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Invited Commentary
February 18, 2021

Toward a Paradigm Shift in the Therapeutic Approach to Fuchs Endothelial Corneal Dystrophy

Author Affiliations
  • 1Netherlands Institute for Innovative Ocular Surgery, Rotterdam, the Netherlands
  • 2Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore
  • 3Melles Cornea Clinic Rotterdam, Rotterdam, the Netherlands
JAMA Ophthalmol. 2021;139(4):431-432. doi:10.1001/jamaophthalmol.2020.7041

Over the past decade, Descemet membrane endothelial keratoplasty (DMEK) has become the standard for the treatment of endothelial diseases, with Fuchs endothelial corneal dystrophy (FECD) being the most common indication.1 Descemet membrane endothelial keratoplasty in eyes with FECD usually results in successful clinical outcomes with low postoperative complication rates.2 Because of the fast and reliable visual rehabilitation after DMEK, the visual threshold for undergoing corneal transplantation has decreased and DMEK is performed in a wide range of FECD stages.3 Currently, surgical indications are based mainly on best-corrected visual acuity, central corneal thickness, and patients’ subjective symptoms.

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