CorneaPub Date : 2025-03-01Epub Date: 2024-09-04DOI: 10.1097/ICO.0000000000003694
Darby D Miller, Isabella V Wagner, Syed A Hasan, Michael W Stewart, Caleb M Towne, Zhuo Li, Keith H Baratz
{"title":"Anatomic Characteristics of Eyes With Fuchs Endothelial Corneal Dystrophy.","authors":"Darby D Miller, Isabella V Wagner, Syed A Hasan, Michael W Stewart, Caleb M Towne, Zhuo Li, Keith H Baratz","doi":"10.1097/ICO.0000000000003694","DOIUrl":"10.1097/ICO.0000000000003694","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to evaluate and compare the anatomic characteristics of eyes with Fuchs endothelial corneal dystrophy (FECD) with eyes without FECD.</p><p><strong>Methods: </strong>This study was a retrospective chart review performed at an academic medical center. Patients with FECD were identified through a search of the electronic medical records. Eligible patients underwent Scheimpflug imaging and optical biometry and were compared with age and sex-matched control subjects who underwent similar testing in preparation for cataract surgery. Several measurements of the cornea, anterior chamber, and eyes were evaluated using multivariable linear regression models and multivariable logistic regression models.</p><p><strong>Results: </strong>A total of 404 eyes (202 eyes with FECD and 202 control eyes) were included in this study. Compared with controls, eyes with FECD had shallower AC depths, lower AC volumes, and narrower angles. Conversely, the spherical equivalent before cataract surgery, corneal pachymetry, and corneal volume were higher in eyes with FECD. On Scheimpflug imaging analysis, these anatomical differences were present in FECD eyes with and without corneal edema. After adjusting for sex, these differences remained statistically significant. Shorter axial length was found to be statistically significant in male eyes but not in female eyes with FECD.</p><p><strong>Conclusions: </strong>This study reports new ocular characteristics in FECD eyes with and without edema. Optical biometry and Scheimpflug imaging established that the anatomic findings in eyes with FECD were not simply due to the larger volume of an edematous cornea but rather unique to eyes with FECD. These findings will provide reliable, normative data for future studies examining surgical, medical, and anatomical factors in FECD.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":"311-323"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142131996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Letter Regarding: Donut-shaped Corneal Allogeneic Intrastromal Segment as an Alternative to Deep Anterior Lamellar Keratoplasty in Advanced Keratoconus.","authors":"Prabhakar Singh, Abhishek Gupta, Mahuya Chattopadhyay","doi":"10.1097/ICO.0000000000003624","DOIUrl":"10.1097/ICO.0000000000003624","url":null,"abstract":"","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":"e5"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141476090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CorneaPub Date : 2025-02-25DOI: 10.1097/ICO.0000000000003841
Tatsuya Nakagawa, Yuichi Tokuda, Masakazu Nakano, Ayana Tateishi, Mari Yasunaga, Theofilos Tourtas, Ursula Schlötzer-Schrehardt, Friedrich Kruse, Kei Tashiro, Noriko Koizumi, Naoki Okumura
{"title":"Transcriptional Profiling of Patients With Fuchs Endothelial Corneal Dystrophy With and Without Trinucleotide Repeat Expansion in TCF4.","authors":"Tatsuya Nakagawa, Yuichi Tokuda, Masakazu Nakano, Ayana Tateishi, Mari Yasunaga, Theofilos Tourtas, Ursula Schlötzer-Schrehardt, Friedrich Kruse, Kei Tashiro, Noriko Koizumi, Naoki Okumura","doi":"10.1097/ICO.0000000000003841","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003841","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate transcriptomic differences between patients with Fuchs endothelial corneal dystrophy (FECD) with and without trinucleotide repeat (TNR) expansion in the transcription factor 4 gene, as the genetic basis for patients with FECD lacking TNR expansion remains unclear.</p><p><strong>Methods: </strong>Bulk RNA sequencing was performed on corneal endothelial cells from 17 subjects: 10 patients with FECD [4 with repeat expansion lengths <50 (RE-) and 6 with expansions of 50 or more (RE+)] and 7 controls. Differential gene expression analysis was conducted using DESeq2. Principal component analysis (PCA), correlation matrix analysis, and heatmap visualization were used to evaluate gene expression patterns. Gene Ontology enrichment analysis was performed on differentially expressed genes (DEGs).