EFFECT OF ROCLANDA (NETARSUDIL/LATANOPROST) ON PERSISTENT CORNEAL EDEMA AFTER CATARACT SURGERY: A PILOT CASE SERIES

Persistent corneal edema following cataract surgery remains a challenging postoperative complication that can significantly delay visual recovery and compromise surgical outcomes. The condition often results from transient or permanent endothelial dysfunction, with limited non-surgical treatment options available once topical steroids and hyperosmotic agents fail.

This study aimed to evaluate the effect of Roclanda (netarsudil 0.02% + latanoprost 0.005%) eye drops on corneal thickness and visual acuity in patients with persistent postoperative corneal edema.

Department of Ophthalmology, University Hospital Dubrava, Zagreb, Croatia.

This prospective, observational pilot study included ten eyes of ten patients who developed corneal edema persisting for at least three months after uncomplicated phacoemulsification with posterior chamber intraocular lens implantation. 

All participants were treated with Roclanda once daily at bedtime for a minimum of three months.  Comprehensive ophthalmic examinations were performed at baseline and at 1,2 and 3 months after starting therapy.

Outcome measures included best-corrected visual acuity (BCVA, logMAR) an central corneal thickness (CCT, µm) measured by anterior-segment OCT. Intraocular pressure (IOP) was monitored at each visit and adverse events were reported.

At baseline, all eyes demonstrated marked central corneal edema with increased CCT and reduced visual acuity. After one month of Roclanda treatment, a modest reduction in corneal edema was observed in most patients. By the third month, mean CCT values showed a consistent decrease, accompanied by a progressive improvement in BCVA. 

No significant adverse effects were recorded. IOP remained stable throughout the study period, and no cases of hyperemia or ocular discomfort necessitating discontinuation were reported.

Adjunctive use of Roclanda may facilitate corneal deturgescence and functional recovery in patients with persistent corneal edema following cataract surgery. The combination of netarsudil and latanoprost was well tolerated and did not induce intraocular pressure instability or ocular irritation during the treatment period.

These preliminary results support the hypothesis that Rho-kinase inhibition by netarsudil could enhance endothelial cell contractility and fluid transport, thereby promoting corneal clearing. Further controlled studies with larger sample sizes and endothelial cell count analysis are warranted to confirm these findings and clarify the precise mechanisms underlying the observed improvement.