Descemet Endothelial Thickness Comparison Trial II (DETECT II)

Oregon Health and Science University, University of California, San Francisco, University of California, Davis, Case Western Reserve University, Dartmouth-Hitchcock Medical Center, University of Pennsylvania

Descemet Endothelial Thickness Comparison Trial (DETECT) II is a multi-center, outcome assessor-masked, placebo-controlled clinical trial randomizing 60 patients with Fuchs endothelial dystrophy to DMEK versus Descemet Stripping Only (DSO) with adjunctive Ripasudil.

Inclusion Criteria: Dysfunctional endothelium from FECD with few guttata extending beyond 4.5 mm Peripheral endothelial cell count >1500 cells/mm2 Good surgical candidate for either procedure as determined by the surgeon Willingness and ability to undergo corneal transplantation Willingness to consistently use study medications (i.e. ROCK-inhibitors) Willingness to participate in follow-up visits Age greater than 18 years Exclusion Criteria: Other primary endothelial dysfunction such as PPMD Any prior intraocular surgery other than cataract surgery Cataract surgery within the last 3 months >3 clock hours of ANY anterior or posterior synechiae >1 quadrant of stromal corneal vascularization Visually significant optic nerve or macular pathology Fellow eye visual acuity <20/200 Pregnancy Inability to comply with post-operative instructions (i.e. unable to position) Hypotony (Intraocular pressure <10mmHg) Peripheral anterior synechiae (iris to angle) in the angle greater than a total of three clock hours Aphakia, anterior chamber IOL or scleral fixated IOL in study eye prior to or anticipated during EK Pre-operative central sub-epithelial or stromal scarring that the investigator believes is visually significant and could impact post-operative stromal clarity assessment