</p><p><strong>Results: </strong>Analysis identified 509 DEGs (281 upregulated, 228 downregulated) between RE- and controls, and 640 DEGs (292 upregulated, 348 downregulated) between RE+ and controls. PCA revealed distinct gene expression patterns in both RE- and RE+ groups compared with controls. Between RE- and RE+ groups, only 10 DEGs were identified: ALDH3A1, ENSG00000286252, RNU6-645P, SNORD113-7, RNU6-429P, SNORA16A, COCH, EGFL6, SEMA3E, and ENSG00000228463. PCA, correlation matrix analysis, and heatmap visualization demonstrated high similarity in overall gene expression patterns between RE- and RE+ groups.</p><p><strong>Conclusions: </strong>Contrary to expectations, gene expression profiles showed remarkable similarity between patients with FECD with and without TNR expansion. Further investigation of the identified DEGs may provide insights into the role of TNR expansion in FECD pathophysiology.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CorneaPub Date : 2025-02-18DOI: 10.1097/ICO.0000000000003835
Luigi Fontana, Natalie di Geronimo, Piera Versura, Antonio Moramarco
{"title":"Long-Term Clinical Outcomes and Anterior Segment Optical Coherence Tomography Findings After Artificial Endothelial Replacement Membrane Implantation.","authors":"Luigi Fontana, Natalie di Geronimo, Piera Versura, Antonio Moramarco","doi":"10.1097/ICO.0000000000003835","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003835","url":null,"abstract":"<p><strong>Purpose: </strong>This study examines the long-term clinical outcomes of an artificial endothelial replacement membrane implant used to treat corneal edema. It also explores the interaction between the device and the posterior surface of the cornea.</p><p><strong>Methods: </strong>Patients suffering from late endothelial keratoplasty failure (5 patients) or bullous keratopathy (2 patients) after multiple surgeries underwent EndoArt (EyeYon Medical, Israel) implantation. Before surgery and at 1-, 3-, 6-, 12-, 18-, and 24-month intervals, corrected distance visual acuity and central corneal thickness were measured. High-resolution anterior segment optical coherence tomography images were analyzed at each interval to detect device detachment and evaluate the implant interaction with the corneal tissue over time.</p><p><strong>Results: </strong>Corrected distance visual acuity improved from a mean of 1.32 ± 0.23 (logarithm of the Minimum Angle of Resolution) preoperatively to 0.95 ± 0.28 (logarithm of the Minimum Angle of Resolution) 2 years after surgery (P = 0.03). Central corneal thickness significantly decreased from 805 ± 131 μm preoperatively to 577 ± 90 μm postoperatively (P = 0.002). Four of the 7 patients experienced device detachment, requiring 1 or more rebubblings to achieve stable implant adhesion. Anterior segment optical coherence tomography showed annular fibrosis developing between the device margin and the host cornea in most patients, particularly those who had never experienced detachment.</p><p><strong>Conclusions: </strong>This study suggests that EndoArt is effective in the long term for improving corneal transparency and visual acuity in patients with chronic corneal edema with a limited prognosis for endothelial keratoplasty. The formation of fibrotic tissue between the periphery of the device and the host cornea may explain the strong adhesion of the implant.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CorneaPub Date : 2025-02-18DOI: 10.1097/ICO.0000000000003837
Chi-Chun Yang, Meng-Jou Chen, Ming-Hsuan Cheng, Nai-Wen Fan
{"title":"Clinical Factors Predicting Favorable Response to Intense Pulsed Light Therapy for Refractory Meibomian Gland Dysfunction: A 6-Month Cohort Study.","authors":"Chi-Chun Yang, Meng-Jou Chen, Ming-Hsuan Cheng, Nai-Wen Fan","doi":"10.1097/ICO.0000000000003837","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003837","url":null,"abstract":"<p><strong>Purpose: </strong>Meibomian gland dysfunction (MGD) is a global health disorder, which can have a deleterious effect on visual function and quality of life. Intense pulsed light (IPL) therapy has been shown to ameliorate MGD. However, the optimal candidates who would benefit most from IPL remain undetermined. Therefore, we aimed in this study to identify the clinical factors associated with favorable outcomes in patients with MGD after IPL therapy.