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Coexistent keratoconus (KC) and Fuchs�â�€�™ endothelial dystrophy (FED), a therapeutic challenge?

Poster Details

First Author: M.Roig-Revert SPAIN

Co Author(s):    C. Peris-Martinez   E. Fernandez-Lopez   M. Hernandez              

Abstract Details

Purpose:

To discuss the best diagnostic and therapeutic approach in patients with coexistent Keratoconus (KC) and Fuchs�â�€�™ Endothelial Dystrophy (FED) through a case series analysis.

Setting:

Cornea Department, FISABIO Oftalmolog�Ã�­a M�Ã�©dica, Valencia, Spain.

Methods:

We reviewed the clinical and topographic findings of 2 patients (4 eyes) with KC and FED. Corneal biomicroscopy, ocular reponse analyzer (O.R.A), Scheimpflug tomography and specular microscopy were performed. No eye required any surgery until last follow-up, being closely monitored every 6 months.

Results:

The first patient is a 56-year-old woman manifesting typical signs and topographic evidence of KC associated with a cornea guttata and reduced number of endothelial cells in specular microscopy compatible with FED in both eyes. In addition, one eye presented a radial and arcuate keratotomy. The second patient is a 24-year-old woman without previous ocular history who presented KC as confirmed by corneal topography, corneal guttae and low endothelial cell counts corroborating a FED. Because of the stability of both diseases no surgery was performed.

Conclusions:

Several difficulties can be encountered in the management of patients with coexistent KC and FED. Corneal thinning in KC may be masked by stromal hydration due to FED and viceversa, normalizing the corneal pachymetry readings and underestimating the disease severity. In the event of requiring surgery what would be the best therapeutic approach in those cases to avoid unexpected postoperative visual outcomes? Full thickness or partial thickness corneal grafts? How would the intraocular lens be calculated?

Financial Disclosure:

NONE

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