Corneal subepithelial tissue of Fuchs' endothelial dystrophy

Fuchs' endothelial dystrophy is characterized by so-called guttata on Descemet's membrane. The endothelium is primarily affected, with endothelial decompensation causing stromal edema or bullous keratopathy. Because Fuchs' endothelial dystrophy primarily affects the endothelium, there have been few studies reporting on the anterior cornea since a study by Iwamoto et al. in 1971. In this study, a corneal sample from each of 11 patients with Fuchs' corneal dystrophy was examined by light microscopy and an additional layer was seen between the epithelium and Bowman's layer. Examination of the samples by electron microscopy showed thickened basement membrane and fibrous tissue and multiplication of the basement membrane in the extra layer. The subepithelial tissue of Fuchs' endothelial dystrophic corneas may be formed by epithelium and stromal cells that have migrated into Bowman's layer.