PURPOSE: Halos and glare during contact lens (CL) wear can negatively impact visual quality and wearer satisfaction, particularly under low-light conditions. The kalifilcon A daily disposable toric CL (INFUSE® for Astigmatism [IfA]) is designed to provide clear, stable vision while supporting ocular surface homeostasis for comfortable wear. This real-world evaluation assessed patient satisfaction and experience with the IfA CL among wearers experiencing frequent halos and glare with their habitual CLs.

METHODS: Astigmatic patients aged ≥18 years (whether new or existing CL wearers) were invited by their eye care professionals to be fitted with IfA CLs and trial them for a 5-day period. Participants then completed an online survey about their experience, with at least 60% of responses validated through follow-up phone calls. This analysis evaluated existing CL wearers who were stratified according to self-reported frequency of halos and glare with their habitual CLs ("quite often or more frequently" versus "now and then or rarely"). A two-sided asymptotic binomial test assessed whether more than 50% of respondents provided favorable ratings for key attributes.

RESULTS: Of 119 existing CL wearers who completed the survey, 26 reported experiencing halos and glare with their habitual CLs quite often or more frequently (73.1% female, mean age 33.1 years). Among these 26 patients, most (80.8%) reported wearing the IfA lens for the full 5-day trial period. Following the trial, 88.5% agreed that IfA lenses provided clear vision when driving at night, 96.0% agreed that they provided clear vision during physical activities, and 92.3% rated their overall opinion of the lens as very good or excellent. Participants experiencing frequent halos and glare also reported favorable perceptions of consistently clear vision throughout the day and reduced halos and glare, even in low-light conditions. Mean overall opinion scores were significantly higher among participants reporting frequent halos and glare compared with those reporting symptoms now and then or rarely (4.54 vs 4.05, p=0.0243). A secondary analysis using broader symptom stratification criteria ("now and then or more frequently" [n=83] versus "rarely" [n=36]) demonstrated similar overall trends.

CONCLUSION: Participants experiencing frequent halos and glare with their habitual CLs reported high levels of satisfaction and favorable perceptions of visual performance with the IfA CL. These findings suggest that symptomatic toric CL wearers may benefit from a daily disposable toric CL designed to support clear, stable vision across real-world activities.

PURPOSE: Soft contact lenses (SCLs) can be a convenient option for patients who do not wish to use spectacles or undergo refractive surgery. This study aimed to assess the real-world performance of, and eye care practitioner (ECP) satisfaction with, Bausch + Lomb (B+L) SCLs. Here, we present a sub-analysis of patients with astigmatism who were fit with a toric kalifilcon A daily disposable SCL.

METHODS: This was a retrospective, multicenter, cross-sectional case review and survey study of licensed optometrists with ≥1 year of experience fitting SCLs. ECPs provided a deidentified convenience sample of ≥10 cases from experienced (≥3 months) SCL users who were refit with a B+L toric SCL, and completed a user-experience survey. Cases reported here had documented visits between October 2020 and September 2025. Key outcomes included monocular and binocular distance best-corrected visual acuity (BCVA), reasons for fit, lens fit characteristics, and adverse events (AEs); survey outcomes included practice characteristics and ECP satisfaction. The protocol received central institutional review board exemption.

RESULTS: This sub-analysis included 50 eyes (28 patients) from six clinical sites. Mean±standard deviation (SD) age at initial lens fitting was 43±13 years, and 68% of patients were female. At baseline with habitual correction, 59% of eyes and 76% of patients had monocular and binocular BCVA of 20/20 or better, respectively. At initial fitting with the toric SCL, 86% of eyes and 82% of patients achieved monocular and binocular BCVA of 20/20 or better, respectively, through over-refraction. Reasons for fitting with the toric SCL included patients' preference for a daily disposable option, and the need for improved visual performance, comfort, and safety. At most recent follow-up, mean±SD lens wear duration was 0.5 (0.6) years (range 0 days–2.2 years); 84% of eyes and 86% of patients achieved monocular and binocular BCVA of 20/20 or better, respectively. No AEs were reported. Of the six ECPs surveyed, three were from small-size practices (2–10 ECPs), one worked independently, and two worked in medium/large practices (≥11 ECPs). ECPs reported performing a mean±SD of 1945±855 SCL fittings/year. Mean±SD ECP overall satisfaction (from 1, very dissatisfied, to 5, very satisfied) with the toric SCL was 4.8±0.5 (n=5 ECPs).

CONCLUSION: This sub-analysis of the real-world performance of SCLs demonstrated that toric kalifilcon A daily disposable SCLs provided good visual outcomes for patients with astigmatism, with no AEs reported. ECPs reported high overall satisfaction with the SCL. These findings suggest that toric kalifilcon A daily disposable SCLs represent a suitable option for patients with astigmatism looking to switch lenses.

PURPOSE: Monovision is a widely used approach for correcting presbyopia; however, it can adversely affect binocular vision, night driving performance, and stereopsis in some patients. Multifocal toric (MFT) contact lenses offer an effective alternative for visual correction in individuals with both presbyopia and astigmatism.

