Jukić Anđela, Pupić Bakrač Ana, Đapic Ivančić Biljana, Kopić Andrijana, Meter Ana, Kasalica Žužul Rajka, Pavan Josip, Jukić Tomislav
Department of Ophthalmology, University Hospital Dubrava, 10000 Zagreb, Croatia.
Department of Neurology, University Hospital Centre Zagreb, 10000 Zagreb, Croatia.
Medicina (Kaunas). 2025 Apr 22;61(5):772. doi: 10.3390/medicina61050772.
Fuchs endothelial corneal dystrophy (FECD) is the most common corneal endothelial dystrophy. It is characterized by the progressive loss of corneal endothelial cells (CECs), guttae formation on the Descemet membrane, and corneal edema, leading to visual impairment. Corneal transplantation remains the standard treatment, but it has limitations such as donor shortages, infection risk, and graft rejection. Rho-kinase (ROCK) inhibitors have emerged as a promising pharmacological alternative. These agents promote CEC proliferation, migration, and adhesion while inhibiting apoptosis and enhancing corneal endothelial wound healing. Several studies have demonstrated the efficacy of ROCK inhibitors in improving corneal clarity and endothelial function, particularly when used as an adjunct to Descemet Stripping Only (DSO) surgery. Additionally, they show potential in preventing corneal edema in FECD patients undergoing cataract surgery. The methodology involved a literature search through the PubMed and Medline databases using relevant keywords. Only peer-reviewed articles in English were included, with additional references from selected articles reviewed to ensure comprehensive coverage. ROCK inhibitors offer a novel pharmacological approach to managing FECD. They have shown potential in promoting endothelial cell regeneration and improving corneal functIion. Despite promising results, further research is required to determine ROCK inhibitors' long-term safety, optimal dosing, and efficacy in surgical and non-surgical FECD patients. Their potential to delay or prevent corneal transplantation represents a significant advancement in FECD management.
富克斯角膜内皮营养不良（FECD）是最常见的角膜内皮营养不良。其特征是角膜内皮细胞（CEC）逐渐丧失、后弹力层形成角膜小滴以及角膜水肿，导致视力受损。角膜移植仍然是标准治疗方法，但存在供体短缺、感染风险和移植排斥等局限性。Rho激酶（ROCK）抑制剂已成为一种有前景的药物替代方案。这些药物可促进CEC增殖、迁移和黏附，同时抑制细胞凋亡并增强角膜内皮伤口愈合。多项研究已证明ROCK抑制剂在改善角膜透明度和内皮功能方面的疗效，特别是在仅行后弹力层剥除术（DSO）时作为辅助用药。此外，它们在预防接受白内障手术的FECD患者发生角膜水肿方面也显示出潜力。该方法涉及使用相关关键词在PubMed和Medline数据库中进行文献检索。仅纳入英文的同行评审文章，并对所选文章的其他参考文献进行审查以确保全面覆盖。ROCK抑制剂为管理FECD提供了一种新的药物方法。它们在促进内皮细胞再生和改善角膜功能方面已显示出潜力。尽管取得了令人鼓舞的结果，但仍需要进一步研究以确定ROCK抑制剂在手术和非手术FECD患者中的长期安全性、最佳剂量和疗效。它们延迟或预防角膜移植的潜力代表了FECD管理方面的重大进展。
