Open AccessRegenerative medicine in Fuchs' endothelial corneal dystrophy
Author(s) -
Amy Yuan,
Roberto Pineda
Publication year - 2021
Publication title -
taiwan journal of ophthalmology
Language(s) - Uncategorized
Resource type - Journals
eISSN - 2211-5072
pISSN - 2211-5056
DOI - 10.4103/tjo.tjo_23_20
Subject(s) - medicine , regenerative medicine , clinical trial , corneal transplantation , transplantation , cornea , wound healing , regeneration (biology) , ophthalmology , surgery , stem cell , pathology , microbiology and biotechnology , biology
The management of Fuchs' endothelial corneal dystrophy (FECD) has evolved rapidly since the introduction of endothelial keratoplasty (EK). In recent years, advances in our understanding of endothelial cell biology, in particular with respect to the regenerative capacity of endothelial cells, have opened the door to novel therapeutic options that stray from the traditional paradigm of allograft transplantation. We review the development of descemetorhexis without EK (DWEK) as a primary treatment for FECD and discuss the lessons learned to date about the mechanism of wound healing, surgical technique, patient selection, and refractive outcomes. Multiple randomized clinical trials are currently underway to evaluate the potential for pharmacological supplementation with rho-associated kinase inhibitors to increase the success rate of corneal clearance following DWEK. Biologic supplementation with intracameral endothelial cell injection and acellular Descemet's membrane transplantation are other avenues of adjuvant therapy. DWEK is a promising surgical option for management of a subset of FECD patients.