CASE REPORT: We present a case series of 10 patients (pts) from five sites who transitioned from monovision to monthly samfilcon A MFT lenses (B+L ULTRA). Cases were collected as part of a wider study with central institutional review board exemption. Seven pts were male and three female, nine were White and one was Asian, and ages ranged from 45 to 74 years at refitting. Prior lens wear duration was between 1 and 12 years. With habitual correction, distance best-corrected visual acuity (BCVA) OU was 20/20 for 6/10 (60%) pts, 20/20− and 20/30+ each in 1/10 (10%) pts, and unknown for 2/10 (20%) pts; near BCVA OU was 20/20 for 4/10 (40%) pts, 20/25− for 1/10 (10%) pts, and unknown for 5/10 (50%) pts. Reasons for switching to samfilcon A MFT lenses included to improve binocularity, reduced monovision tolerance, and the need for more balanced distance and near vision. At initial fit, lens powers included sphere −5.75 to +4.00 D; cylinder −2.25 to −0.75 D; and add low for 7/20 (35%) eyes, high for 11/20 (55%) eyes, and unknown for 2/20 (10%) eyes. Distance BCVA OU through over-refraction at initial fit was 20/20 for 6/10 (60%) pts, 20/25 for 1/10 (10%) pts, and unknown for 3/10 (30%) pts. Near BCVA OU through over-refraction at initial fit was 20/20 in 2/10 (20%) pts, 20/25, 20/30 and 20/60 each in 1/10 (10%) pts, and unknown in 5/10 (50%) pts. At most recent fit, 7 days–6 years after initial lens fit, all pts continued to wear samfilcon A MFT lenses, with adjustments due to refractive changes in eight pts (15 eyes). Lens powers at most recent fit included sphere −5.50 to +4.00 D; cylinder −2.25 to −0.75 D; add low for 3/20 (15%) eyes, high for 15/20 (75%) eyes, and unknown for 2/20 (10%) eyes. Distance BCVA OU without over-refraction at most recent fit was 20/20 for 7/10 (70%) pts, 20/25 and 20/30+ for 1/10 (10%) pts each, and unknown for 1/10 (10%) pts. Near BCVA OU without over-refraction at most recent fit was 20/20 for 4/10 (40%) pts, 20/25+ for 1/10 (10%) pts, 20/25 for 2/10 (20%) pts, 20/40 and 0.5M each in 1/10 (10%) pts, and unknown for 1/10 (10%) pts (Figure). At initial and most recent fitting visits, the lens MF fitting guide was used for 16/20 (80%) and 11/15 (73%) eyes, respectively, and good lens centration and movement were achieved for all pts. No adverse events (AEs) were reported.

CONCLUSION: This case series demonstrates that transitioning pts from monovision to monthly samfilcon A MFT lenses was associated with good visual acuity outcomes and lens fit, with no AEs reported. These findings support that samfilcon A MFT lenses represent a suitable option for pts wearing monovision lenses and open to moving to monthly MFT lenses.

PURPOSE: Reusable contact lens (CL) wearers may experience dryness, tired eyes, and reduced comfort over the course of lens wear, particularly with longer wearing times and digital device use. CL care solutions may help support a positive wearing experience by maintaining lens comfort, hydration, cleanliness, and freshness. Biotrue Hydration Plus (BHP) is a multi-purpose solution (MPS) developed to improve comfort. This analysis assessed real-world satisfaction and performance of BHP MPS among habitual samfilcon A monthly replacement CL wearers.

METHODS: Eligible adults (≥18 years) who were habitual soft CL users with an eye exam within 2 years were recruited to the study. Participants used BHP MPS for 7 days with a new pair of CLs before completing an online survey using a 7-point Likert scale. This analysis included participants who habitually wore samfilcon A monthly replacement CLs. A two-sided asymptotic binomial test assessed whether >50% of responses indicated agreement or satisfaction for key attributes.

RESULTS: The analysis included 215 habitual samfilcon A monthly replacement lens wearers (68.8% female, mean age 46.7 years). Most were experienced CL wearers, with 69.3% having worn CLs for >10 years; 59.1% wore CLs 7 days/week, with mean daily CL wear of 11.8 hours and mean CL wear during computer, smartphone, or tablet use of 7.2 hours/day. Following BHP MPS use, 95.8% of participants were satisfied with how their CLs felt. Participants reported high agreement that BHP MPS helped lenses stay comfortable throughout the day (94.0%) and even at the end of the day (92.1%). Agreement was also high that BHP MPS helped lenses stay hydrated throughout the day (94.4%) and even at the end of the day (91.2%), was gentle on the eyes (94.4%), kept lenses feeling fresh (94.4%), and helped prevent CL dryness (92.5%). Additionally, 92.6% agreed that BHP MPS helped keep lenses comfortable even when using screens for hours. Agreement responses were statistically significantly greater than 50% for all key performance attributes (p<0.001).

CONCLUSION: Among habitual samfilcon A monthly replacement CL wearers, BHP MPS demonstrated high satisfaction and favorable real-world performance across comfort, hydration, freshness, gentleness, and dryness-prevention attributes. These findings suggest that CL care solution choice can support the wearing experience of monthly lens wearers, including those with long daily wear times and substantial digital device use.

PURPOSE: Blink® Triple Care (BTC) is a benzalkonium chloride-free OTC eye drop, combining hyaluronic acid for hydration, nano-emulsion lipids for tear film stabilization, and osmoprotectants for cellular protection, designed to address both aqueous and evaporative components of dry eye. This analysis assesses symptom relief and durability observed with BTC within both the clinical trial setting and the real-world setting.

