Descemet-Stripping ohne Transplantat bei Fuchsʼscher endothelialer Hornhautdystrophie?

Zusammenfassung

Traditionell wird das Hornhautendothel als postmitotisch angesehen, sodass von einer spontanen Regeneration nach Verlust von Endothelzellen (z. B. im Rahmen der Fuchsʼschen endothelialen Hornhautdystrophie) nicht ausgegangen wird. Dennoch konnte in mehreren Fällen beobachtet werden, dass eine ödematöse Hornhaut nach Entfernung eines kleineren Areals der Descemet-Membran aufklart. Der posteriore Aspekt dieses Bereichs wurde von Hornhautendothelzellen wieder bedeckt. Hieraus entstand ein operatives Therapiekonzept ohne posteriores lamelläres Transplantat: „Descemet stripping only“. Zugleich legen Daten aus In-vitro-Versuchen nahe, dass Rho-Kinase-Inhibitoren (ROCK-Inhibitoren) pharmakologische Wirkstoffe sind, die eine Proliferation und Migration des Hornhautendothels fördern und somit den Heilungsverlauf nach Descemet-Stripping positiv beeinflussen. Mittlerweile liegen erste Daten aus kleineren prospektiven, kontrollierten klinischen Studien vor, die durchweg gute Ergebnisse nach Descemet-Stripping und ROCK-Inhibitor-Augentropfen berichten. Offene Fragen bestehen jedoch derzeit noch hinsichtlich der Charakteristika der Patientengruppe, die von diesem Therapieansatz besonders profitiert und hinsichtlich der Nachhaltigkeit eines Therapieerfolgs.

Schlüsselwörter

Kornea - ROCK-Inhibitor - Keratoplastik - Fuchsʼsche endotheliale Hornhautdystrophie - Descemet-Stripping

