To report early safety and efficacy of Descemet stripping only (DSO) supplemented with ripasudil. A pre-post clinical trial with a historical control group for time to heal and cell count parameters. The study received ethics approval and was conducted with oversight of a data safety monitoring board. All enrolled patients had a superior endothelial cell count of >1000 cells/mm2 and were symptomatic from the presence of central guttata degrading vision and/or producing glare. DSO was carried out with a peeling technique and not combined with any other intervention. Ripasudil 0.4% was applied topically from day 1 postoperatively at a dose of 6 times/d until corneal clearance. Cases with relapse of edema were permitted to restart on ripasudil at a reduced dose of 2 drops/d for a further 2 weeks. Stopping rules with progression to a corneal graft were established. Baseline ocular and systemic investigations were carried out and repeated at varying intervals to monitor for local and systemic adverse eventsuded local and systemic safety analysis. We judge that this treatment option is emerging as a reliable intervention for select patients with Fuchs' Endothelial Corneal Dystrophy (FECD) with an acceptable safety profile. The observation of relapse edema is strong evidence of a drug effect. The longevity of these results remains unknown. This trial of DSO supplemented with ripasudil included local and systemic safety analysis. We judge that this treatment option is emerging as a reliable intervention for select patients with Fuchs' Endothelial Corneal Dystrophy (FECD) with an acceptable safety profile. The observation of relapse edema is strong evidence of a drug effect. The longevity of these results remains unknown. To assess the feasibility of Descemet membrane endothelial keratoplasty (DMEK) surgery using the glasses-assisted 3-dimensional (3D) display system NGENUITY (Alcon Laboratories, Fort Worth, TX) and to compare with standard DMEK surgery by using a conventional operating microscope. Twelve consecutive cases of DMEK surgery were performed using the glasses-assisted 3D display system NGENUITY (Alcon) and matched with similar cases performed by using the OPMI-Lumera 700 surgical microscope (Carl Zeiss Meditec, Jena, Germany) in this prospective cross-sectional study realized at the Rothschild Foundation, Paris, France. DMEK graft preparation time, graft unfolding time, time to perform the descemetorhexis (DM), and overall surgical time were recorded. Best corrected visual acuity, endothelial cell density of the donor tissue measured by specular microscopy, and the recipient's central corneal thickness were recorded preoperatively and again at 1 and 3 months postoperatively. In the 3D group, time to perform td with conventional surgery. The percent endothelial cell loss from preoperative at 3 months was 35% in the 3D group and 26% in the conventional group, respectively, with no significant difference (P > 0.05). Performing DMEK surgery using a 3D display system is feasible; however, it is more challenging and the total surgical time is longer. This method would certainly be useful for instructional courses. Performing DMEK surgery using a 3D display system is feasible; however, it is more challenging and the total surgical time is longer. This method would certainly be useful for instructional courses. This review discusses the main aspects of pediatric keratoconus (KC) based on the current evidence to propose a guideline for helping early diagnosis and improving efficacy in treatment. This literature review was performed using PubMed, Ovid, and Elsevier databases. For the database search, the primary entered term included "pediatric keratoconus," connected to descriptors such as "keratoconus," "screening," "corneal cross-linking" (CXL), and "keratoplasty." Peer-reviewed and scholarly resources including original scientific articles and review articles were included. The prevalence of KC changes among populations. The greatest incidence has been reported in Middle-Eastern populations, an estimate of incidence of 1/2,000 individuals per year. https://www.selleckchem.com/products/nms-873.html Scheimpflug imaging, optical coherence tomography, and slit-scan tomography are commonly used to detect early diagnosis. Epithelium-off CXL is the treatment that should be discussed as soon as there is evidence for disease progression. Actually, penetrating keratoplasty represents the more common technique of pediatric keratoplasty; however, deep anterior lamellar keratoplasty probably seems as the best surgical option because of healthy endothelium. Options to increase visual acuity thereafter include contact lens fitting and corneal implants. The review of the literature confirms that KC in children is more aggressive than that in adults. In the attempt to preserve a good visual acuity, guidelines for improving early diagnosis and appropriate treatment seem crucial. The review of the literature confirms that KC in children is more aggressive than that in adults. In the attempt to preserve a good visual acuity, guidelines for improving early diagnosis and appropriate treatment seem crucial. We describe and contrast the strengths of precision medicine with Western medicine, and complex trait genetics with Mendelian genetics. Classic genetics focuses on highly penetrant pathogenic variants in a single gene believed to cause or confer a high risk for well-defined phenotypes. However, a minority of disorders have a single gene cause. Further, even individuals with identical Mendelian disease-associated genotypes may exhibit substantial phenotypic variability indicative of genetic and environmental modifiers. Still, most diseases are considered complex traits (or complex diseases). New insights into the genetic underpinnings of complex traits provide opportunities for advances in diagnosis and management. Precision medicine provides the framework for integrating complex trait knowledge into clinical care through a sophisticated analysis pipeline. Multidimensional modeling of acquired diseases includes multiple genetic risks scattered over many genes and gene regulators that must be interpreted on the basis of functional evidence (e.