METHODS: In a multicenter, randomized, double-masked, active-controlled 30-day trial, adults aged 18-69 years with self-reported dry eye symptoms were randomized to BTC or a commercially available non-lipid eye drop and assessed at baseline, day 7, and day 30 using visual analog scales for ocular comfort and vision quality, patient-reported outcomes, subject-reported ocular symptoms, non-invasive tear break-up time, and slit-lamp findings. In a prospective real-world survey, US adult dry eye sufferers who had used OTC artificial tears in the prior 6 months and had OSDI-confirmed symptoms administered one drop of masked BTC and completed questionnaires immediately and at 4, 8, and 10 hours.

RESULTS: In the randomized trial, 158 subjects were randomized and 130 completed per protocol. BTC improved overall ocular comfort at day 30 by 21.4 points (95% CI 15.1, 27.7) from baseline. Comfort improvement with BTC was evident at day 7, with a mean change of 14.3 points (95% CI 8.6, 19.9). End-of-day comfort increased from 40.4 at baseline to 69.1 at day 7 and 75.0 at day 30. Self-reported severe dryness decreased from 8 eyes at baseline to 2 eyes at days 7 and 30. No Grade 3 or higher corneal edema, neovascularization, corneal staining, conjunctival injection, tarsal abnormality, or corneal infiltrate was observed. In the real-world setting, 621 participants evaluated BTC after single use; 33%, 35%, and 33% had mild, moderate, or moderate/severe dry eye by OSDI, respectively. Participants reported that their dry eyes felt better immediately (80%), at 4 hours (85%), 8 hours (85%), and 10 hours (83%); agreement that dry eyes felt relieved was 70%, 83%, 83%, and 83%, respectively. Overall, 84% agreed their eyes felt relieved throughout the day and 81% agreed BTC provided long-lasting relief. Performance remained high across baseline OSDI severity categories.

CONCLUSION: Across controlled and real-world settings, BTC was associated with meaningful dry eye symptom relief that was evident after single use and durable through 10 hours, with sustained comfort gains during 30 days of use. These findings support BTC as an OTC option for patients seeking rapid and lasting relief from dry eye symptoms across the aqueous–evaporative spectrum and across severity levels.

PURPOSE: Bacterial conjunctivitis accounts for 50% of all conjunctivitis cases in the United States (US). Hallmark symptoms include eye redness and mucopurulent discharge. Despite a range of topical antibiotic treatments available, bacterial conjunctivitis still poses significant economic and humanistic burden ranging from lost work productivity, significant healthcare resource utilization (HCRU) and increased healthcare expenditure estimated to be around $800 million annually. This study aims to quantify the economic and HCRU burden of bacterial conjunctivitis.

METHODS: The case-only cross-sectional study identified patient with a diagnosis of conjunctivitis and an associated prescription for an ophthalmic anti-bacterial agent between January 2018 – December 2023 in the Medical Expenditure Panel Survey (MEPS) database. Total healthcare costs comprise of direct and indirect costs. Direct costs were calculated as a sum of patient out-of-pocket costs and insurer-paid costs. Indirect costs were estimated based on wage-based productivity loss due to work absenteeism. All costs were inflation-adjusted to 2026 using the Consumer Price Index. HCRU was measured using pharmacy visits, office-based visits, outpatient visits and emergency room (ER) visits. Cost and prevalence trends were estimated to identify variation across the 6-year period.

RESULTS: Study identified ~6.1 million patient cases receiving an anti-bacterial agent for bacterial conjunctivitis over the 6-year period with an average annual case rate of over 1 million. Majority of the patients were children (53.8%), female (59.2%) and non-Hispanic White (72.9%) belonging to high income (>400% poverty line) households (53.1%) with private insurance (73.2%) and a mean (SD) cohort age of 23.7 (23.2) years. Mean (SD) number of pharmacy events and costs were 1.2 (0.45) and $34.6 ($66.4) respectively. Mean (SD) office-based visits and costs were 0.9 (0.83) and $260.0 ($489.0) respectively. Mean (SD) outpatient visits and costs were 0.1 (0.29) and $377.8 ($636.4) respectively. Mean (SD) ER visits and costs were 0.1 (0.24) and $412.4 ($228.6) respectively. Total mean direct healthcare expenditure was $278.1. Total mean indirect healthcare expenditure was $445.8 assuming two workdays of absenteeism either as a patient or as a caregiver. Total mean healthcare expenditure was $723.9 over the 6-year period. Prevalence of bacterial conjunctivitis ranged from 0.2 to 1.8 million whereas total mean healthcare expenditure ranged from $154.9 to $1,290.2 over the 6-year period.

CONCLUSION: Bacterial conjunctivitis despite being an acute condition poses significant HCRU and healthcare expenditure burden in the US primarily affecting children and females. Higher indirect compared to direct healthcare costs are an indication of significant productivity lost due to absenteeism as well as the acute nature of the condition. Lower prevalence and healthcare expenditure trend estimates are typically observed in the COVID-19 years.

PURPOSE: Topical over-the-counter ocular vasoconstrictors can relieve ocular redness, but sustained adrenergic agonist use has raised concerns about rebound redness, tachyphylaxis/loss of effect, and overuse or misuse. Brimonidine tartrate 0.025% ophthalmic solution (BTOS; LUMIFY®) is a selective α2-adrenergic receptor agonist, differing from α1 or mixed α1/α2 vasoconstrictors such as tetrahydrozoline and naphazoline. Because of its α2 selectivity, BTOS is hypothesized to have a lower propensity for rebound redness, tachyphylaxis, and related overuse/misuse. This analysis summarized current pharmacovigilance data for BTOS and newly marketed LUMIFY® Preservative Free (BTOS-PF).

