MAY 28, 2019
Cornea/External Disease
This study evaluates the efficacy of Descemet stripping with postoperative rho kinase inhibitor drops in patients with Fuchs corneal dystrophy.
Study design
The authors performed a phase 4, non-placebo controlled prospective trial in 18 patients. Participants were assigned to 4 daily doses of ripasudil for 2 months or no treatment after undergoing Descemet stripping without endothelial keratoplasty.
Outcomes
Compared with controls, the ripasudil cohort demonstrated faster vision recovery (4.6 vs. 6.5 weeks; P<0.01) and had a higher average endothelial cell density (ECD) through 12 months.
Limitations
The study was non-randomized and the patients and observer were not masked.
Clinical significance
The findings suggest that Descemet stripping only combined with a postoperative ripasudil regimen may be a viable treatment for patients with Fuchs who have a peripheral ECD of 1000 cells/mm2 or greater. This is a very promising and exciting result that has the potential to greatly alter the treatment of Fuchs endothelial dystrophy in patients with clear peripheral corneas. A randomized, controlled trial is necessary to confirm these results.