Official ESCRS | European Society of Cataract & Refractive Surgeons


Chemical keratoplasty by using rho-kinase inhibitor as eye drops

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Session Details

Session Title: Cornea: Medical

Session Date/Time: Monday 16/09/2019 | 08:30-10:30

Paper Time: 10:06

Venue: Free Paper Forum: Podium 2

First Author: : R.Shah INDIA

Co Author(s): :    J. Kakadia                             

Abstract Details


For advanced corneal endothelial dysfunction, such as Fuch's Endothelial Dystrophy or iatrogenic severe endothelial loss leading to pseudophakic or aphakic bullous keratopathy, so far, various types of surgical keratoplasty (penetrating/endo-lamellar, DSEK/DMEK) were the only possible cure. Surgical transplant of/from human donor cornea has its own large set of problems, difficulties and failure rates. Taking the original fundamental research work of Shigeru Kinoshita, Okumura N, Koizumi N et al, to a clinical stage, we have developed a pharmaceutical alternative to surgical keratoplasty for above mentioned corneal endothelial diseases. So, we did a prospective clinical study.


Solo private practice hospitals of Dr. Ramesh C. Shah-Bombay, India and Dr. Jagdeep M. Kakadia-Bhavnagar, India.


We selected 18 eyes of 18 patients of age range 45-80, mean age 60, having either significant corneal edema or bullous keratopathy due to severe endothelial loss following cataract surgery, who were advised to undergo surgical keratoplasty (DSEK/DMEK) by cornea specialists, after waiting for over 6-8 months for spontaneous recovery. We formulated topical eye drops, by a proprietary self-developed recipe formula, from the chemical compound known as Rho-Kinase (ROCK) Inhibitor, Y-27632, C₁₄H₂₁N₃O · 2HCl. We treated all above referred 18 eyes, using these eye drops 2 hourly over 8-10 weeks via a special drug delivery contact lens system.


We found that these eye drops cleared up all 18 corneas of 18 eyes in 9-12 weeks. Central corneal edema reduced from around 1000-900 microns to (normal) 500 microns, vision improved from hand movements perception to 6/12, endothelial cell count improved from not countable to 700 cells per after using drops for 3 weeks. After another3 weeks this cell count increased from 700 to 1400, andin the following 3 weeks it reached 2800 cells per After stopping the use of drops, cell population stopped growing.


This indicates that (1) these eye drops induce one mitotic cell division over a period of every 20 days (2) mother and daughter cells simultaneously divide themselves, causing exponential growth of cell population (3) cell division can be switched off by stopping theuse of eye drops. None of the above patients had shown any side or adverse effects. Use of ROCK Inhibitor as eye drops is an excellent medical treatment as an alternative to surgical keratoplasty.

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