New kid on the block!
ROCK inhibitor eyedrops for corneal endothelial regeneration. These drops have been introduced about 5 years ago in Japan in the trial stage.. and now would be available commercially… they defy the logic that endothelial cells cannot divide.. actually they do not make the end cells divide but stimulate the stem cells to divide.. they have applications in endothelial diseases like Fuchs dystrophy and other corneal dystrophies, endothelial damage post cataract surgery and viral endothelitis.
We had mentioned in our previous papers that there are stem cells everywhere in the eye including stroma (now known as mesenchymal stem cells), endothelium and also in the sclera. Also in the nerve coats. The neurotrophic stem cells help the nerves to grow back in neurotization surgeries ( series of 5 cases in neurotrophic keratopathy ) and growth factor treatment which has now been introduced in UK but prohibitively expensive like the ROCK inhibitors.
As of now surgical endo keratoplasty and surgical corneal neurotization is the affordable treatment. The stem cell story has just begun and so also DNA modification (CRISPR) and AI devices. These are the key areas of the future.