Failed Descemet Stripping Only (DSO) with Adjuvant Rho-Kinase Inhibitor Therapy in a Fuchsʼ Endothelial Dystrophy Patient: A Case Report

Background

Fuchsʼ endothelial dystrophy is an autosomal dominant inherited corneal disease that is accompanied by a significant decrease in visual acuity [1]. Most corneal transplants worldwide are performed due to this dystrophy [2]. 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 [3], [4]. 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 [5]. Instead of keratoplasty, a cell-based therapy can additionally be performed [5]. 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 [6], [7]. A recent study demonstrated the superiority of adjuvant therapy with ripasudil, a Rho-kinase inhibitor [8].

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.

Publication History

Received: 23 September 2020

Accepted: 07 March 2021

Article published online:
30 April 2021

• References

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