METHODS: Post-marketing data from a periodic safety report covering 09 Dec 2024–08 Dec 2025 were reviewed; clinical trial safety data were excluded. Sales-based exposure was expressed as patient-treatment days (PTDs). MedDRA preferred terms and safety topics potentially consistent with rebound redness, tachyphylaxis/loss of effect, or overuse/misuse were reviewed, including rebound effect, ocular hyperemia, drug ineffective/lack-of-effect terms, symptom recurrence, drug tolerance, off-label use, overdose, drug abuse, drug misuse, and medication-error/product-use terms.

RESULTS: During the interval assessed, total exposure was 828,306,265 PTDs: 780,758,324 for BTOS and 47,547,941 for BTOS-PF. BTOS-PF was approved in April 2024 and marketed from May 2025; therefore, this represents the first real-world safety reporting interval for BTOS-PF. For rebound effect with long-term use, no cases were reported. During the interval, 93 lack-of-efficacy cases were reported (73 BTOS; 20 BTOS-PF), representing a reporting rate of approximately 0.11 lack-of-efficacy cases per million PTDs. Off-label-use reports included 54 non-serious cases (48 BTOS; 6 BTOS-PF). Misuse was infrequently reported: 7 non-serious cases (4 BTOS; 3 BTOS-PF), coded as intentional product use issue or intentional product misuse. Two non-serious accidental-overdose cases were reported with BTOS; no drug-abuse cases were reported during the interval. No trend, signal, or new safety information affecting the benefit-risk profile was identified for these topics.

CONCLUSION: Across substantial real-world exposure, including initial post-launch experience with BTOS-PF, pharmacovigilance data showed low reporting of events potentially suggestive of rebound redness, tachyphylaxis/loss of effect, or overuse/misuse. These findings align with the α2-selective mechanism-of-action hypothesis and with LUMIFY® clinical trial observations of low ocular rebound redness and no apparent loss of effectiveness.

PURPOSE: Brimonidine tartrate ophthalmic solution 0.025% (Lumify®; BTOS) is a selective α2-adrenergic receptor agonist that provides rapid ocular redness relief with very low risk of rebound redness or tachyphylaxis. A new BTOS formulation (BTOS-HA) has been developed containing hyaluronic acid, a natural component in tears that helps to keep the eye moisturized and protects it from mechanical stress during blinking. A Phase 3 study established the non-inferiority of BTOS-HA to BTOS via its primary endpoint of redness reduction from 5–240 minutes after instillation. This analysis further explores the activity of the novel BTOS-HA.

METHODS: Adults with investigator-rated ocular redness >1 in both eyes (0–4 scale) received BTOS-HA 4 times daily for 4 weeks (N=289). Investigator-rated redness was assessed before and for 10 hours after first instillation on Day 1, with additional assessments on Days 15 and 29. Safety included ocular and non-ocular treatment-emergent adverse events (TEAEs), best-corrected visual acuity, slit-lamp biomicroscopy, intraocular pressure, dilated fundus examination, and rebound redness through Day 36.

RESULTS: On Day 1, after a single BTOS-HA instillation, mean (SD) redness score decreased from 2.27 (0.53) pre-instillation to 1.58 (0.73) at 30 seconds (mean change -0.69; p< 0.0001) and 0.95 (0.67) at 1 minute. Mean scores were < 0.5 from 5 through 120 minutes (0.29 to 0.44), and statistically significant reduction persisted at 10 hours (1.82 [0.74]; mean change -0.45; p< 0.0001). >50% total clearance was observed beginning at 5 minutes through 60 minutes. Ocular TEAEs occurred in 19/289 (6.6%) and non-ocular TEAEs in 14/289 (4.8%); only instillation-site irritation (5/289, 1.7%) and urinary tract infection (3/289, 1.0%) occurred in ≥1% of BTOS-HA-treated subjects. All ocular TEAEs were mild or moderate. One serious non-ocular TEAE occurred and was not treatment related. Investigator-assessed rebound redness was low: 6/277 (2.2%). No clinically meaningful safety findings were observed for best-corrected visual acuity, intraocular pressure, slit-lamp biomicroscopy, or dilated fundus examination.

CONCLUSION: BTOS-HA provided rapid redness reduction within 30 seconds of first instillation, with mean redness scores < 0.5 from 5 to 120 minutes and statistically significant reduction maintained through 10 hours. Over 4 weeks of dosing, BTOS-HA was well tolerated, with infrequent ocular and non-ocular TEAEs and low rebound redness.

PURPOSE: Dry eye disease (DED) is a chronic, multifactorial condition of the ocular surface characterized by loss of tear film homeostasis that impacts 5-15% of the US population. The discomfort and visual inconsistency of DED may interfere with activities of everyday living such as reading, driving, and the use of screens/monitors, ultimately impacting the quality of life (QoL) and well- being of the individual. Perflurohexyloctane (PFHO) ophthalmic solution is used to treat the signs and symptoms of DED directly targeting excessive tear evaporation. This study evaluated the patient-reported clinical symptoms in patients treated with PFHO.

