Ripasudil in managing posttraumatic corneal decompensation

This report aims to illustrate the role of Rho-Kinase inhibitor, ripasudil, in the management of posttraumatic corneal decompensation. A 32-year-old male presented with blunt trauma to the left eye while opening an oxygen cylinder, resulting in a corneal epithelial defect, stromal edema, and hyphaema. Initial management with topical antibiotics, steroids, cycloplegics, and antiglaucoma led to the resolution of the epithelial defect and hyphema. However, the persistent corneal edema prompted the addition of topical ripasudil (0.4%) thrice daily. There was rapid resolution of corneal edema and improvement in visual acuity, recovering to 6/6 in just 21 days. While ripasudil has been primarily studied in corneal endothelial decompensation in Fuch’s endothelial dystrophy and postcataract surgery corneal edema, this case highlights its adjuvant role in accelerating endothelial recovery in posttraumatic corneal decompensation.