Publication History

Received: 25 January 2022

Accepted: 09 March 2022

Article published online:
17 May 2022

• References/Literatur

• 1 Vedana G, Villarreal G, Jun AS. Fuchs endothelial corneal dystrophy: current perspectives. Clin Ophthalmol 2016; 10: 321-330 DOI: 10.2147/OPTH.S83467.
• 2 Mimura T, Yamagami S, Amano S. Corneal endothelial regeneration and tissue engineering. Prog Retin Eye Res 2013; 35: 1-17 DOI: 10.1016/j.preteyeres.2013.01.003.
• 3 Son HS, Villarreal G, Meng H. et al. On the origin of “guttae”. Br J Ophthalmol 2014; 98: 1308-1310 DOI: 10.1136/bjophthalmol-2014-305069.
• 4 Weiss JS, Møller HU, Aldave AJ. et al. IC3D classification of corneal dystrophies–edition 2. Cornea 2015; 34: 117-159 DOI: 10.1097/ICO.0000000000000307.
• 5 Zoega GM, Fujisawa A, Sasaki H. et al. Prevalence and risk factors for cornea guttata in the Reykjavik Eye Study. Ophthalmology 2006; 113: 565-569 DOI: 10.1016/j.ophtha.2005.12.014.
• 6 Zoega GM, Arnarsson A, Sasaki H. et al. The 7-year cumulative incidence of cornea guttata and morphological changes in the corneal endothelium in the Reykjavik Eye Study. Acta Ophthalmol 2013; 91: 212-218 DOI: 10.1111/j.1755-3768.2011.02360.x.
• 7 Cursiefen C, Küchle M, Naumann GO. Changing indications for penetrating keratoplasty: histopathology of 1,250 corneal buttons. Cornea 1998; 17: 468-470 DOI: 10.1097/00003226-199809000-00002.
• 8 Kruse FE, Schlötzer-Schrehardt U, Tourtas T. Optimizing outcomes with Descemetʼs membrane endothelial keratoplasty. Curr Opin Ophthalmol 2014; 25: 325-334 DOI: 10.1097/ICU.0000000000000072.
• 9 Heindl LM, Cursiefen C. Split-Cornea-Transplantation – ein neues Konzept gegen Spendermangel. Klin Monbl Augenheilkd 2012; 229: 608-614 DOI: 10.1055/s-0031-1299494.
• 10 Geerling G, Duncker GI. Fortschritte in der Hornhautchirurgie und „Was interessiert mich mein Geschwätz von gestern!“. Klin Monbl Augenheilkd 2010; 227: 451-452 DOI: 10.1055/s-0029-1245477.
• 11 Flockerzi E, Maier P, Böhringer D. et al. Trends in Corneal Transplantation from 2001 to 2016 in Germany: A Report of the DOG-Section Cornea and its Keratoplasty Registry. Am J Ophthalmol 2018; 188: 91-98 DOI: 10.1016/j.ajo.2018.01.018.
• 12 Whikehart DR, Parikh CH, Vaughn AV. et al. Evidence suggesting the existence of stem cells for the human corneal endothelium. Mol Vis 2005; 11: 816-824
• 13 McGowan SL, Edelhauser HF, Pfister RR. et al. Stem cell markers in the human posterior limbus and corneal endothelium of unwounded and wounded corneas. Mol Vis 2007; 13: 1984-2000
• 14 Jacobi C, Zhivov A, Korbmacher J. et al. Evidence of endothelial cell migration after Descemet membrane endothelial keratoplasty. Am J Ophthalmol 2011; 152: 537-542.e2 DOI: 10.1016/j.ajo.2011.04.005.
• 15 Stewart RMK, Hiscott PS, Kaye SB. Endothelial migration and new Descemet membrane after endothelial keratoplasty. Am J Ophthalmol 2010; 149: 683 author reply 683-684 DOI: 10.1016/j.ajo.2009.12.004.
• 16 Balachandran C, Ham L, Verschoor CA. et al. Spontaneous corneal clearance despite graft detachment in Descemet membrane endothelial keratoplasty. Am J Ophthalmol 2009; 148: 227-234.e1 DOI: 10.1016/j.ajo.2009.02.033.
• 17 Koenig SB. Long-term corneal clarity after spontaneous repair of an iatrogenic descemetorhexis in a patient with Fuchs dystrophy. Cornea 2013; 32: 886-888 DOI: 10.1097/ICO.0b013e3182886aaa.
