Descemet Stripping without Transplantation in Fuchs Endothelial Corneal Dystrophy

Abstract

Traditionally, corneal endothelium is considered post-mitotic, which means that spontaneous regeneration after loss of endothelial cells (e.g., in the context of Fuchs endothelial corneal dystrophy) is not expected. Nevertheless, it has been observed in several cases that an edematous cornea can clear after removal of a smaller area of Descemetʼs membrane. The posterior aspect of this area becomes covered again by corneal endothelial cells. This has resulted in a new surgical approach that does not involve a posterior lamellar graft: “Descemet stripping only”. At the same time, data from in vitro experiments suggest that Rho kinase inhibitors (ROCK inhibitors) are pharmacological agents that promote proliferation and migration of corneal endothelium, and thus have a positive influence on healing.

Key words

cornea - keratoplasty - ROCK inhibitor - Descemet stripping - Fuchs endothelial corneal dystrophy

Publikationsverlauf

Eingereicht: 25. Januar 2022

Angenommen: 09. März 2022

Artikel online veröffentlicht:
17. Mai 2022

• References/Literatur

• 1 Vedana G, Villarreal G, Jun AS. Fuchs endothelial corneal dystrophy: current perspectives. Clin Ophthalmol 2016; 10: 321-330
• 2 Mimura T, Yamagami S, Amano S. Corneal endothelial regeneration and tissue engineering. Prog Retin Eye Res 2013; 35: 1-17
• 3 Son HS, Villarreal G, Meng H. et al. On the origin of “guttae”. Br J Ophthalmol 2014; 98: 1308-1310
• 4 Weiss JS, Møller HU, Aldave AJ. et al. IC3D classification of corneal dystrophies–edition 2. Cornea 2015; 34: 117-159
• 5 Zoega GM, Fujisawa A, Sasaki H. et al. Prevalence and risk factors for cornea guttata in the Reykjavik Eye Study. Ophthalmology 2006; 113: 565-569
• 6 Zoega GM, Arnarsson A, Sasaki H. et al. The 7-year cumulative incidence of cornea guttata and morphological changes in the corneal endothelium in the Reykjavik Eye Study. Acta Ophthalmol 2013; 91: 212-218
• 7 Cursiefen C, Küchle M, Naumann GO. Changing indications for penetrating keratoplasty: histopathology of 1,250 corneal buttons. Cornea 1998; 17: 468-470
• 8 Kruse FE, Schlötzer-Schrehardt U, Tourtas T. Optimizing outcomes with Descemetʼs membrane endothelial keratoplasty. Curr Opin Ophthalmol 2014; 25: 325-334
• 9 Heindl LM, Cursiefen C. Split-Cornea-Transplantation – ein neues Konzept gegen Spendermangel. Klin Monbl Augenheilkd 2012; 229: 608-614
• 10 Geerling G, Duncker GI. Fortschritte in der Hornhautchirurgie und „Was interessiert mich mein Geschwätz von gestern!“. Klin Monbl Augenheilkd 2010; 227: 451-452
• 11 Flockerzi E, Maier P, Böhringer D. et al. Trends in Corneal Transplantation from 2001 to 2016 in Germany: A Report of the DOG-Section Cornea and its Keratoplasty Registry. Am J Ophthalmol 2018; 188: 91-98
• 12 Whikehart DR, Parikh CH, Vaughn AV. et al. Evidence suggesting the existence of stem cells for the human corneal endothelium. Mol Vis 2005; 11: 816-824
• 13 McGowan SL, Edelhauser HF, Pfister RR. et al. Stem cell markers in the human posterior limbus and corneal endothelium of unwounded and wounded corneas. Mol Vis 2007; 13: 1984-2000
