A small group of patients with Fuchs’ corneal dystrophy were successfully treated with a Rho-associated kinase (ROCK) inhibitor topical medication—a technique that could have far-reaching clinical implications, according to researchers from Japan who presented their findings at the annual meeting of the American Academy of Ophthalmology in November.
The preliminary study, conducted by investigators at Kyoto Prefectural University of Medicine, reported that a one-week treatment of the ROCK inhibitor Y-27632 stimulated the proliferation of corneal endothelial cells in four test patients with Fuchs’ corneal dystrophy.
Patients showed corneal healing and restored visual acuity, as well as reduced corneal thickness from 700 cells/mm2 to 563 cells/mm2 by three months after treatment.
“Overall, it’s intriguing and, if it proves to be viable, may reduce the number of surgeries required for Fuchs’ and other endothelial diseases,” says Joseph Shovlin, OD, of Scranton, Pa. “ROCK inhibitors would represent the first successful medical treatment using a topical agent for certain forms of endothelial disease.”
The technique involves transcorneal freezing to remove damaged endothelial cells, and then applying the eye drops to promote proliferation in the remaining functional cells. This small study treated eight patients—four with Fuchs’ and four with pseudophakic bullous keratophy. Although the technique was not effective for pseudophakic bullous keratophy, it could pave the way for minimally invasive surgery for Fuchs’ and other forms of corneal problems, the researchers say.
While more research must be done before such a topical drop becomes available, “it’s crucial that ODs are aware of such potential non-surgical treatments in order to render the very best care possible, and also field questions that may arise in the course of patient care,” Dr. Shovlin says.