Fuchs Endothelial Dystrophy
Eye Drops for Glaucoma
My father has Fuch's Dystrophy and when researching whether glaucoma eye drops would increase the edema in his cornea even more. I found information that the drops might actually do harm: they may hasten the loss of endothelial cells already being lost owing to Fuchs Dystrophy and may therefore hasten the need for a corneal transplant.
Are all of the glaucoma eye drops equally harmful in Fuchs Endothelial Dystrophy sufferers? Is it possible that Alphagan is actually less harmful because in addition to increasing drainage, it also reduces fluid production, which might mean less edema?
Thanks for your Question
Eye drops for Glaucoma can be used in patients with Fuchs Endothelial Dystrophy who has glaucoma or high intraocular pressure this will help to reduce the active pressure on aqueous humor to pass into corneal stoma through weak endothelial layer.
Some researches found that even in patient with Fuchs Endothelial Dystrophy and normal intraocular pressure, using anti-glaucoma eye drops can be helpful to reduce the corneal edema by further decreasing the active pressure of aqueous humor.
Alphagan eye drops is very helpful to reduce intraocular pressure because as you said it helps to increase the drianage of aqueous humor outside the eye and also reduce the secretion of aqueous.
There is a group of anti-glaucoma eye drops called carbonic anhydrase inhibitor ( Dorzolomide), this group should not be used in patients with Fuchs Endothelial Dystrophy.
Corneal endothelial cells pump the fluid outside the cornea through a pump mechanism which depends mainly on carbonic anhydrase enzyme. Blocking this enzyme will further reduce the function of endothelial cells and more corneal edema will occur.