Fuchs endothelial corneal dystrophy and small eyes

  • Nicole Shao-Yuen Lim Sydney Eye Hospital
  • John Males
DOI: https://doi.org/10.35119/asjoo.v17i1.445
Keywords: anterior chamber depth, axial length, Fuchs endothelial corneal dystrophy, hypermetropia, hyperopia

Abstract

Aim: To determine whether there is an association between Fuchs endothelial corneal dystrophy (FECD) and shorter axial length (AL), shallower anterior chamber depth (ACD) and higher spherical equivalent (SE). In addition, to evaluate whether there is a correlation between AL and severity of corneal decompensation in FECD, using corneal thickness as a proxy.

Design: Retrospective cohort study.

Methods: This was a single-centre study conducted in a cornea clinic in Sydney, Australia. Detailed clinical measurements of 91 eyes of 50 FECD patients were compared with 110 eyes of 55 controls. Main outcome measures included AL, ACD and SE. Other outcome measures included central corneal thickness, visual acuity, intraocular pressure and keratometry.

Results: Mean AL of FECD patients was 23.6 mm (standard deviation [SD] ±0.9 mm), compared with 24.7 mm (SD ±1.8 mm) for controls (1.1 mm difference [95% confidence interval [CI] 0.5-1.6], p < 0.001, independent sample t-test); corresponding means for ACD were 3.0 and 3.3 mm (0.32 mm difference [95%CI 0.2-0.5], p < 0.001, independent t-test). Eleven out of the 22 FECD patients with available refraction data had hypermetropic refraction compared with 16 out of 36 controls (p = 0.68, chi-squared test). The mean SE of FECD patients (+0.10D) was higher than controls (−1.33D) (1.4D difference [0.1-2.8], p = 0.04, independent t-test). No statistically significant correlation was found between AL and corneal thickness (p = 0.28, linear regression).

Conclusion: In this retrospective cohort study, a strong association was established between FECD and small eyes, with shorter AL and shallower ACD, compared with controls. These results have important implications for surgical planning, as shorter AL and ACD in FECD patients likely contribute to their high risk of corneal decompensation following cataract surgery.

Author Biography

John Males

Dr John Males, Principal surgeon at Sydney Cornea Clinic, is a leader in laser vision correction, cataract surgery, corneal transplantation including DSEK, DSAEK and DALK, keratoconus treatments including collagen cross linking, corneal rings (Kerarings and Intacs), phakic intraocular lenses, and anterior segment reconstruction.

John is a consultant ophthalmologist at Sydney Eye Hospital, St Vincent's Public and St Vincent's Private Hospitals, Concord Hospital and Macquarie University Hospital. He is a Clinical Senior Lecturer at both the University of Sydney, Macquarie University and is the head of the Corneal Unit at Sydney Eye Hospital. John is the Head of the Department of Ophthalmology at St Vincent's Public Hospital. He is a Co-ordinator for the Masters of Refractive Surgery at the University Sydney, the first post graduate degree in refractive surgery in the world.

Dr Males underwent his medical training at the University of Sydney and his Ophthalmic training in Sydney Eye Hospital, and Bristol Eye Hospital in the United Kingdom.

Dr Males has been at the forefront of ophthalmology and has introduced numerous surgical techniques in Australia. His achievements include:

  • The first in Australia to perform DSAEK endothelial corneal transplantation;
  • The first in Australia to perform collagen cross linking (C3R, UVX) for the stabilisation of keratoconus;
  • The first in Australia to perform custom iris implant surgery with the Human Optics iris prosthesis;
  • Amongst the first surgeons to perform laser assisted cataract surgery in Australia; and
  • Amongst the leading group of surgeons performing SMILE laser vision correction in Australia.

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Published
2020-01-17
How to Cite
Lim, N., & Males, J. (2020). Fuchs endothelial corneal dystrophy and small eyes. Asian Journal of Ophthalmology, 17(1), 35-40. https://doi.org/10.35119/asjoo.v17i1.445
Issue
Vol 17 No 1 (2019): Asian Journal of Ophthalmology
Section
Original Articles

Copyright (c) 2020 Nicole Shao-Yuen Lim, John Males

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