Laser in situ keratomileusis in patients with corneal guttata and family history of Fuchs' endothelial dystrophy.

PURPOSE To report 1-year results of laser in situ keratomileusis (LASIK) in 7 eyes with corneal endothelial guttata and a family history of Fuchs' endothelial dystrophy. SETTING John Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. METHODS A retrospective chart review was performed of 4 patients (7 eyes) who had trace to 1+endothelial guttata and a family history of Fuchs dystrophy and then had uneventful LASIK for the correction of myopia and myopic astigmatism. Preoperative and postoperative measurements included uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), corneal pachymetry, endothelial cell density (ECD), manifest refraction, and spherical equivalent. The changes in ECD, pachymetry, and spherical equivalent after LASIK were subjected to statistical analysis using a paired Student t test to determine significance. RESULTS Transient corneal edema was noted in the early postoperative period in 3 eyes of 2 patients. At 1 year, 6 of the 7 (86%) eyes had lost > or =2 lines of BSCVA. A statistically significant decrease in ECD of 12.4% +/- 2.7% was observed at 1 year compared with baseline (P < .001). An increase in corneal thickness (P = .006) and a statistically significant myopic shift in spherical equivalent (P = .017) was also noted at 1 year compared with 3 months. CONCLUSIONS Patients with mild corneal guttata and a family history of Fuchs' dystrophy are prone to transient corneal edema, loss of BSCVA, endothelial cell loss, and myopic regression after uneventful LASIK for correction of myopia and myopic astigmatism.