Pilot Study of Corneal Clearance With the Use of a Rho-Kinase Inhibitor After Descemetorhexis Without Endothelial Keratoplasty for Fuchs Endothelial Corneal Dystrophy.

Abstract

PURPOSE:

To investigate corneal clearance time using a topical rho-kinase inhibitor, netarsudil, after descemetorhexis without endothelial keratoplasty (DWEK).

METHODS:

Twenty eyes from 10 patients with Fuchs endothelial corneal dystrophy had DWEK with cataract surgery. For the first eye of each participant, netarsudil was administered immediately after surgery until corneal clearance. For the second eye, netarsudil was withheld 2 weeks beyond the time for corneal clearance of the first eye and then administered only if corneal edema was still present. Interpatient and intrapatient comparisons were made for pachymetry, endothelial cell count, intraocular pressure, and time to corneal clearance.

RESULTS:

Intrapatient comparison demonstrated no significant difference in preoperative pachymetry (P value 0.58), endothelial cell counts (P value 0.97), and intraocular pressure (P value 0.46) between eyes treated with netarsudil immediately after DWEK and those with delayed netarsudil use. Average time for corneal clearance in eyes treated with netarsudil immediately after surgery was 4.6 ± 1.7 weeks, which was significantly shorter than eyes not treated with netarsudil immediately at 8 ± 1.9 weeks (P < 0.01). Corneal clearance occurred in eyes between 1 and 2 weeks after addition of netarsudil as a "rescue" drop. Interpatient comparison demonstrated significantly greater endothelial cell counts in eyes treated with netarsudil immediately compared with eyes with a delay in netarsudil use (P = 0.05).

CONCLUSIONS:

Netarsudil significantly reduces the time to corneal clearance after DWEK. Furthermore, increased endothelial cell counts in eyes with immediate netarsudil use versus delayed netarsudil use suggests that the immediate perioperative period is crucial in cell regeneration and migration.

• Authors: Emma Davies, Ula Jurkunas, Roberto Pineda 2nd
• Journal: Cornea (Cornea) Vol. 40 Issue 7 Pg. 899-902 (Jul 01 2021) ISSN: 1536-4798 [Electronic] United States
• PMID: 33758139 (Publication Type: Journal Article)
• Copyright: Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

Chemical References

• Benzoates
• Ophthalmic Solutions
• Protein Kinase Inhibitors
• beta-Alanine
• rho-Associated Kinases
• netarsudil

Topics

• Administration, Ophthalmic
• Aged
• Aged, 80 and over
• Benzoates (pharmacokinetics)
• Cornea (metabolism)
• Corneal Pachymetry
• Descemet Membrane (metabolism, surgery)
• Descemet Stripping Endothelial Keratoplasty
• Female
• Fuchs' Endothelial Dystrophy (metabolism, surgery)
• Humans
• Intraocular Pressure
• Male
• Middle Aged
• Ophthalmic Solutions
• Pilot Projects
• Protein Kinase Inhibitors (pharmacokinetics)
• Tonometry, Ocular
• Visual Acuity
• beta-Alanine (analogs & derivatives, pharmacokinetics)
• rho-Associated Kinases (antagonists & inhibitors)