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Failed Descemet Stripping Only (DSO) with Adjuvant Rho-Kinase Inhibitor Therapy in a Fuchsʼ Endothelial Dystrophy Patient: A Case ReportTherapieversagen einer Descemet Stripping only (DSO) mit adjuvanter Rho-Kinase-Inhibitor-Therapie bei einem Patienten mit Fuchs-Endotheldystrophie: ein Fallbericht
Fuchsʼ endothelial dystrophy is an autosomal dominant inherited corneal disease that is accompanied by a significant decrease in visual acuity . Most corneal transplants worldwide are performed due to this dystrophy . The technique of Descemet stripping only (DSO) – also called descemetorhexis without endothelial keratoplasty (DWEK) – was proposed in 2018 as a new therapeutic option for Fuchsʼ dystrophy , . In contrast to lamellar keratoplasty (Descemet Stripping Automated Endothelial Keratoplasty [DSAEK]/Descemet Membrane Endothelial Keratoplasty [DMEK]), DSO does not involve keratoplasty after peeling off the central endothelium. It is expected that the patients remaining surrounding endothelial cells will migrate into the defect independently . Instead of keratoplasty, a cell-based therapy can additionally be performed . In animal experiments, it could be shown that the inhibition of the Rho-kinase pathway led to improved adhesion of corneal endothelial cells and expression of endothelial functional proteins , . A recent study demonstrated the superiority of adjuvant therapy with ripasudil, a Rho-kinase inhibitor .
We report the case of a failed DSO with adjuvant Rho-kinase inhibitor therapy for Fuchsʼ endothelial corneal dystrophy 1 year after surgery. Visual and histopathological findings are presented.
Received: 23 September 2020
Accepted: 07 March 2021
30 April 2021 (online)
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