Effect of the rho-kinase inhibitor ripasudil in needling with mitomycin C for the failure of filtering bleb after trabeculectomy: a cross-sectional study

• Published in: BMC ophthalmology 2022-11, Vol.22 (1), p.433-8, Article 433
• Main Authors: Mizuno, Yu, Okada, Naoki, Onoe, Hiromitsu, Tokumo, Kana, Okumichi, Hideaki, Hirooka, Kazuyuki, Kiuchi, Yoshiaki
• Format: Article
• Language: English
• Subjects: Care and treatment; Comparative analysis; Confidence intervals; Cross-Sectional Studies; Enzyme inhibitors; Eye; Failure; Fibroblasts; Fibrosis; Glaucoma; Glaucoma - drug therapy; Glaucoma - surgery; Humans; Hypotheses; Intraocular Pressure; Kinases; Mitomycin; Mitomycin - therapeutic use; Mitomycin C; Needling; Ophthalmic drugs; Ophthalmology; Polyvinyl alcohol; Protein kinase inhibitors; Protein Kinase Inhibitors - therapeutic use; Protein kinases; Retrospective Studies; Rho-associated kinase; rho-Associated Kinases; Rho-associated protein kinase inhibitor; Ripasudil; Statistical analysis; Surgery; Surgical outcomes; Survival analysis; Trabeculectomy; Trabeculectomy - methods; Treatment Outcome
• ISSN: 1471-2415; 1471-2415
• DOI: 10.1186/s12886-022-02680-9

Rho-kinase inhibitors can inhibit fibrosis after glaucoma surgery. This study aimed to evaluate the effect of rho-kinase inhibitor after needling procedure with mitomycin C for the failure of filtering bleb with trabeculectomy. This retrospective single-center study examined the effects of rho-kinase inhibitor after the needling procedure. We included 27 eyes of 27 patients with glaucoma who underwent needling procedure using mitomycin C and were subsequently treated with ripasudil-a rho-associated protein kinase inhibitor (ripasudil group)-or without ripasudil (control group). The ripasudil and control groups were compared in terms of intraocular pressure (IOP) and the number of antiglaucoma medications. Success at 12 months after the needling procedure was defined as a > 20% decrease in IOP from the preoperative period without surgical reintervention. At 12 months after the needling procedure, the mean IOP decreased from 16.9 ± 4.5 to 12.6 ± 1.1 mmHg in the control group and from 16.0 ± 5.3 to 12.2 ± 1.2 mmHg in the ripasudil group (p = 0.77). The 12-month success rates were 60.00% and 56.25% in the control and ripasudil groups (p = 0.98), respectively. In the preoperative period, the numbers of antiglaucoma drugs were 0.27 ± 0.46 and 0.92 ± 0.91 in the control and ripasudil groups (p = 0.022), respectively, and at 12 months after the needling procedure, they were 1.07 ± 1.44 and 0.73 ± 1.10 (p = 0.52), respectively. Treatment with ripasudil (a rho-associated protein kinase inhibitor) after the needling procedure with mitomycin C did not show better results than treatment with the mitomycin C needling procedure alone at 12 months after the procedure.