Treatment Of Corneal Edema After Complicated Cataract Surgery With Fixed Combination Of 0.02% Netarsudil And 0.005% Latanoprost

To evaluate the use of fixed combination 0.02% netarsudil and 0.005% latanoprost for treatment of corneal edema after complicated cataract surgery.

Eye Hospital, University Medical Centre Ljubljana

Patients with persistent corneal edema (>600 mm) after complicated cataract surgery were treated with topical combination of 0.02% netarsudil and 0.005% latanoprost (Roclanda, Santen Oy, Finland) 1x daily for three months. Initial and follow-up examination included best corrected visual acuity (BCVA), corneal topography and tomography (Sirius+, CSO) and anterior segment coherence tomography (Anterion,Heidelberg Engineering). Primary endpoint was change in central corneal thickness (CCT) from baseline to 1 and 3 months. Secondary endpoint was BCVA improvement.

6 patients completed the treatment. The mean baseline BCVA was 0.05 (counting fingers on half meter -  0.2) on Snellen chart. On average, edema persisted for 325 days (3 - 1046). The mean CCT reduced from 787mm (632 - 988) pre-treatment to 675mm (573 – 862) at 3 months; namely there was a mean -93mm (-8 - -311) reduction at 1 month, and a -134mm (-14 - -415) reduction in thickness at 3 months. 4 out of 6 patients (67%) achieved complete resolution of corneal edema. After 3 months, mean BCVA improvement was +5,8 Snellen lines (+2 -  +18). There were no serious side effects, 4/6 (67%) patients had mild conjunctival hyperemia, and 3/6 (50%) complained about mild irritation immediately after drop application.

Topical fixed combination of 0.02% netarsudil and 0.005% latanoprost was well-tolerated and resulted in reduction of corneal thickness and improvement of BCVA in patients with persisting corneal edema after complicated cataract surgery. This minimally invasive treatment could potentially spare the patient from further surgical interventions. Further study on bigger cohort with longer follow up is needed to evaluate the long-term effect.