METHODS: Patients ≥21 years with ≥1 prescription of PFHO between November 2025 – May 2026 in the Veradigm Network EHR linked to administrative claims were identified. Index treatment was defined as initial prescription of PFHO as the first EHR record with no evidence of PFHO in the 6-month baseline period. Patient outcome surveys were administered at baseline, week 2 and week 4 following PFHO prescription. Primary endpoints included (1) Ocular Surface Disease Index (OSDI) scores comprising of ocular symptoms, vision-related functioning and environmental triggers and (2) Visual Analog Scale (VAS) symptoms comprising eye dryness, burning/stinging, eye itching, light sensitivity, eye pain, eye tiredness, eye irritation and blurred vision. Change from baseline to each of the two follow-up periods for both endpoints. Statistical significance was set at p<0.05.

RESULTS: 111 patients at baseline [90.1% female; mean (SD) age 64.3(12.9) years), 77.5% white, 92.8% non-Hispanic] had a new prescription for PFHO during study period 68.2% patients with a cataract diagnosis(n=66) had underwent a cataract surgery at baseline, 86.4% patients had at least one OTC drug for DED symptoms while 99% had at least one prescription drug in the past year for DED. OSDI total mean (SD) score decreased significantly from 46.4 (21.9) to 33.1 (20.6) at week 2 (n=61), while mean (SD) OSDI total score decreased significantly from 44.0 (21.2) to 29.5(18.8) at week 4 (n=60). Significant reductions in patient-reported severity were observed for all symptoms at all post-baseline assessments (P < 0.001) using VAS scale.

CONCLUSION: In this real-world cohort, treatment with PFHO was associated with significant and early reductions in patient-reported dry eye symptom severity over a 4-week period. Improvements in OSDI total scores, observed as early as week 2 and sustained through week 4, alongside consistent reductions across all VAS symptom domains, indicate decreased symptom burden and enhanced vision-related functioning in a real-world setting. These findings support the effectiveness of PFHO in alleviating symptoms of dry eye disease, highlighting its potential to improve patient quality of life and daily visual function.

PURPOSE: Contact lens use can disrupt the tear film and increase eye dryness. Perfluorohexyloctane ophthalmic solution (PFHO), which is indicated for the treatment of signs and symptoms of dry eye disease, was shown to be safe and efficacious in non-contact lens wearers and in a single-site study utilizing on-label dosing in habitual contact lens wearers. PFHO has not been evaluated when instilled while wearing contact lenses. This study evaluated the impact of concomitant use of PFHO during contact lens wear.

METHODS: This was a phase 4, multicenter, prospective, open-label trial. Adult habitual wearers of soft, frequent-replacement contact lenses (daily-disposable, biweekly, or monthly) instilled PFHO bilaterally 4 times daily (1 time before, 3 times while wearing lenses) for 30 days. The primary endpoint was change from baseline at Day 30 in the Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8; maximum score: 37, higher scores indicate greater contact lens– related symptoms).

RESULTS: A total of 104 patients were enrolled (79.8% female; 51.9% daily replacement contact lens type modality; mean [SD] age, 39.9 [11.3] years; age range, 18-67 years). The mean (SD) CLDEQ-8 score at baseline was 12.2 (6.6). Mean (SD) change from baseline was -2.8 (4.9) at Day 7, -3.8 (4.7) at Day 14, and -4.3 (5.8) at Day 30 (P<0.001). There were no potential safety signals as all objective clinical assessment exploratory endpoints were stable throughout the study. Additional subjective parameters that were significantly improved from baseline averaged across Week 4 included mean total daily contact lens wear time, comfortable wear time, end-of- day eye dryness while wearing contact lenses, and end-of-day discomfort while wearing contact lenses (P<0.001 for all). Ocular adverse events (AEs) were reported in 10 (4.8%) of 208 eyes, and all were mild or moderate in intensity. There were no serious AEs reported. One patient (1.0%) discontinued PFHO due to AEs of eye dryness and instillation discomfort.

CONCLUSIONS: Concomitant use of PFHO with contact lens wear was well tolerated among habitual wearers of soft, frequent-replacement contact lenses with no indication of potential safety concerns. Furthermore, PFHO administration was associated with notable improvements in patient-reported assessments of contact lens performance and tolerability.

PURPOSE: Lifitegrast ophthalmic solution 5% (LIF) and perfluorohexyloctane ophthalmic solution (PFHO) target distinct pathophysiologic mechanisms of dry eye disease (DED), addressing ocular surface inflammation and excessive tear evaporation, respectively. This study evaluated real-world efficacy and safety outcomes of concomitant LIF + PFHO therapy in patients with DED.

METHODS: This noninterventional, multicenter retrospective chart review (United States). Patients ≥18 years of age with a diagnosis of DED who were treated concomitantly with LIF + PFHO without receiving any other prescription DED therapy during LIF + PFHO use were included. Extracted data included demographics, DED characteristics, treatment initiation (simultaneous vs additive), clinical symptoms (evaluated on a 0-3 rating scale) and signs (eye redness, fluorescein, and lissamine green staining on a 0-3 rating scale; other endpoints by quantitative measure), and adverse events (AEs). Data were collected at the index (baseline) visit, first follow-up visit, and last available follow-up visit. Data are expressed as mean (SD).

