title: Rho-associated kinase inhibitor eye drop treatment as a possible medical treatment for Fuchs corneal dystrophy.
abstract: OBJECTIVE
  To report a case of Fuchs corneal dystrophy that was successfully treated by Rho-associated kinase (ROCK) inhibitor eye drops, subsequent to transcorneal freezing of damaged corneal endothelial cells.
  
  
  METHODS
  A 52-year-old Japanese man with a diagnosis of late-onset Fuchs corneal dystrophy was referred to our hospital as a candidate for keratoplasty. Best-corrected vision was 20/20 in the right eye and 20/63 in the left eye. Multiple guttae were observed in both eyes. The right cornea was clear, but the left showed severe central edema, with a central corneal thickness of 703 μm. We were unable to perform specular microscopy in the central cornea, but endothelial cells were observed in the midperiphery at a density of 757 cells per square millimeter. The patient was treated by a corneal endothelial denudation in the prepupillary region followed by the topical administration of a selective ROCK inhibitor, Y-27632, as eye drops for 1 week. Follow-up of 24 months is reported.
  
  
  RESULTS
  Corneal clarity recovered and vision improved to 20/20 two weeks after the treatment. At 6 months, vision had improved to 20/16 and central corneal thickness measured was 568 μm, significantly lower than its pretreatment value. Endothelial function and vision have been well maintained up to the most recent observation, 24 months after the treatment. The average corneal endothelial density in the central and peripheral cornea was 1549.3 ± 89.7 and 705.0 ± 61.1 cells per square millimeter, respectively.
  
  
  CONCLUSIONS
  The case highlights the possibility of medical treatments involving the use of ROCK inhibitor eye drops as an alternative to graft surgery for certain forms of corneal endothelial disease.
authors.affiliation: Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Koizumi
authors.forename: Naoki
authors.initials: N
authors.lastname: Okumura
authors.forename: Morio
authors.initials: M
authors.lastname: Ueno
authors.forename: Hiroko
authors.initials: H
authors.lastname: Nakagawa
authors.forename: Junji
authors.initials: J
authors.lastname: Hamuro
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kinoshita
mesh_terms: D000577:Amides / Q000627:therapeutic use*; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D005642:Fuchs' Endothelial Dystrophy / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000627:therapeutic use*; D011725:Pyridines / Q000627:therapeutic use*; D016896:Treatment Outcome; D054460:rho-Associated Kinases / Q000037:antagonists & inhibitors*
chemical_list: D000577:Amides; D004791:Enzyme Inhibitors; D009883:Ophthalmic Solutions; D011725:Pyridines; C108830:Y 27632; D054460:rho-Associated Kinases