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.