• 14 Jacobi C, Zhivov A, Korbmacher J. et al. Evidence of endothelial cell migration after Descemet membrane endothelial keratoplasty. Am J Ophthalmol 2011; 152: 537-542.e2
• 15 Stewart RMK, Hiscott PS, Kaye SB. Endothelial migration and new Descemet membrane after endothelial keratoplasty. Am J Ophthalmol 2010; 149: 683 author reply 683-684
• 16 Balachandran C, Ham L, Verschoor CA. et al. Spontaneous corneal clearance despite graft detachment in Descemet membrane endothelial keratoplasty. Am J Ophthalmol 2009; 148: 227-234.e1
• 17 Koenig SB. Long-term corneal clarity after spontaneous repair of an iatrogenic descemetorhexis in a patient with Fuchs dystrophy. Cornea 2013; 32: 886-888
• 18 Braunstein RE, Airiani S, Chang MA. et al. Corneal edema resolution after “descemetorhexis”. J Cataract Refract Surg 2003; 29: 1436-1439
• 19 Jullienne R, Manoli P, Tiffet T. et al. Corneal endothelium self-healing mathematical model after inadvertent descemetorhexis. J Cataract Refract Surg 2015; 41: 2313-2318
• 20 Pan JC, Au Eong KG. Spontaneous resolution of corneal oedema after inadvertent “descemetorhexis” during cataract surgery. Clin Experiment Ophthalmol 2006; 34: 896-897
• 21 Ruhe K, Finis D, Fuchsluger T. et al. Spontane Visuserholung durch Endothelzellmigration bei großem, zentralem postoperativem Descemetdefekt. Klin Monbl Augenheilkd 2012; 229: 632-634
• 22 Baráková D, Darsová D. A Case Report Illustrating the Spontaneous Vision Recovery After Inadvertent Central Descemetorhexis During Anterior Capsulotomy. Int Med Case Rep J 2021; 14: 45-49
• 23 Zafirakis P, Kymionis GD, Grentzelos MA. et al. Corneal graft detachment without corneal edema after Descemet stripping automated endothelial keratoplasty. Cornea 2010; 29: 456-458
• 24 Shah RD, Randleman JB, Grossniklaus HE. Spontaneous corneal clearing after Descemetʼs stripping without endothelial replacement. Ophthalmology 2012; 119: 256-260
• 25 Moloney G, Chan UT, Hamilton A. et al. Descemetorhexis for Fuchsʼ dystrophy. Can J Ophthalmol 2015; 50: 68-72
• 26 Arbelaez JG, Price MO, Price FW. Long-term follow-up and complications of stripping Descemet membrane without placement of graft in eyes with Fuchs endothelial dystrophy. Cornea 2014; 33: 1295-1299
• 27 Dirisamer M, Yeh RY, van Dijk K. et al. Recipient endothelium may relate to corneal clearance in Descemet membrane endothelial transfer. Am J Ophthalmol 2012; 154: 290-296.e1
• 28 Borkar DS, Veldman P, Colby KA. Treatment of Fuchs Endothelial Dystrophy by Descemet Stripping Without Endothelial Keratoplasty. Cornea 2016; 35: 1267-1273
• 29 Amano M, Nakayama M, Kaibuchi K. Rho-kinase/ROCK: A key regulator of the cytoskeleton and cell polarity. Cytoskeleton (Hoboken) 2010; 67: 545-554
• 30 Defert O, Boland S. Rho kinase inhibitors: a patent review (2014–2016). Expert Opin Ther Pat 2017; 27: 507-515
• 31 Okumura N, Koizumi N, Ueno M. et al. The new therapeutic concept of using a rho kinase inhibitor for the treatment of corneal endothelial dysfunction. Cornea 2011; 30 (Suppl. 01) S54-S59
• 32 Koizumi N, Okumura N, Ueno M. et al. New therapeutic modality for corneal endothelial disease using Rho-associated kinase inhibitor eye drops. Cornea 2014; 33 (Suppl. 01) S25-31