• 18 Braunstein RE, Airiani S, Chang MA. et al. Corneal edema resolution after “descemetorhexis”. J Cataract Refract Surg 2003; 29: 1436-1439 DOI: 10.1016/s0886-3350(02)01984-3.
• 19 Jullienne R, Manoli P, Tiffet T. et al. Corneal endothelium self-healing mathematical model after inadvertent descemetorhexis. J Cataract Refract Surg 2015; 41: 2313-2318 DOI: 10.1016/j.jcrs.2015.10.043.
• 20 Pan JC, Au Eong KG. Spontaneous resolution of corneal oedema after inadvertent “descemetorhexis” during cataract surgery. Clin Experiment Ophthalmol 2006; 34: 896-897 DOI: 10.1111/j.1442-9071.2006.01360.x.
• 21 Ruhe K, Finis D, Fuchsluger T. et al. Spontane Visuserholung durch Endothelzellmigration bei großem, zentralem postoperativem Descemetdefekt. Klin Monbl Augenheilkd 2012; 229: 632-634 DOI: 10.1055/s-0031-1299512.
• 22 Baráková D, Darsová D. A Case Report Illustrating the Spontaneous Vision Recovery After Inadvertent Central Descemetorhexis During Anterior Capsulotomy. Int Med Case Rep J 2021; 14: 45-49 DOI: 10.2147/IMCRJ.S290179.
• 23 Zafirakis P, Kymionis GD, Grentzelos MA. et al. Corneal graft detachment without corneal edema after Descemet stripping automated endothelial keratoplasty. Cornea 2010; 29: 456-458 DOI: 10.1097/ICO.0b013e3181b46bc2.
• 24 Shah RD, Randleman JB, Grossniklaus HE. Spontaneous corneal clearing after Descemetʼs stripping without endothelial replacement. Ophthalmology 2012; 119: 256-260 DOI: 10.1016/j.ophtha.2011.07.032.
• 25 Moloney G, Chan UT, Hamilton A. et al. Descemetorhexis for Fuchsʼ dystrophy. Can J Ophthalmol 2015; 50: 68-72 DOI: 10.1016/j.jcjo.2014.10.014.
• 26 Arbelaez JG, Price MO, Price FW. Long-term follow-up and complications of stripping Descemet membrane without placement of graft in eyes with Fuchs endothelial dystrophy. Cornea 2014; 33: 1295-1299 DOI: 10.1097/ICO.0000000000000270.
• 27 Dirisamer M, Yeh RY, van Dijk K. et al. Recipient endothelium may relate to corneal clearance in Descemet membrane endothelial transfer. Am J Ophthalmol 2012; 154: 290-296.e1 DOI: 10.1016/j.ajo.2012.02.032.
• 28 Borkar DS, Veldman P, Colby KA. Treatment of Fuchs Endothelial Dystrophy by Descemet Stripping Without Endothelial Keratoplasty. Cornea 2016; 35: 1267-1273 DOI: 10.1097/ICO.0000000000000915.
• 29 Amano M, Nakayama M, Kaibuchi K. Rho-kinase/ROCK: A key regulator of the cytoskeleton and cell polarity. Cytoskeleton (Hoboken) 2010; 67: 545-554 DOI: 10.1002/cm.20472.
• 30 Defert O, Boland S. Rho kinase inhibitors: a patent review (2014–2016). Expert Opin Ther Pat 2017; 27: 507-515 DOI: 10.1080/13543776.2017.1272579.
• 31 Okumura N, Koizumi N, Ueno M. et al. The new therapeutic concept of using a rho kinase inhibitor for the treatment of corneal endothelial dysfunction. Cornea 2011; 30 (Suppl. 01) S54-S59 DOI: 10.1097/ICO.0b013e3182281ee1.
• 32 Koizumi N, Okumura N, Ueno M. et al. New therapeutic modality for corneal endothelial disease using Rho-associated kinase inhibitor eye drops. Cornea 2014; 33 (Suppl. 01) S25-31 DOI: 10.1097/ICO.0000000000000240.
• 33 Okumura N, Koizumi N, Kay EP. et al. The ROCK inhibitor eye drop accelerates corneal endothelium wound healing. Invest Ophthalmol Vis Sci 2013; 54: 2493-2502 DOI: 10.1167/iovs.12-11320.
• 34 Soh YQ, Peh G, George BL. et al. Predicative Factors for Corneal Endothelial Cell Migration. Invest Ophthalmol Vis Sci 2016; 57: 338-348 DOI: 10.1167/iovs.15-18300.