</p><p><strong>Methods: </strong>This single-center retrospective study included patients with refractory MGD treated with a course of IPL therapy combined with meibomian gland expression, with a follow-up period of 6 months. The outcome measures were the standardized patient evaluation of eye dryness (SPEED) score, tear breakup time, lid telangiectasia, meibum quality, and expressibility. Good responders were defined as those with at least a 1-point reduction in SPEED score and a 1-grade decrease in meibum quality at 6 months. Data were analyzed using the t test, chi-square test, and binary logistic regression analysis.</p><p><strong>Results: </strong>A total of 90 eyes in 90 patients (good responders: 48 eyes, nonresponders: 42 eyes) were included. Univariate analysis revealed that the good responders had a higher SPEED score at baseline than the nonresponders. Multivariate logistic regression analysis showed that more severe symptoms, more inspissated meibum, better expressibility, and milder degree of lid telangiectasia were independently associated with a favorable response.</p><p><strong>Conclusions: </strong>Our findings suggest that patients with worse symptoms, poorer meibum quality, milder telangiectasia, or less obstruction are more likely to have a good response to IPL therapy.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Long-Term Clarity of Tectonic Lamellar Keratoplasty for Limbal Dermoids.","authors":"Yasufumi Tomioka, Kotomi Bato, Tomo Suzuki, Koichi Wakimasu, Hideki Fukuoka, Naoki Okumura, Tsutomu Inatomi, Chie Sotozono, Shigeru Kinoshita","doi":"10.1097/ICO.0000000000003825","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003825","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the long-term outcome of surgical intervention for limbal dermoids and to evaluate the safety and efficacy of tectonic lamellar keratoplasty.</p><p><strong>Methods: </strong>This retrospective cohort study included 86 eyes that underwent tectonic lamellar keratoplasty by 5 corneal surgeons at Kyoto Prefectural University of Medicine and Baptist Eye Institute, Kyoto, Japan, from 1992 through 2024. The study subjects were categorized into 2 groups: group A, consisting of 35 eyes that underwent amblyopia treatment, and group B, consisting of 51 eyes that did not.</p><p><strong>Results: </strong>Kaplan-Meier survival analysis revealed 95.3% (82 of 86 eyes) maintained clear tectonic corneal grafts with healthy ocular surfaces postoperatively. Three eyes developed psudopterygium formation, and 1 eye developed a corneal infection. Improvement of 0.2 logarithm of the minimum angle of resolution units or more because of preoperative amblyopia treatment was observed in 48.6% (17 of 35 eyes) in group A. Surgical intervention resulted in an improvement of 0.2 logarithm of the minimum angle of resolution units or more in 25.7% (9 of 35 eyes) in group A, and 15.7% (8 of 51 eyes) in group B. One case of corneal infection resulted in decreased best-corrected visual acuity. No other cases exhibited best-corrected visual acuity deterioration.</p><p><strong>Conclusions: </strong>Tectonic lamellar keratoplasty can be performed safely with very few postoperative complications, maintaining long-term corneal clarity, reasonable visual acuity, and satisfactory cosmetic results.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CorneaPub Date : 2025-02-18DOI: 10.1097/ICO.0000000000003836
Kepa Balparda, Luis García-Onrubia, Francisco Javier Valentín-Bravo, Arantxa Acera, Jesus Merayo-Lloves, Luis Fernández-Vega-Cueto, Isabela Franco-Sánchez, Mariana López-Velásquez, David J Galarreta
