# Descemet Endothelial Thickness Comparison Trial (DETECT)

> **NIH NIH UG1** · KAISER FOUNDATION RESEARCH INSTITUTE · 2021 · $63,241

## Abstract

PROJECT SUMMARY/ABSTRACT
Although endothelial keratoplasty is one of the most commonly performed transplant surgeries, it is unknown
which technique provides optimal visual acuity outcomes while minimizing endothelial cell loss and
complications. Post-operative endothelial cell counts have been shown to correlate with risk of subsequent
graft failure, with significant cost to individual patients and society. Topical rho-kinase inhibitors such as
ripasudil 0.4% may play an important role in maintaining endothelial health after keratoplasty.
Here we propose the Descemet Endothelial Thickness Comparison Trial (DETECT), a randomized, outcome-
masked, multi-center, four-arm clinical trial with a 2x2 factorial design. The purpose of this study is to
determine differences in visual outcomes between two types of corneal transplant surgeries, ultrathin
Descemet stripping automated endothelial keratoplasty (UT-DSAEK) and Descemet membrane endothelial
keratoplasty (DMEK), and to determine the effect of rho-kinase inhibitors on endothelial cell counts after
keratoplasty. Patients presenting to Oregon Health & Science University, Stanford University, NorthShore
University HealthSystem, University of Maryland, and to Kaiser Permanente Northern California with
endothelial dysfunction who are good candidates for either UT-DSAEK or DMEK will be eligible for inclusion.
Participants will be randomized to one of four treatment groups in this 2x2 factorial design study:
 Endothelial Keratoplasty
UT-DSAEK DMEK
Adjuvant
Topical
Medication
Ripasudil
0.4%
UT-DSAEK +
0.4% ripasudil
 DMEK +
0.4% ripasudil
Placebo
UT-DSAEK
 + placebo
DMEK +
placebo
This approach is innovative for a number of reasons including its testing of a novel treatment, ripasudil 0.4%,
and the randomization of surgery, which is relatively rare. It is aligned with the priorities of the NEI, studying
new high-resolution imaging techniques such as endothelial cell imaging, anterior-segment optical coherence
and Pentacam Scheimflug imaging, to guide post-operative treatment and as potential surrogate trial endpoints
in future trials. This world class team of collaborators have a proven track record for executing large NEI-
funded trials in ophthalmology, and are well positioned to answer the two important questions presented in this
proposal.

## Key facts

- **NIH application ID:** 10088896
- **Project number:** 1UG1EY030417-01A1
- **Recipient organization:** KAISER FOUNDATION RESEARCH INSTITUTE
- **Principal Investigator:** Jennifer Rose-Nussbaumer
- **Activity code:** UG1 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $63,241
- **Award type:** 1
- **Project period:** 2021-04-01 → 2021-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10088896

## Citation

> US National Institutes of Health, RePORTER application 10088896, Descemet Endothelial Thickness Comparison Trial (DETECT) (1UG1EY030417-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10088896. Licensed CC0.

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