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Rho-Associated Kinase Inhibitor Eye Drop Treatment as a Possible Medical Treatment for Fuchs Corneal Dystrophy

Koizumi, Noriko MD, PhD; Okumura, Naoki MD, PhD; Ueno, Morio MD, PhD; Nakagawa, Hiroko MD; Hamuro, Junji PhD; Kinoshita, Shigeru MD, PhD

doi: 10.1097/ICO.0b013e318285475d
Case Report

Purpose: To report a case of Fuchs corneal dystrophy that was successfully treated by Rho-associated kinase (ROCK) inhibitor eye drops, subsequent to transcorneal freezing of damaged corneal endothelial cells.

Methods: A 52-year-old Japanese man with a diagnosis of late-onset Fuchs corneal dystrophy was referred to our hospital as a candidate for keratoplasty. Best-corrected vision was 20/20 in the right eye and 20/63 in the left eye. Multiple guttae were observed in both eyes. The right cornea was clear, but the left showed severe central edema, with a central corneal thickness of 703 μm. We were unable to perform specular microscopy in the central cornea, but endothelial cells were observed in the midperiphery at a density of 757 cells per square millimeter. The patient was treated by a corneal endothelial denudation in the prepupillary region followed by the topical administration of a selective ROCK inhibitor, Y-27632, as eye drops for 1 week. Follow-up of 24 months is reported.

Results: Corneal clarity recovered and vision improved to 20/20 two weeks after the treatment. At 6 months, vision had improved to 20/16 and central corneal thickness measured was 568 μm, significantly lower than its pretreatment value. Endothelial function and vision have been well maintained up to the most recent observation, 24 months after the treatment. The average corneal endothelial density in the central and peripheral cornea was 1549.3 ± 89.7 and 705.0 ± 61.1 cells per square millimeter, respectively.

Conclusions: The case highlights the possibility of medical treatments involving the use of ROCK inhibitor eye drops as an alternative to graft surgery for certain forms of corneal endothelial disease.

*Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan; and

Department of Biomedical Engineering, Faculty of Life and Medical Sciences, Doshisha University, Kyotanabe, Japan.

Reprints: Shigeru Kinoshita, Department of Ophthalmology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Hirokoji-agaru, Kawaramachi-dori, Kamigyo-ku, Kyoto 602-0841, Japan (e-mail:

Supported by A-STEP Feasibility Study from the Japan Science and Technology Agency (AS2314212G for S.K. and N.O.) and the Funding Program for Next Generation World-Leading Researchers from the Cabinet Office in Japan (LS117 for N.K.).

The authors have no funding or conflicts of interest to disclose.

Received September 03, 2012

Accepted December 27, 2012

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.