Twelve-year outcome of Rho-associated protein kinase inhibitor eye drop treatment for Fuchs endothelial corneal dystrophy: A case study

Yasufumi Tomioka; Koji Kitazawa; Hideki Fukuoka; Morio Ueno; Noriko Koizumi; Chie Sotozono; Shigeru Kinoshita

doi:10.1016/j.ajoc.2023.101839

Twelve-year outcome of Rho-associated protein kinase inhibitor eye drop treatment for Fuchs endothelial corneal dystrophy: A case study

Am J Ophthalmol Case Rep. 2023 Mar 31:30:101839. doi: 10.1016/j.ajoc.2023.101839. eCollection 2023 Jun.

Authors

Yasufumi Tomioka¹, Koji Kitazawa¹, Hideki Fukuoka¹, Morio Ueno¹, Noriko Koizumi¹, Chie Sotozono¹, Shigeru Kinoshita²

Affiliations

¹ Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
² Department of Frontier Medical Science and Technology for Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Abstract

Purpose: To report the safety, efficacy, and long-term outcome in a case of Fuchs endothelial corneal dystrophy (FECD) treated by Rho-associated protein kinase (ROCK)-inhibitor eye drops in combination with removal of degenerated corneal endothelial cells (CECs) subsequent to transcorneal freezing.

Observations: A 52-year-old Japanese man diagnosed with early-stage FECD developed central corneal edema with decreased visual acuity (VA) in his left eye and was treated by ROCK inhibitor eye drops (Y-27632 10mM) q.i.d. for 1 week starting immediately subsequent to the removal of the damaged CECs via 2-mm-diameter transcorneal freezing in May 18, 2010. Before treatment, the best-corrected VA (BCVA) was 20/20 OD and 20/63 OS, and the central corneal thickness in the left eye was 643 μm and specular microscopy image at the central cornea was not detected due to edema. Corneal transparency recovered, and the BCVA improved to 20/20 within two weeks. At 12 years post treatment, the cornea in left eye remained transparent without corneal edema, and the CEC density at the central cornea was 1294 cells/mm² and the central corneal thickness was 581 μm. The annual decrease of CECs at the central cornea was 1.1%, and VA was maintained at 20/25. Multiple guttae were observed in the peripheral region, but few in the central region were removed by transcorneal freezing treatment, and relatively normal and healthy CECs were observed.

Conclusions and importance: The findings in this case suggest the potential long-term safety and efficacy of the medical therapy by ROCK-inhibitor eye drop for early-stage FECD.

Keywords: FECD; ROCK inhibitor; Transcorneal freezing; Y-27632.

Publication types

Case Reports