PURPOSE: Dry eye disease (DED) is common in patients undergoing cataract surgery. Perfluorohexyloctane ophthalmic solution (PFHO) forms an anti-evaporative monolayer at the tear-film surface to reduce both signs and symptoms of DED. This study evaluated whether preoperative PFHO treatment affected postoperative refractive accuracy.

METHODS: This prospective, multicenter, open-label, phase 4 study (NCT06346340) enrolled patients with DED who were candidates for phacoemulsification with posterior chamber intraocular lens (IOL) implantation. Patients instilled PFHO in both eyes QID for 30 days preoperatively and received a second 30-day PFHO treatment beginning approximately 1 month after surgery. The 30-day postoperative standard-of-care visit included assessment of refractive outcome (manifest refraction). The primary endpoint was the mean difference between absolute deviations from predicted refractive error in the study eye.

RESULTS: The study enrolled 97 patients (75.3% female; mean age, 68.6 years). The mean difference between absolute deviations in predicted refractive error measured before and after presurgery PFHO treatment was -0.027 ± 0.167 D (P=0.1385). The difference in the baseline predicted refractive error and the predicted refractive error post-PFHO treatment was within 0.3 D for 94.2% of study eyes. The percentage of patients with calculated IOL power within +0.50 D of the correct IOL power was 72.1% before and 83.7% after PFHO treatment. Two adverse events were considered related to treatment (mild eye pruritus and mild noninfective conjunctivitis).

CONCLUSION: In patients with DED undergoing cataract surgery, PFHO did not alter the accuracy of preoperative biometry and keratometry measurements or impact the predicted refractive error. The accuracy of IOL power determination was increased after preoperative PFHO treatment. PFHO was well tolerated in this patient population.