{"title":"Multivariate Determinants of Emotional Compromise and Subjective Functional Quality of Life in Surgery-Naïve Patients With Keratoconus as Measured With the Keratoconus End Points Assessment Questionnaire.","authors":"Kepa Balparda, Luis García-Onrubia, Francisco Javier Valentín-Bravo, Arantxa Acera, Jesus Merayo-Lloves, Luis Fernández-Vega-Cueto, Isabela Franco-Sánchez, Mariana López-Velásquez, David J Galarreta","doi":"10.1097/ICO.0000000000003836","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003836","url":null,"abstract":"<p><strong>Purpose: </strong>Keratoconus affects patients' quality of life. No study has assessed the multivariate determinants of quality of life using the keratoconus end points assessment questionnaire (KEPAQ).</p><p><strong>Methods: </strong>This study included patients with keratoconus with no history of ocular surgery, who underwent clinical evaluation and tomographic imaging using a dual Scheimpflug/Placido device (Galilei G6). Emotional and functional quality of life was assessed using the KEPAQ. Multiple linear regression models were constructed for each KEPAQ subscale to adjust for confounding variables.</p><p><strong>Results: </strong>A total of 140 surgery-naïve patients with keratoconus were included, with a median age of 39 years and a male predominance (57.1%). For the KEPAQ-E subscale, the multivariate model was significant [F(84,10) = 2.79; adjusted R2 = 0.160, P = 0.005], showing that female sex (β = -0.41) and worse corrected distance visual acuity in the better-seeing eye (β = -0.29) were associated with lower quality of life. Including the functional subscale score significantly enhanced the model's performance (adjusted R2 = 0.464, β = 0.60). For the KEPAQ-F subscale, the model was also significant [F(84,10) = 2.37; adjusted R2 = 0.127, P = 0.016], with corneal astigmatism in the better-seeing eye (β = -0.30) reducing quality of life. Adding the emotional subscale score improved the model (adjusted R2 = 0.442, β = 0.62).</p><p><strong>Conclusions: </strong>Female sex, reduced vision, and corneal astigmatism negatively affect quality of life in patients with keratoconus. Nonetheless, patients' perceived impairment as measured in 1 subscale is a stronger predictor of overall quality of life than clinical and tomographic factors alone.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CorneaPub Date : 2025-02-18DOI: 10.1097/ICO.0000000000003829
Irving M Raber, Ashley Khalili, Rin Khang, Preema M Buch, Ralph C Eagle, Go Hun Seo, Hane Lee, Tatyana Milman
{"title":"Corneal Myofibromatous and Pterygium-Like Changes in a Family With a PDGFRB Variant.","authors":"Irving M Raber, Ashley Khalili, Rin Khang, Preema M Buch, Ralph C Eagle, Go Hun Seo, Hane Lee, Tatyana Milman","doi":"10.1097/ICO.0000000000003829","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003829","url":null,"abstract":"<p><strong>Purpose: </strong>To report the clinical, pathologic, and genetic findings in a family with early-onset pterygia, corneal vascularization, and corneal myofibromatous lesions.</p><p><strong>Methods: </strong>We performed clinical, pathologic, and genetic analysis of 12 members of a family originating in Puebla Mexico, who manifested with pterygia/pseudopterygia and corneal opacification transmitted in an autosomal-dominant inheritance pattern. Three unaffected family members also were evaluated.</p><p><strong>Results: </strong>Clinical findings included isolated pterygia, isolated corneal subepithelial and anterior stromal opacities associated with varying degree of corneal vascularization, and a combination of pterygia and corneal opacities. Nine patients (17 eyes) underwent surgical procedures, including penetrating keratoplasty (9/17), superficial keratectomy (7/17), and pterygium excision (7/17). Five patients (eight eyes) had more than one surgery for recurrence of pterygia (2/8), recurrent corneal opacities obscuring the visual axis (3/8), penetrating keratoplasty failure (1/8), and indication not known (2/8). Documented recurrences occurred early, within 1 to 2 years of surgery. Histopathology of 21 specimens available for evaluation (nine penetrating keratoplasty corneas, seven superficial keratectomies, and five conjunctival-corneal tissues from pterygium/pseudopterygium excision) from seven patients showed varying degrees of myofibroblastic proliferation. Exome sequencing identified a heterozygous c.1610C>A (p.Ala537Asp) variant in the platelet-derived growth factor receptor beta (PDGFRB) gene in all 11 affected family members tested and in one of three unaffected family members.</p><p><strong>Conclusions: </strong>The combined clinical presentation, histopathologic features, and genetic findings suggest an autosomal dominantly inherited predisposition to exuberant corneal myofibroblastic proliferation, driven by the platelet-derived growth factor receptor activation.