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 the use of PFHO in patients undergoing cataract surgery.

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.

RESULTS: The study enrolled 97 patients (75.3% female; mean age, 68.6 years). The mean difference in absolute deviations between manifest refraction and predicted refractive error measured before and after preoperative PFHO treatment (primary endpoint) was -0.027 ± 0.167 D (P=0.1385). The difference in predicted refractive error at baseline versus 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. Treatment with PFHO significantly improved DED signs and symptoms, including total and central corneal fluorescein staining, eye dryness, and Ocular Surface Disease Index scores, before and after cataract surgery (P<0.0001 for all. most patients experienced stable or improved root mean square higher-order aberrations in the central 6.0 mm of the cornea after pfho treatment. the percentage of patients with best-corrected visual acuity of 20 20 or better was 86.0 at first postoperative assessment and 91.8 after 30 days of subsequent 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. Patients experienced significant reductions in signs and symptoms of DED. PFHO was well tolerated in this patient population.