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Injection of Cultured Cells with a ROCK Inhibitor for Bullous Keratopathy

Kinoshita, Shigeru, Koizumi, Noriko, Ueno, Morio, Okumura, Naoki, Imai, Kojiro, Tanaka, Hiroshi, Yamamoto, Yuji, Nakamura, Takahiro, Inatomi, Tsutomu, Bush, John, Toda, Munetoyo, Hagiya, Michio, Yokota, Isao, Teramukai, Satoshi, Sotozono, Chie, Hamuro, Junji·2018·New England Journal of Medicine

Abstract

BACKGROUND: Corneal endothelial cell (CEC) disorders, such as Fuchs's endothelial corneal dystrophy, induce abnormal corneal hydration and result in corneal haziness and vision loss known as bullous keratopathy. We investigated whether injection of cultured human CECs supplemented with a rho-associated protein kinase (ROCK) inhibitor into the anterior chamber could increase CEC density. METHODS: passaged cells were supplemented with a ROCK inhibitor (final volume, 300 μl) and injected into the anterior chamber of the eye that was selected for treatment. After the procedure, patients were placed in a prone position for 3 hours. The primary outcome was restoration of corneal transparency, with a CEC density of more than 500 cells per square millimeter at the central cornea at 24 weeks after cell injection. Secondary outcomes were a corneal thickness of less than 630 μm and an improvement in best corrected visual acuity equivalent to two lines or more on a Landolt C eye chart at 24 weeks after cell injection. RESULTS: At 24 weeks after cell injection, we recorded a CEC density of more than 500 cells per square millimeter (range, 947 to 2833) in 11 of the 11 treated eyes (100%; 95% confidence interval [CI], 72 to 100), of which 10 had a CEC density exceeding 1000 cells per square millimeter. A corneal thickness of less than 630 μm (range, 489 to 640) was attained in 10 of the 11 treated eyes (91%; 95% CI, 59 to 100), and an improvement in best corrected visual acuity of two lines or more was recorded in 9 of the 11 treated eyes (82%; 95% CI, 48 to 98). CONCLUSIONS: Injection of human CECs supplemented with a ROCK inhibitor was followed by an increase in CEC density after 24 weeks in 11 persons with bullous keratopathy. (Funded by the Japan Agency for Medical Research and Development and others; UMIN number, UMIN000012534 .).

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Metadata

Authors
Kinoshita, S., Koizumi, N., Ueno, M., Okumura, N., Imai, K., Tanaka, H., Yamamoto, Y., Nakamura, T., Inatomi, T., Bush, J., Toda, M., Hagiya, M., Yokota, I., Teramukai, S., Sotozono, C., & Hamuro, J.
Venue
New England Journal of Medicine
Published
2018-03-15
Volume
378
Issue
11
Pages
995-1003
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
OpenAlex
W2793941328
Cited by
542
References
27
FWCI
33.70
Type
journal article
Language
en
Open access
closed

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CoChat. (2026). Citation check: Injection of Cultured Cells with a ROCK Inhibitor for Bullous Keratopathy. https://app.cochat.ai/papers/10.1056/nejmoa1712770
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Kinoshita, S., Koizumi, N., Ueno, M., Okumura, N., Imai, K., Tanaka, H., Yamamoto, Y., Nakamura, T., Inatomi, T., Bush, J., Toda, M., Hagiya, M., Yokota, I., Teramukai, S., Sotozono, C., & Hamuro, J. (2018). Injection of Cultured Cells with a ROCK Inhibitor for Bullous Keratopathy. New England Journal of Medicine. https://doi.org/10.1056/nejmoa1712770

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