Effect of Netarsudil 0.02% on a Patient with Fuchs Corneal Dystrophy and Radial Keratotomy

This study reports an unusual case of dramatic change in visual acuity, pachymetry, and corneal topography in a patient with a history of Fuchs dystrophy and radial keratotomy following the use of Rho-kinase (ROCK) inhibitor. A patient with a history of 8-cut radial keratotomy (RK), astigmatic keratotomy (AK), and Fuchs dystrophy showed dramatic changes in visual acuity, pachymetry, and corneal topography after using one drop of netarsudil 0.02%. The dramatic effect of netarsudil in our patient may be due to increased penetration of a rho-kinase inhibitor from the corneal incisions, facilitating the effect on corneal endothelium, resulting in a dramatic improvement in corneal pachymetry. This suggests a potential role for corneal incisions to improve the effectiveness of rho-kinase inhibitors in patients with Fuchs dystrophy.