Investigating The Clinical Application Of Topical Rho Kinase Inhibitors In Patients Following Descemet Membrane Endothelial Keratoplasty: A Case Series
Published 2026 - 44th Congress of the ESCRS
Reference: CC03.08 | Type: Case Report | DOI: 10.82333/h6kp-s004
Authors: Dr Nadav Shemesh* 1 , Dr Nir Erdinest 2 , Dr Ori Saban 2 , Dr Itay Lavy 2
1Ophthalmology,Hadassah Medical Center,Jerusalem,Israel;Ophthalmology,Hadassah Medical Center,Jerusalem,Israel, 2Ophthalmology,Hadassah Medical Center,Jerusalem,Israel
Purpose
To explore the clinical application of topical Ripasudil, a Rho kinase (ROCK) inhibitor, as an adjunct therapeutic strategy to reduce graft detachment risk and improve clinical outcomes in patients with corneal edema following Descemet membrane endothelial keratoplasty (DMEK).
Setting
This case series included three patients who developed corneal edema following DMEK and were treated with topical Ripasudil as an adjunct therapy. Pre- and post-treatment evaluations included best-corrected visual acuity (BCVA; logMAR), central corneal thickness (CCT; μm), and endothelial cell count (ECC; cells/mm²). Outcomes were assessed at baseline and at final follow-up visit.
Report of case
Three patients with post-DMEK corneal edema were treated with topical Ripasudil. Two of three cases demonstrated significant improvements in both CCT and BCVA following treatment. In the third case, a notable increase in ECC was observed, with stable BCVA. No adverse effects were reported in any of the three cases.
Conclusion/Take home message
This case series suggests that topical Ripasudil may serve as an effective adjunct therapy in patients with corneal edema following DMEK, potentially enhancing endothelial cell function and improving postoperative outcomes. The absence of adverse effects supports its safety profile in this setting. Larger prospective studies are warranted to validate these preliminary findings and establish the optimal role of ROCK inhibitors in post-DMEK management.