Very mild corneal edema may not require treatment. An ophthalmologist may treat early corneal edema with hyperosmotic saline eye drops to draw off excess fluid from the cornea. Patients with Fuchs dystrophy who experience blurring of vision in the early morning can also direct a hair dryer at the eye from arm’s length, using air without heat, to draw off moisture in the early mornings. Corneal edema resulting from a herpes simplex virus infection of the eye is often successfully treated with steroid eye drops and anti-viral medications.
When corneal edema progresses to the extent that can no longer be treated with medications, a corneal transplant is often necessary to restore vision. A penetrating keratoplasty (“PK” or “PKP”) is a traditional type of
corneal transplant in which all the corneal layers from a donor cornea are transplanted to restore the damaged corneal endothelium. A newer surgical technique for corneal transplantation is Descemet’s stripping endothelial keratoplasty (“DSEK”), a procedure involving removal and replacement of only the diseased endothelial layer of the cornea.
Since cataract surgery sometimes exacerbates mild corneal edema in patients with Fuchs corneal endothelial dystrophy, surgeons may sometimes recommend corneal transplantation at the same time as cataract surgery.