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To investigate the changes of corneal endothelium under different crosslinking conditions and the protective effect of ripasudil. Methods. Corneal crosslinking groups were infiltrated with riboflavin and subsequently irradiated with 0.54\u2009J\/cm2 or 1.08\u2009J\/cm2 UVA, while noncrosslinking groups included neither UVA nor riboflavin treatment, only 1.08\u2009J\/cm2 UVA and only riboflavin treatment. Corneal opacity, variations in corneal endothelial cells, and corneal thickness of all groups were observed by slit lamp, in vivo confocal microscopy, and optical coherence tomography. Immunofluorescence staining and scanning electron microscopy were performed to evaluate changes in the structure and function of the corneal endothelium. The mice that received a corneal crosslinking dose of 1.08\u2009J\/cm2 were instilled with ripasudil to explore its protective effect on the corneal endothelium. Results. Treatment with UVA and riboflavin caused an increase in corneal opacity and corneal thickness and decreased endothelial cell density. Furthermore, treatment with UVA and riboflavin caused endothelial cell DNA damage and destroyed the tight junction and pump function of the endothelium, while riboflavin or the same dose of UVA alone did not affect the endothelium. Ripasudil reduced DNA damage in endothelial cells, increased the density of cells, and protected the endothelium\u2019s integrity and function. Conclusion. Riboflavin combined with UVA can damage the corneal endothelium\u2019s normal functioning. The corneal endothelium\u2019s wound healing is dose-dependent, and the ROCK inhibitor ripasudil maintains the endothelium\u2019s pump and barrier functions.<\/jats:p>","DOI":"10.1155\/2022\/5179247","type":"journal-article","created":{"date-parts":[[2022,1,14]],"date-time":"2022-01-14T01:20:09Z","timestamp":1642123209000},"page":"1-12","source":"Crossref","is-referenced-by-count":2,"title":["Crosslinking-Induced Corneal Endothelium Dysfunction and Its Protection by Topical Ripasudil Treatment"],"prefix":"10.1155","volume":"2022","author":[{"given":"Xuemei","family":"Wang","sequence":"first","affiliation":[{"name":"Eye Institute and Affiliated Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China"},{"name":"Fujian Provincial Key Laboratory of Ophthalmology and Visual Science & Ocular Surface and Corneal Diseases, Xiamen University, Xiamen, Fujian, 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