For patients with Fuchs dystrophy—a common corneal condition that progresses to sight loss and is the leading indication for corneal transplant—the development of a novel treatment approach holds new promise for enhanced outcomes. The approach, pioneered by Kathryn A. Colby, MD, PhD, chair and the Elisabeth J. Cohen, MD, Professor of Ophthalmology in the Department of Ophthalmology, combines minimally invasive surgery and a novel application of Rho-associated protein kinase (ROCK) inhibitors to trigger cell regeneration within the cornea’s endothelial layer.

Dr. Colby’s research, currently under investigation through a multicenter, multinational clinical trial, builds on decades of work to provide patients with Fuchs dystrophy an alternative to corneal replacement, which carries risk of tissue rejection and blindness. The selective removal of damaged tissue within the central endothelial layer has been shown over time to effectively restore function while eliminating the risks associated with corneal transplant. More recently, Dr. Colby has used ROCK inhibitors to enhance surgical efficacy by stimulating cell rejuvenation and increasing the presence of healthy endothelial tissue. Her study aims to provide an evidence basis for the approach, which requires both the removal of endothelial cells and the application of a ROCK inhibitor in tandem to achieve efficacy.

“Equipping the body with its own means to heal is always preferable to foreign transplant, and we now understand that endothelial cells do in fact have that capability once damaged tissue is resected,” notes Dr. Colby. “This is a revolution in the surgical treatment of Fuchs disease.”

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