RESULTS: Sixty-eight patients (mean [range] age: 61 [30-80] years) from 23 clinicians were included. At the index visit, 52% of patients had moderate DED, 71% had mixed-mechanism DED, while Meibomian gland dysfunction was reported in 49% of charts. Patients were treated with 4.5 (2.7) treatments (prescription, over-the-counter, and/or procedural) prior to initiating the concomitant LIF + PFHO therapy.] 43% of patients received LIF first, 22% of patients received PFHO first, whilst 35% of patient received LIF and separately PFHO at the same visit. Most common baseline symptoms were eye dryness, blurry or fluctuating vision, burning/stinging, and impairment of daily activities. Eye dryness was reduced from 2.1 (0.6) to 0.8 (0.8) and 0.5 (0.7) at the first and second follow-up visits (P<0.001 for both). Patients also experienced significant reductions in all other patient-reported symptoms. Improvements were observed in fluorescein staining (1.9 [0.7] to 0.8 [0.8] and 0.6 [0.6]) at the first and second follow-up visits (P<0.001 for both). Concomitant therapy also resulted in significant improvements in lissamine staining, conjunctival redness, tear break-up time, and tear osmolarity. No unexpected AEs were reported; 19 AEs occurred in 13 patients, the majority of which were mild to moderate in severity. Most (84%) of patients remained on concomitant therapy after their last follow-up visit.

CONCLUSION: In this real-world analysis, patients with DED experienced substantial improvements in symptoms, daily functioning, and clinical signs with concomitant LIF + PFHO therapy. Concomitant therapy was well tolerated, with no unexpected safety findings.

PURPOSE: Perfluorohexyloctane ophthalmic solution (PFHO) and lifitegrast ophthalmic solution 5% (LIF) address distinct mechanisms of dry eye disease (DED), targeting excessive tear evaporation and ocular surface inflammation, respectively. Understanding eyecare providers’ (ECPs) experience managing DED with concomitant PFHO/LIF treatment can inform patient care and future therapeutic strategies. The aim of this provider survey was to evaluate real-world utility and outcomes of concomitant PFHO/LIF use in patients with DED.

METHODS: A geographically diverse sample of ECPs managing DED with concomitant PFHO/LIF were invited to complete a survey that included items regarding reasons for concomitant therapy, patient type, time to improvement, and duration of therapy. Provider satisfaction for overall management, sign/symptom improvement, and tolerability was rated on a 5-point scale (from not at all satisfied to extremely satisfied).

RESULTS: A total of 83 ECPs (30 ophthalmologists and 53 optometrists) completed the survey. ECPs treated a mean of 221 (range, 16‒600) DED patients per month, with 90% reporting using concomitant PFHO/LIF in up to 30% of their patients. ECPs reported that they would be very/extremely likely to prescribe concomitant PFHO/LIF in 10%, 40%, and 83% of patients with mild, moderate, and severe DED, respectively. Concomitant PFHO/LIF was commonly prescribed in patients with mixed mechanisms of DED and in patients with ocular surface inflammation. Most clinicians initiated PFHO or LIF and then added on the other therapy. The primary rationale for concomitant PFHO/LIF use was rapid symptom relief and complementary mechanism of action, over long-term relief, sign relief, or safety/tolerability profile. Symptom improvement was typically observed within 2 to 3 weeks, and most clinicians anticipated indefinite duration of combination therapy. Satisfaction ratings (mean [SD], 0‒5 scale) for overall management of DED, improving symptoms, improving signs, and tolerability were 4.16 (0.69), 4.12 (0.73), 4.10 (0.70), and 3.67 (0.90), respectively.

CONCLUSION: Findings from this real-world survey of ECPs highlight the utility of concomitant use of PFHO and LIF for the treatment of DED in a broad spectrum of patients with DED. Physicians reported a high level of satisfaction with the efficacy and tolerability of concomitant therapy.

PURPOSE: Dry eye disease (DED) is a multifactorial disease, with a subset of etiologies associated with inflammation. Lifitegrast ophthalmic solution 5% is a lymphocyte function- associated antigen-1 (LFA-1) antagonist approved for the treatment of DED. A post hoc analysis of phase 3 lifitegrast studies (OPUS-2 and OPUS-3) identified a subset of patients who had rapid, robust, and sustained improvement in DED symptoms. Real-world studies can further clarify the clinical characteristics of treatment responders. This first phase of a 3-part study explored eye care provider (ECP) definitions of “robust responders” to lifitegrast treatment based on patient characteristics and clinical findings.

METHODS: A series of semi-structured qualitative interviews were conducted with US ECPs. Interview questions pertained to ECP experience with lifitegrast, definition of a robust response, and patient and clinical characteristics associated with the quality of response. Transcripts were analyzed thematically to identify recurring concepts and clinically relevant insights.

RESULTS: Ten experienced ECPs (ophthalmologists and optometrists) who routinely treat patients with DED and prescribe lifitegrast were interviewed. Although the definition of a robust responder to lifitegrast treatment differed across ECPs, ≥1 common feature(s) described by 7 of 10 ECPs included improvement or reduction in DED symptoms within 4 to 6 weeks and a reduction in ocular surface staining. Inflammation was viewed as central to treatment by 5 ECPs, with robust responders frequently described as having positive inflammatory markers, aqueous- deficient dry eye, or inflammatory meibomian gland dysfunction. Other commonly cited patient characteristics included peri- or postmenopause (women), comorbid autoimmune or systemic inflammatory disease (eg, Sjögren’s syndrome, rheumatoid arthritis), positive MMP-9, high digital screen use, and contact lens intolerance or postsurgical dry eye. Improvements in quality of life and functional vision were also identified as key indicators of robust response.

CONCLUSION: Eye care providers identified a clinically meaningful subset of patients with DED who showed robust response to lifitegrast, largely driven by inflammation-mediated disease. These qualitative findings will inform subsequent real-world studies to further characterize robust responders using objective clinical data.

