Prescription eye drop reduces tear evaporation in dry eye disease patients

It is well documented that an unstable tear lipid layer causes tear evaporation, which is a cause of dry eye disease (DED). Perfluorohexyloctane ophthalmic solution (Miebo, Bausch + Lomb) is FDA approved to treat this issue.

Here, three optometrists familiar with Miebo provide an overview of the treatment and its utility in practice.

Overview

Bausch + Lomb describes Miebo as a preservative-free eye drop that stabilizes the tear film, so tears will not evaporate. This, in turn, prevents the eyes from drying out and, thus, the symptoms, such as fluctuating and unstable vision, irritation and burning, that accompany ocular dryness, say those interviewed.

“Eye care providers have not had a drop to prevent tear evaporation,” explains Mile Brujic, OD, FAAO, a partner at Premier Vision Group, a four-location practice in Northwest Ohio. “Additionally, whenever prescribing a drop, I am concerned about preservatives and inactives, so I’m pleased that this treatment is both preservative and inactive-free.”

Miebo received FDA approval after two, multi-center, randomized (Miebo or saline treatment), double-masked, eight-week phase 3 studies showed the drop met primary sign and symptom efficacy endpoints. These two studies were GOBI¹ and MOJAVE.² The most common eye side effects were blurred vision (1%) and ocular redness (3%).

Utility in Practice

Justin Schweitzer, OD, FAAO, who practices at Vance Thompson Vision, in South Dakota, says that being in a practice that performs cataract, refractive, glaucoma, and cornea surgery, he is particularly interested in how Miebo might be able to prepare the ocular surface ahead of these surgeries.

“My perspective is focused on outcomes, and many of our patients do have evaporative dry eye,” he explains. “If we aren’t treating this successfully, their surgical outcomes are affected.”

Melissa Barnett, OD, FAAO, FSLS, FBLCA, director of Optometry at the University of California, Davis Eye Center in Davis, Calif., says she believes that the simplicity of using this treatment option — instilling drops — will help with patient compliance.

“I think patients are highly motivated to find a treatment that works, but patient compliance is always a critical factor,” she explains. “Given the ease of using Miebo, as well as how busy patients’ lives are, I think we will have improved patient compliance.”

Dr. Brujic stresses that Miebo provides the opportunity for the eye care provider to “up their game” in managing DED, as it’s another addition to the providers treatment arsenal. OM

References

1. Tauber J, Berdy GJ, Wirta DL, Krosser S, Vittitow JL. NOV03 for Dry Eye Disease Associated with Meibomian Gland Dysfunction: Results of the Randomized Phase 3 GOBI Study. Ophthalmology. 2023 May;130(5):516-524. doi: 10.1016/j.ophtha.2022.12.021.Epub 2022 Dec 24.
2. Sheppard JD, Kurata F, Epitropoulos AT, Krosser S, Vittitow JL. NOV03 for Signs and Symptoms of Dry Eye Disease Associated With Meibomian Gland Dysfunction: The Randomized Phase 3 MOJAVE Study. Am J Ophthalmol. 2023;252:265-274. DOI: 10.1016/j.ajo.2023.03.008