{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T12:39:33Z","timestamp":1764333573345,"version":"build-2065373602"},"reference-count":166,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T00:00:00Z","timestamp":1755043200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>There is growing interest in the application of Rho-associated protein kinase (ROCK) inhibitors (ROCKI) to the treatment of corneal diseases. ROCK is a key regulator of several cellular processes in the cornea, including cytoskeletal organization, cell proliferation, migration, inflammation, and wound healing. ROCKI, such as ripasudil and netarsudil, enhances endothelial cell migration, and promotes repair in conditions characterized by endothelial dysfunction. These agents also exert anti-inflammatory, anti-angiogenic, and anti-fibrotic effects for wound healing. As such, ROCKI demonstrate promise as therapeutic options for conditions such as Fuchs\u2019 endothelial corneal dystrophy, pseudophakic bullous keratopathy, and iridocorneal endothelial syndrome. Emerging data further supports ROCKI\u2019s potential in managing corneal neovascularization and supporting recovery following cataract surgery and keratoplasty, reducing the need for donor tissue. This narrative review provides a comprehensive evaluation of ROCKI\u2019s mechanism of action, pharmacological properties, safety profile, applications in corneal disease management, emerging clinical trials, and novel approaches. We emphasize both preclinical and clinical findings, highlight existing evidence gaps, and outline future research priorities.<\/jats:p>","DOI":"10.3390\/life15081283","type":"journal-article","created":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T13:30:38Z","timestamp":1755091838000},"page":"1283","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A Comprehensive Review of the Role of Rho-Kinase Inhibitors in Corneal Diseases"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5493-3445","authenticated-orcid":false,"given":"Elizabeth Y. X.","family":"Leong","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, National University Health System, Singapore 119228, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianbin","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, National University Health System, Singapore 119228, Singapore"},{"name":"Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2247-0949","authenticated-orcid":false,"given":"Duoduo","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, National University Health System, Singapore 119228, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6930-5046","authenticated-orcid":false,"given":"Blanche X. H.","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, National University Health System, Singapore 119228, Singapore"},{"name":"Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Ang","sequence":"additional","affiliation":[{"name":"Cornea and Oculoplastics Units, Department of Ophthalmology, Royal Perth Hospital, Perth, WA 6000, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5466-1176","authenticated-orcid":false,"given":"Evan","family":"Wong","sequence":"additional","affiliation":[{"name":"Cornea and Oculoplastics Units, Department of Ophthalmology, Royal Perth Hospital, Perth, WA 6000, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nigel","family":"Morlet","sequence":"additional","affiliation":[{"name":"Cornea and Oculoplastics Units, Department of Ophthalmology, Royal Perth Hospital, Perth, WA 6000, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6362-4898","authenticated-orcid":false,"given":"Jodhbir S.","family":"Mehta","sequence":"additional","affiliation":[{"name":"Singapore Eye Research Institute, Singapore 169856, Singapore"},{"name":"Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, Singapore 169857, Singapore"},{"name":"Corneal and External Eye Disease, Singapore National Eye Centre, Singapore 168751, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2219-3184","authenticated-orcid":false,"given":"Chris H. L.","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, National University Health System, Singapore 119228, Singapore"},{"name":"Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore"},{"name":"Cornea and Oculoplastics Units, Department of Ophthalmology, Royal Perth Hospital, Perth, WA 6000, Australia"},{"name":"Singapore Eye Research Institute, Singapore 169856, Singapore"},{"name":"Centre for Sustainable Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,13]]},"reference":[{"key":"ref_1","first-page":"101","article-title":"Use of Rho Kinase Inhibitors in Ophthalmology: A Review of the Literature","volume":"7","author":"Moshirfar","year":"2018","journal-title":"Med. Hypothesis Discov. Innov. 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