Objective: To determine if keratocyte populations are different in corneas with Fuchs dystrophy compared with control corneas. Methods: Eleven corneas excised during penetrating keratoplasty for Fuchs dystrophy and 5 control corneas of eyes enucleated for choroidal melanoma were examined using light microscopy. Twenty control corneas age-matched to the corneas with Fuchs dystrophy were examined using confocal microscopy in vivo. The number of keratocytes in a full-thickness column of central stroma with frontal area of 1 mm2, determined using histologic and confocal methods, was compared between corneas with Fuchs dystrophy and controls. Results: By histology, the mean (SD) number of cells in a full-thickness column of stroma in Fuchs dystrophy (12 215 cells) was less than in control corneas (15 628 cells; P < .001). The mean (SD) number of keratocytes in the anterior 10% of the stroma of corneas with Fuchs dystrophy (682 cells) was less than in the control corneas measured using histology (1858 cells; P < .001) and confocal microscopy (1481 cells; P < .001). Conclusions: Keratocytes are depleted by 54% to 63% in the anterior 10% of the stroma of corneas that require penetrating keratoplasty for Fuchs dystrophy. Keratocyte loss might contribute to anterior stromal changes that persist and degrade vision after endothelial keratoplasty.
ASJC Scopus subject areas