Objectives: This study evaluated the therapeutic potential of topical Ripasudil hydrochloride hydrate in managing various forms of corneal edema. Methods: This retrospective study included 96 patients of 72.20 ± 10.52 years, with 53 females (55.2%) who were treated with Ripasudil for corneal edema, with a mean treatment duration of 5.2 ± 2.3 months, divided into four groups: post-cataract surgery (n = 32), Fuchs endothelial corneal dystrophy (FECD; n = 29), post-Descemet membrane endothelial keratoplasty (DMEK; n = 25), and post-penetrating keratoplasty (PKP; n = 10). All patients were treated with Ripasudil, typically administered three times daily in the first week and twice daily in the following months. Clinical efficacy outcomes were assessed using changes in best-corrected visual acuity (BCVA), central corneal thickness (CCT), and endothelial cell count (ECC) with specular microscopy, anterior segment optical coherence tomography (OCT), and slit-lamp examination, while intraocular pressure (IOP) was measured using the iCare tonometer. Results: Ripasudil treatment led to a reduction in CCT and improvement in visual acuity across most groups, with minimal changes in ECC. CCT decreased by 30.44 μm (p < 0.001), 25.56 μm (p < 0.001), 8.41 μm (p = 0.05), and 6.80 μm (p > 0.1); visual acuity improved by 0.27 (p = 0.001), 0.18 (p = 0.02), 0.17 (p = 0.025), and 0.07 logMAR units (p > 0.1); and ECC changed by +7.0 (p > 0.1), 15.4 (p > 0.1), −7.6 (p > 0.1), and 2.3 cells/mm² (p > 0.1) in the post-cataract surgery, FECD, post-DMEK, and post-PKP groups, respectively. Conclusions: No adverse events or progression of edema were recorded during the follow-up period. These findings support the role of Ripasudil as a non-invasive pharmacological approach to managing corneal edema and delaying or possibly avoiding surgical interventions, such as corneal transplantation, in selected cases.

This study evaluates the safety and efficacy of a novel triangular suture technique (TST) as an alternative method to scleral-fixated intraocular lens implantation in patients with intraocular lens (IOL) dislocation following cataract surgery. The aim is to assess visual outcomes, intraocular pressure (IOP) control, and complication rates over an extended follow-up period. A retrospective cohort study analyzed 43 patients (48.8% female; mean age 77.9 ± 10.3 years) who underwent scleral-supported IOL implantation using the TST. Preoperative assessments included ocular history, baseline visual acuity, and IOP. Postoperative follow-up was conducted at 6 defined intervals over 26 months. All surgeries were performed using a uniform triangular scleral suture approach with 10-0 polypropylene in a three-point support pattern. Sutures were placed 3.0 mm posterior to the limbus at 11, 7, and 3 o’clock positions (corresponding to the triangular configuration), with subconjunctival passage between designated clock-hour positions to prevent erosion and ensure proper IOL centration. Outcome measures included uncorrected visual acuity, best-corrected visual acuity, IOP, glaucoma medication requirements, and central macular thickness. Uncorrected visual acuity improved significantly from 0.92 ± 0.55 to 0.50 ± 0.40 logarithm of the minimum angle of resolution (logMAR) at 6 months ( P < .01). Best-corrected visual acuity improved significantly from 0.75 ± 0.34 to 0.36 ± 0.42 logMAR at 6 months ( P < .01) and was maintained at 0.37 ± 0.50 logMAR at 26 months ( P < .01). A transient IOP rise was observed on the first postoperative day (mean 18.14 ± 5.65 mm Hg; P < .05), with normalization thereafter. No significant complications were observed over the 24-month follow-up period. The TST provides a safe and effective alternative to conventional scleral-fixated intraocular lens fixation methods, offering significant and sustained visual improvement, minimal complications, excellent IOL stability, and stable anatomical outcomes over extended follow-up.