Netarsudil Use After Descemtorhexis Without Endothelial Keratoplasty

Study Overview
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Brief Summary
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This will be a prospective assessment of whether adjuvant Netarsudil use in patients undergoing Descemetorhexis without endothelial keratoplasty improves time to corneal clearance and post-operative central endothelial cell counts. The anticipated enrollment is 25 patients.

Detailed Description
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Subjects meeting inclusion criteria will be identified by Massachusetts Eye and Ear cornea surgeons during their pre-operative assessment and invited to participate in the study. Written informed consent will be obtained from the patient. The patients will then be added to a shared Epic patient list with a shared to-do column (outside of the patient record) indicating their subject ID and date of recruitment. All subjects will be asked to provide their best contact phone number which will be updated in the chart. Upon obtaining informed consent, subjects will receive a bottle of Netarsudil from the Massachusetts Eye and Ear research pharmacy with post-operative instructions to use the drop once a day at bedtime starting on post-operative day 1 . Each patient will then receive regular, scheduled post-operative monitoring with a post-operative day 1 visit, post-operative week 1 visit, post-operative month 1 visit, and then every 2 month follow up for twelve months. Clinical examination, including best corrected visual acuity and intraocular pressure, will be recorded during every visit. Corneal topography and specular microscopy will be performed during the pre-operative assessment and during each bi-monthly visit in order to monitor for post-operative outcomes. A retrospective chart review will be performed prior to new patient enrollment for patients who had previously had DWEK and did not receive a rho-kinase inhibitor. These patients will be included for pre-operative and post-operative vision, pachymetry, corneal topography results, and specular microscopy results with minimization of data acquisition as no informed consent can be obtained from these patients.

Official Title
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Prospective Assessment of Whether Adjuvant Netarsurdil Use Improves Post-Operative Outcomes in Patients Undergoing Descemetorhexis Without Endothelial Keratoplasty

Conditions
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Fuchs' Endothelial Dystrophy

Intervention / Treatment
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* Drug: Netarsudil Ophthalmic


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Fuchs corneal dystrophy Exclusion Criteria: Women of childbearing potential Other corneal eye diseases Non-compliance with netarsudil Intolerance of netarsudil

Ages Eligible for Study
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Minimum Age: 40 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Netarsudil use<br>Patients will receive Netarsudil eye drops to use 1 drop nightly in the operative eye after DWEK surgery until corneal clearance | Drug: Netarsudil Ophthalmic<br>* Use of netarsudil after Descemetorhexis without endothelial keratoplasty<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in central corneal pachymetry over time | Corneal thickness on clinical examination and corneal topography | Measured at post-operative month one visit and then every 2 months for 1 year | 
| Change in endothelial cell count over time | Central endothelial cell count by specular microscopy | Measured at post-operative month one visit and then every 2 months for 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Descemetorhexis without endothelial keratoplasty