Descemet Stripping Only for Symptomatic Fuchs Endothelial Dystrophy-A Retrospective Case Series Comparing ROCK-I vs....

Area of Science:

• Ophthalmology
• Corneal Surgery
• Endothelial Keratoplasty

Background:

• Fuchs endothelial corneal dystrophy (FECD) is a progressive condition affecting the corneal endothelium.
• Symptomatic FECD can lead to visual impairment due to central guttata and endothelial dysfunction.
• Current treatments often involve endothelial keratoplasty, which may have associated risks and longer recovery times.

Purpose of the Study:

• To evaluate the efficacy and outcomes of Descemet stripping only (DSO) in patients with symptomatic FECD.
• To assess visual acuity, corneal clearance, and endothelial cell counts following DSO.
• To compare the use of topical rho-associated protein kinase (ROCK) inhibitors versus hypertonic sodium chloride for postoperative management.

Main Methods:

• A retrospective study of 13 eyes from 9 patients with symptomatic FECD undergoing DSO.
• Procedures involved a 4 mm central Descemetorhexis without graft implantation.
• Postoperative management included topical ROCK inhibitors or hypertonic sodium chloride 5% in different eye groups.

Main Results:

• All eyes achieved corneal clearance within an average of 7.2 weeks.
• Significant improvement in visual acuity was observed (0.392 to 0.225 logMAR, p=0.001).
• Mean postoperative endothelial cell count was 778 cells/mm², and central corneal thickness decreased.

Conclusions:

• Descemet stripping only (DSO) is a viable and effective procedure for visual rehabilitation in patients with FECD and visual degradation from central guttata.
• DSO offers a less invasive alternative to endothelial keratoplasty for select FECD patients.
• While not statistically significant, ROCK inhibitors showed a trend towards faster corneal clearance and higher endothelial cell counts compared to hypertonic saline.