PURPOSE: Lifitegrast ophthalmic solution 5% is indicated for treatment of signs and symptoms of dry eye disease (DED). Lifitegrast demonstrated symptom relief starting at 2 weeks and a favorable safety profile in clinical trials. The aim of this report was to describe real-world evidence for lifitegrast collected from 2 studies: a provider survey and a pharmacovigilance database analysis.

METHODS: Eyecare providers (ECPs: ophthalmologists and optometrists) completed a survey and submitted case reports on patients treated with lifitegrast. Twelve ECPs treated an average of 1288 patients with DED annually, with 21% of these patients, on average, receiving lifitegrast. Seven ECPs provided 36 case reports of patients (mean age, 51 years; mean number of follow-up visits, 5) with aqueous-deficient (39%), evaporative (14%), or mixed (47%) DED. Postmarketing safety data from approval in the United States (July 2016) to July 10, 2024, were reviewed using a company pharmacovigilance database with reports from providers and patients.

RESULTS: In the survey, two-thirds (67%) of ECPs reported near/complete symptom resolution in patients after 1 to 3 months of lifitegrast treatment. Case report data indicated that improvement was sustained throughout treatment, with a mean duration of 29 months (range, 1-69). Adverse events (AEs) considered by the ECPs as related to lifitegrast use included blurred vision, burning/stinging, and dysgeusia; all were mild or moderate in severity. In the postmarketing pharmacovigilance database, cumulative patient exposure with 8 years of worldwide use was estimated at 915,260 patient treatment-years. No new safety signals were identified.

CONCLUSION: Results from the ECP survey show that treatment with lifitegrast provides sustained symptom relief in patients with DED, and the AEs reported were consistent with the known safety profile of lifitegrast. Long-term use revealed no new or changing safety signals during routine safety monitoring.

PURPOSE: Latanoprostene bunod (LBN) 0.024% ophthalmic solution is indicated for the reduction of intraocular pressure in patients with open-angle glaucoma (OAG) and ocular hypertension (OHT). The presence of concomitant dry eye disease (DED) may adversely affect adherence to glaucoma therapies, potentially leading to poorer outcomes. This study aimed to evaluate real- world LBN treatment patterns including adherence, persistence, and discontinuation and to compare outcomes between patients with OAG with and without comorbid incident DED.

METHODS: A retrospective analysis of 100% Medicare Fee-for-Service (Parts A/B/D) claims data was conducted to identify patients aged ≥65 years with OAG, with or without incident DED, who received an LBN prescription between January 2017 and June 2020. Index date was defined as the earliest DED diagnosis or treatment occurring within six months following OAG identification. Patients initiating LBN after the index date were followed for 12 months. Adherence was assessed using the Proportion of Days Covered (PDC), measured through the end of the supply period, with PDC ≥0.80 indicating adherence. Switching was defined as initiation of an alternative therapy during the final days of LBN supply or within a 60-day gap. Discontinuation was defined as a gap of at least 60 days after the end of LBN supply.

RESULTS: A total of 912 patients met all inclusion criteria. The cohort was predominantly female (55%) and White (79%), with a mean (SD) age of 77.3 (8.1) years. Among patients with DED (n=194), the most common subtype was aqueous-deficient DED (47.4%), followed by mixed forms (34.0%), evaporative (9.8%), and inflammatory (8.9%). The distribution of OAG/OHT severity was comparable between cohorts. In patients without DED (n=718), disease severity was categorized as severe (19.1%), moderate (19.6%), mild (14.1%), and OHT (9.5%). Among patients with comorbid DED, severity was distributed as severe (17.5%), moderate (14.9%), mild (10.3%), and OHT (8.2%). Among the comorbid DED cohort, mean (SD) PDC for LBN was 0.75 (0.24), with 45.1% of patients achieving adherence (PDC ≥0.80). Approximately 44.5% (n=406) of patients discontinued treatment, and among these, 62.1% (n=252) subsequently restarted LBN. Patients without DED had a mean (SD) PDC of 0.73 (0.24), which was not significantly different from patients with DED, who had a mean (SD) PDC of 0.75 (0.24) (p>0.05).

CONCLUSION: Average adherence to LBN was approximately 75%, with nearly half of patients meeting the ≥80% adherence threshold. Adherence rates were comparable between patients with and without comorbid DED, suggesting similar tolerability of LBN irrespective of DED status. Notably, a substantial proportion of patients who discontinued therapy later resumed treatment. These findings underscore the durability, tolerability, and real-world clinical utility of LBN in older patients with OAG/OHT, including those with concomitant DED.

PURPOSE: Latanoprostene bunod 0.024% (LBN) is a once-daily topical therapy approved for intraocular pressure (IOP) reduction in individuals with open-angle glaucoma (OAG) or ocular hypertension (OHT). Despite its distinct dual mechanism of action, its real-world use as an early treatment option in glaucoma care is not well characterized. This study evaluated the demographic and clinical profile of patients with OAG or OHT who initiated LBN therapy.

METHODS: This retrospective observational study used linked Medicare fee-for-service Parts A, B, and D claims and IRIS® Registry data from January 1, 2021, to December 31, 2023. Eligible patients had evidence of OAG/OHT diagnosis or treatment and an IRIS-recorded IOP value between 8 and 40 mmHg within a 30-days during calendar year 2022. Patients were excluded if they were under age 65, were diagnosed with other forms of glaucoma, and/or received unknown laterality procedures. Also, patients with prior glaucoma therapy during the baseline period were excluded to identify new therapy initiators.

