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Preoperative Use of the Rho Kinase Inhibitor Ripasudil Protects the Corneal Endothelium from Trabeculectomy-Induced
Yamato Katsura1, Hisataka Fujimoto1, Masashi Takata1
1Department of Ophthalmology, Hyogo Medical University, Nishinomiya, Hyogo, Japan.
Clinical Ophthalmology (Auckland, N.Z.)
|May 7, 2026
Summary
Preoperative ripasudil eye drops significantly reduced corneal endothelial cell loss after glaucoma surgery. This Rho kinase inhibitor helps maintain corneal health during trabeculectomy procedures.
Area of Science:
- Ophthalmology
- Corneal Science
- Glaucoma Research
Background:
- Rho kinase inhibitors are emerging treatments for glaucoma and corneal disorders.
- Ripasudil, a Rho kinase inhibitor, is approved for glaucoma but requires further study for corneal endothelial disorders.
Purpose of the Study:
- To evaluate the effectiveness of preoperative ripasudil in preserving corneal endothelial cells following trabeculectomy.
Main Methods:
- Retrospective observational study of 139 eyes with primary open-angle glaucoma undergoing trabeculectomy.
- Patients received either ripasudil eye drops preoperatively or no preoperative ripasudil.
- Corneal endothelial cell density changes were the primary outcome measure.
Main Results:
- The ripasudil group showed significantly lower endothelial cell density loss after trabeculectomy compared to the without-ripasudil group ( -0.16% vs. 6.66%, p < 0.001).
- In eyes undergoing combined surgery, the ripasudil group also had significantly less cell loss (0.97% vs. 7.70%, p < 0.05).
Conclusions:
- Preoperative ripasudil eye drops may preserve corneal endothelial cell integrity in glaucoma patients undergoing trabeculectomy.