• 35 Koizumi N, Okumura N, Ueno M. et al. Rho-associated kinase inhibitor eye drop treatment as a possible medical treatment for Fuchs corneal dystrophy. Cornea 2013; 32: 1167-1170 DOI: 10.1097/ICO.0b013e318285475d.
• 36 Garnock-Jones KP. Ripasudil: first global approval. Drugs 2014; 74: 2211-2215 DOI: 10.1007/s40265-014-0333-2.
• 37 Tanihara H, Inoue T, Yamamoto T. et al. One-year clinical evaluation of 0.4 % ripasudil (K-115) in patients with open-angle glaucoma and ocular hypertension. Acta Ophthalmol 2016; 94: e26-34 DOI: 10.1111/aos.12829.
• 38 Tanihara H, Inoue T, Yamamoto T. et al. Phase 2 randomized clinical study of a Rho kinase inhibitor, K-115, in primary open-angle glaucoma and ocular hypertension. Am J Ophthalmol 2013; 156: 731-736 DOI: 10.1016/j.ajo.2013.05.016.
• 39 Tanihara H, Inoue T, Yamamoto T. et al. Phase 1 clinical trials of a selective Rho kinase inhibitor, K-115. JAMA Ophthalmol 2013; 131: 1288-1295 DOI: 10.1001/jamaophthalmol.2013.323.
• 40 Nakagawa H, Koizumi N, Okumura N. et al. Morphological Changes of Human Corneal Endothelial Cells after Rho-Associated Kinase Inhibitor Eye Drop (Ripasudil) Administration: A Prospective Open-Label Clinical Study. PLoS One 2015; 10: e0136802 DOI: 10.1371/journal.pone.0136802.
• 41 Okumura N, Okazaki Y, Inoue R. et al. Rho-Associated Kinase Inhibitor Eye Drop (Ripasudil) Transiently Alters the Morphology of Corneal Endothelial Cells. Invest Ophthalmol Vis Sci 2015; 56: 7560-7567 DOI: 10.1167/iovs.15-17887.
• 42 Okumura N, Okazaki Y, Inoue R. et al. Effect of the Rho-Associated Kinase Inhibitor Eye Drop (Ripasudil) on Corneal Endothelial Wound Healing. Invest Ophthalmol Vis Sci 2016; 57: 1284-1292 DOI: 10.1167/iovs.15-18586.
• 43 Bruinsma M, Tong CM, Melles GRJ. What does the future hold for the treatment of Fuchs endothelial dystrophy; will “keratoplasty” still be a valid procedure?. Eye (Lond) 2013; 27: 1115-1122 DOI: 10.1038/eye.2013.153.
• 44 Menzel-Severing J, Schrader S, Schlötzer-Schrehardt U. et al. Transcorneal freezing and topical Rho-kinase inhibitor treatment in Fuchs endothelial corneal dystrophy. Eye (Lond) 2022; DOI: 10.1038/s41433-021-01520-2.
• 45 Moloney G, Garcerant Congote D, Hirnschall N. et al. Descemet Stripping Only Supplemented With Topical Ripasudil for Fuchs Endothelial Dystrophy 12-Month Outcomes of the Sydney Eye Hospital Study. Cornea 2021; 40: 320-326 DOI: 10.1097/ICO.0000000000002437.
• 46 Iovieno A, Moramarco A, Fontana L. Descemet stripping only in Fuchsʼ endothelial dystrophy without use of topical Rho-kinase inhibitors: 5-year follow-up. Can J Ophthalmol 2021; DOI: 10.1016/j.jcjo.2021.06.010.
• 47 Macsai MS, Shiloach M. Use of Topical Rho Kinase Inhibitors in the Treatment of Fuchs Dystrophy after Descemet Stripping Only. Cornea 2019; 38: 529-534 DOI: 10.1097/ICO.0000000000001883.
• 48 Davies E, Jurkunas U, Pineda 2nd R. Pilot Study of Corneal Clearance With the Use of a Rho-Kinase Inhibitor After Descemetorhexis Without Endothelial Keratoplasty for Fuchs Endothelial Corneal Dystrophy. Cornea 2021; 40: 899-902 DOI: 10.1097/ICO.0000000000002691.
• 49 Kaufman AR, Nosé RM, Pineda 2nd R. Descemetorhexis Without Endothelial Keratoplasty (DWEK): Proposal for Nomenclature Standardization. Cornea 2018; 37: e20-e21 DOI: 10.1097/ICO.0000000000001528.
• 50 Artaechevarria Artieda J, Wells M, Devasahayam RN. et al. 5-Year Outcomes of Descemet Stripping Only in Fuchs Dystrophy. Cornea 2020; 39: 1048-1051 DOI: 10.1097/ICO.0000000000002270.