Clinical Evaluation of Ripasudil for Corneal Edema: A Large-Scale Retrospective Cohort Study

Area of Science:

• Ophthalmology
• Corneal Diseases
• Pharmacology

Background:

• Corneal edema presents a significant challenge in ophthalmology, often requiring surgical intervention.
• Topical pharmacotherapies offer a less invasive alternative for managing corneal edema.

Purpose of the Study:

• To evaluate the therapeutic efficacy of topical Ripasudil hydrochloride hydrate in managing diverse forms of corneal edema.
• To assess the impact of Ripasudil on visual acuity, corneal thickness, and endothelial cell count.

Main Methods:

• Retrospective study of 96 patients with corneal edema (post-cataract surgery, FECD, post-DMEK, post-PKP).
• Patients received topical Ripasudil, with dosage adjusted over time.
• Outcomes measured included best-corrected visual acuity (BCVA), central corneal thickness (CCT), and endothelial cell count (ECC).

Main Results:

• Ripasudil significantly reduced CCT and improved BCVA across most patient groups.
• Central corneal thickness decreased by up to 30.44 μm (p < 0.001).
• Visual acuity improved by up to 0.27 logMAR units (p = 0.001), with minimal impact on ECC.

Conclusions:

• Topical Ripasudil is a safe and effective non-invasive treatment for corneal edema.
• Ripasudil may help delay or avoid surgical interventions like corneal transplantation in select patients.
• No adverse events or edema progression were observed during the study period.