RESULTS: A total of 388,057 patients with OAG/OHT were identified, of whom 29,911 initiated an interventional therapy during follow-up. Among these, 304 patients initiated LBN. Patients receiving LBN were primarily female (61.8%), had a mean (SD) age of 78.4 (8.3) years, and were largely Caucasian (75.7%). The mean (SD) IOP at index was 19.0 (6.4) mmHg. Overall, 25.7% of patients had IOP >21 mmHg, whereas 74.3% had IOP values within the 8–21 mmHg range. With respect to disease severity, 32.0% had mild glaucoma, 24.1% had moderate glaucoma, 6.2% had OHT without glaucoma, and 9.3% had severe glaucoma.

CONCLUSION: In this real-world Medicare population, LBN initiation was observed across varying levels of glaucoma severity, with a substantial proportion of patients presenting with IOP ≤21 mmHg at baseline. These findings suggest that LBN may be used earlier in the treatment pathway and may have relevance for managing older adults with OAG/OHT in routine clinical practice.

PURPOSE: Glaucoma is a neurodegenerative disease that leads to progressive vision loss. Management of glaucoma typically focuses on reducing intraocular pressure (IOP) using topical ocular hypotensive medications as first line therapy. Latanoprostene Bunod 0.024% (LBN) is indicated for IOP reduction in patients with open-angle glaucoma (OAG) and ocular hypertension (OHT). Previous real-world studies have shown significant clinical benefit through IOP reduction in OAG patients that switched from other topical IOP reducing medications to LBN. However, the real-world impact of switching to LBN in patients with varying baseline IOP and glaucoma severity has not yet been fully quantified. This study aims to characterize the impact of switching to LBN in these patients with varying baseline IOP and glaucoma severity

METHODS: Patients (≥18 years) with OAG/OHT and ≥1 LBN claim following a prior topical therapy between July 2017 and June 2023 were identified using the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight) linked to a third-party commercial insurance claims database. The date of first LBN prescription was defined as the index date with preceding 6- months as baseline and following 6-months as the follow-up period. Patients at baseline were stratified based on (1) IOP (≤18 mmHg, 19-20 mmHg, ≥21 mmHg) and (2) Glaucoma severity (mild, moderate, severe and unspecified). Change in IOP at baseline and after switching to LBN were compared any time between day 30-180 after the first LBN-claim. Statistical significance was set at p<0.05.

RESULTS: A total of 833 patients with OAG/OHT met the study criteria that switched to LBN from prior topical therapy. Based on baseline IOP, 399 (47.9%) patients had IOP ≤18 mmHg, 163 (19.6%) had IOP 19-20 mmHg and 271 (32.5%) had IOP ≥21 mmHg. The mean (SD) reduction in IOP in the ≤18 mmHg cohort was 0.8 (3.2) mmHg, in the 19-20 mmHg cohort was 2.6 (3.5) mmHg reduction and in the ≥21 mmHg cohort was 5.9 (5.6) mmHg reduction from baseline to 30-180 days post-first LBN. Based on baseline glaucoma severity, 278 (33.4%) patients were mild OAG, 236 (28.3%) were moderate OAG and 148 (17.8%) were severe OAG. The mean (SD) reduction in IOP in the mild OAG cohort was 2.8 (4.6) mmHg, in the moderate cohort was 2.7 (4.3) mmHg reduction and in the severe cohort was 2.4 (4.5) mmHg. All unadjusted analyses for mean reduction in IOP yielded a P-value of <0.001. In patients with baseline IOP of 19-20 mmHg and those with ≥21 mmHg, ~55% of patients and ~76% patients had an IOP reduction of ≥3 mmHg, respectively.

CONCLUSION: Significant reduction in IOP across OAG/OHT patients with varying baseline IOP and glaucoma severity shows the clinical benefit of switching to LBN in real-world clinical practice. These findings corroborate prior real-world findings that showed 2.8 mmHg reduction in IOP after switching to LBN.

PURPOSE: Latanoprostene bunod ophthalmic solution 0.024% (LBN) is a nitric oxide-donating prostaglandin analog indicated for the reduction of intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension. This study characterized real-world eye care practitioners’ (ECPs’) experiences and perceptions of LBN in clinical practice.

METHODS: A cross-sectional online survey was administered to ECPs in the United States who had prescribed LBN to ≥10 patients within the prior ≥1 month. Respondents reported on their prescribing patterns, patient characteristics, perceived efficacy, tolerability, and overall satisfaction. Descriptive statistics were used to summarize responses.

RESULTS: Fifty-five ECPs completed the survey (mean [SD] age, 68 ± 15 years). Respondents reported a mean (SD) of 1.42 ± 1.07 years of experience prescribing LBN and a median (IQR) of 1 (1–2) new LBN prescriptions per week, with a median [range] of 29 [17–52] patients currently treated with LBN. Overall, 70% (38/54) of ECPs reported being satisfied or very satisfied with LBN, 65% (35/54) perceived LBN to be more effective than other prostaglandin analogs, and 87% (48/55) indicated they would recommend LBN to a colleague (Table). Perceived efficacy and tolerability were the most frequently cited reasons for prescribing LBN (Figure).

CONCLUSION: In this real-world survey, ECPs reported favorable experiences with LBN, including high levels of satisfaction, perceived efficacy, and willingness to recommend. These findings complement clinical trial data and support the role of LBN in the management of open-angle glaucoma and ocular hypertension.