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Six-Month Results of Multiple Femtosecond Laser-Assisted Corneal Allogeneic Ring Segments Implantation: A Case Series.","authors":"Nicole Mechleb, Damien Gatinel, Léa Fitoussi, Alain Saad","doi":"10.1097/ICO.0000000000003831","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003831","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the short- and mid-term clinical outcomes of corneal allogeneic intrastromal ring segments (CAIRS) and assess their efficacy and safety in keratoconus treatment.</p><p><strong>Methods: </strong>Case series of 79 eyes from 71 patients with keratoconus who underwent femtosecond-assisted CAIRS implantation at the Adolphe de Rothschild Hospital Foundation, Noémie de Rothschild Institute. Preoperative and postoperative examinations were conducted at 3 and 6 months. Anterior segment optical coherence tomography and corneal tomography with aberrometric and pachymetric analyses were performed at each visit. Visual, refractive, and topographic parameters were extracted.</p><p><strong>Results: </strong>Corrected distance visual acuity improved by 1, 2, and 3 lines or more in 33%, 44%, and 52% of cases, respectively. Significant improvements were observed in K1, K2, Km, Kmax, topographic astigmatism, sphere, cylinder, spherical equivalent, total root mean square, higher-order aberrations, vertical coma, and spherical aberrations (all P < 0.01 or P < 0.05). Eleven patients (13.9%) were dissatisfied with their outcomes. In addition, 9 patients (13.65%) experienced a loss in corrected distance visual acuity at 3 months postoperatively (6 eyes lost 1 line, and 3 lost 2 lines), yet remained satisfied with their results because of improved refraction and uncorrected vision.</p><p><strong>Conclusions: </strong>This study is the largest to date evaluating femtosecond-assisted CAIRS implantations and highlights CAIRS as a promising treatment for keratoconus.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Efficacy of the Rho-Kinase Inhibitor for Corneal Endothelial Protection in Fuchs Endothelial Corneal Dystrophy After Phacoemulsification.","authors":"Benjama Keeratidamkerngsakul, Vilavun Puangsricharern, Susama Chokesuwattanaskul, Krit Pongpirul, Thanachaporn Kittipibul","doi":"10.1097/ICO.0000000000003827","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003827","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy of Rho-kinase (ROCK) inhibitors in corneal endothelial protection in Fuchs endothelial corneal dystrophy (FECD) after phacoemulsification.</p><p><strong>Methods: </strong>Forty-eight eyes from 31 patients with FECD and cataracts were randomly assigned to receive either the topical ROCK inhibitor (or ripasudil) or placebo 4 times a day, in addition to the standard antibiotic and antiinflammatory eye drops, for 1 month after phacoemulsification. Endothelial cell density (ECD), central corneal thickness (CCT), and corneal densitometry were measured. The primary outcome was the central ECD (C-ECD) loss percentage 3 months after phacoemulsification. Secondary outcomes included C-ECD loss and paracentral ECD loss percentages and the CCT change ratio at different time points after phacoemulsification. Adverse events were evaluated.</p><p><strong>Results: </strong>There was significantly less cell loss among those eyes treated with ripasudil. C-ECD significantly increased from a baseline of 2361 cells/mm2 (95% confidence interval, 2151-2571) to 2506 cells/mm2 (95% confidence interval, 2296-2716) 3 months after phacoemulsification. The paracentral ECD loss was 0.4% in the ripasudil group versus 7.3% in the control group. Corneal densitometry remained relatively unchanged in the ripasudil group but increased significantly over time in the control group. The mean CCT increased slightly in both groups from baseline to the final follow-up at 3 months, albeit without significant differences between the groups. In the ripasudil group, transient conjunctival erythema was the most common adverse event.</p><p><strong>Conclusions: </strong>The topical ROCK inhibitor, or ripasudil, demonstrated beneficial effects on preventing endothelial cell loss and improving endothelial function in patients with FECD undergoing phacoemulsification. Corneal densitometry showed reduced corneal light scattering in the ripasudil group after phacoemulsification, suggesting improved corneal endothelial function.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}