• 33 Okumura N, Koizumi N, Kay EP. et al. The ROCK inhibitor eye drop accelerates corneal endothelium wound healing. Invest Ophthalmol Vis Sci 2013; 54: 2493-2502
• 34 Soh YQ, Peh G, George BL. et al. Predicative Factors for Corneal Endothelial Cell Migration. Invest Ophthalmol Vis Sci 2016; 57: 338-348
• 35 Koizumi N, Okumura N, Ueno M. et al. Rho-associated kinase inhibitor eye drop treatment as a possible medical treatment for Fuchs corneal dystrophy. Cornea 2013; 32: 1167-1170
• 36 Garnock-Jones KP. Ripasudil: first global approval. Drugs 2014; 74: 2211-2215
• 37 Tanihara H, Inoue T, Yamamoto T. et al. One-year clinical evaluation of 0.4 % ripasudil (K-115) in patients with open-angle glaucoma and ocular hypertension. Acta Ophthalmol 2016; 94: e26-34
• 38 Tanihara H, Inoue T, Yamamoto T. et al. Phase 2 randomized clinical study of a Rho kinase inhibitor, K-115, in primary open-angle glaucoma and ocular hypertension. Am J Ophthalmol 2013; 156: 731-736
• 39 Tanihara H, Inoue T, Yamamoto T. et al. Phase 1 clinical trials of a selective Rho kinase inhibitor, K-115. JAMA Ophthalmol 2013; 131: 1288-1295
• 40 Nakagawa H, Koizumi N, Okumura N. et al. Morphological Changes of Human Corneal Endothelial Cells after Rho-Associated Kinase Inhibitor Eye Drop (Ripasudil) Administration: A Prospective Open-Label Clinical Study. PLoS One 2015; 10: e0136802
• 41 Okumura N, Okazaki Y, Inoue R. et al. Rho-Associated Kinase Inhibitor Eye Drop (Ripasudil) Transiently Alters the Morphology of Corneal Endothelial Cells. Invest Ophthalmol Vis Sci 2015; 56: 7560-7567
• 42 Okumura N, Okazaki Y, Inoue R. et al. Effect of the Rho-Associated Kinase Inhibitor Eye Drop (Ripasudil) on Corneal Endothelial Wound Healing. Invest Ophthalmol Vis Sci 2016; 57: 1284-1292
• 43 Bruinsma M, Tong CM, Melles GRJ. What does the future hold for the treatment of Fuchs endothelial dystrophy; will “keratoplasty” still be a valid procedure?. Eye (Lond) 2013; 27: 1115-1122
• 44 Menzel-Severing J, Schrader S, Schlötzer-Schrehardt U. et al. Transcorneal freezing and topical Rho-kinase inhibitor treatment in Fuchs endothelial corneal dystrophy. Eye (Lond) 2022;
• 45 Moloney G, Garcerant Congote D, Hirnschall N. et al. Descemet Stripping Only Supplemented With Topical Ripasudil for Fuchs Endothelial Dystrophy 12-Month Outcomes of the Sydney Eye Hospital Study. Cornea 2021; 40: 320-326
• 46 Iovieno A, Moramarco A, Fontana L. Descemet stripping only in Fuchsʼ endothelial dystrophy without use of topical Rho-kinase inhibitors: 5-year follow-up. Can J Ophthalmol 2021;
• 47 Macsai MS, Shiloach M. Use of Topical Rho Kinase Inhibitors in the Treatment of Fuchs Dystrophy after Descemet Stripping Only. Cornea 2019; 38: 529-534
• 48 Davies E, Jurkunas U, Pineda 2nd R. Pilot Study of Corneal Clearance With the Use of a Rho-Kinase Inhibitor After Descemetorhexis Without Endothelial Keratoplasty for Fuchs Endothelial Corneal Dystrophy. Cornea 2021; 40: 899-902
• 49 Kaufman AR, Nosé RM, Pineda 2nd R. Descemetorhexis Without Endothelial Keratoplasty (DWEK): Proposal for Nomenclature Standardization. Cornea 2018; 37: e20-e21
• 50 Artaechevarria Artieda J, Wells M, Devasahayam RN. et al. 5-Year Outcomes of Descemet Stripping Only in Fuchs Dystrophy. Cornea 2020; 39: 1048-1051