantifies the corneal hydration control mechanism and may provide a test of endothelial function which can be used to monitor the progression of Fuchs' disease and guide decisions related to corneal surgery.