Data presented at the 2025 American Society of Cataract and Refractive Surgery (ASCRS) Annual Meeting reveals that perfluorohexyloctane ophthalmic solution (PFHO; MIEBO) delivers unprecedented rapid relief for patients with dry eye disease (DED), with significant symptom improvement occurring within minutes of application.
The phase 4, multicenter, open-label study enrolled 99 adults with a history of DED who administered PFHO in both eyes four times daily. Patients presented with a mean tear film breakup time of 3.6 seconds and moderate to severe meibomian gland dysfunction at baseline.
Remarkably Fast Symptom Relief
Dr. Jason Bacharach, director of research at North Bay Eye Associates and presenter of the findings, emphasized the exceptional speed of symptom relief: "At five minutes after the first dose, [we observed] a significant improvement in a variety of symptoms and the total composite dry eye symptom improvement score on the Visual Analogue Scale (VAS) was so large, almost 50% after one dose."
This rapid onset of action represents a significant advancement in dry eye treatment, as most controlled studies typically measure efficacy at much later timepoints, usually day 3 or day 7 after treatment initiation.
"This, I believe, was one of the fastest onset benefit studies for a topical dry eye therapy that has been reported to date," noted Dr. Bacharach.
Sustained Improvement and High Patient Satisfaction
The primary endpoint—mean change in overall DED symptom severity at Day 7—showed a statistically significant 61.7% reduction (P <.0001). Importantly, symptom improvements were consistent across all measured timepoints and extended across individual symptom domains, including dryness, burning, irritation, and blurred vision.
Patient satisfaction scores were notably high, with median ratings increasing from 83.0 at Day 3 to 86.0 at Day 7, and reaching 90.0 by Day 14. Dr. Bacharach suggested these high satisfaction rates could translate to better treatment adherence.
"If patients are happy with the therapy, whatever that therapy is, they're more prone to stay on, improving adherence," Dr. Bacharach explained. "That's what I have found clinically in my practice. People using PFHO really want to stay on the drop, and that is a huge benefit."
Mechanism of Action
The unique physical properties of perfluorohexyloctane contribute to its rapid efficacy. Dr. Bacharach explained that the medication's small molecular size allows it to remain on the ocular surface and create a protective barrier.
"We think that because of its ability to create a barrier at the air tear film, particularly lipid level interface, the patients develop a significant improvement early on and then maintain an improvement until their next dosing," he said. "It reduces evaporation on the front of the eye, with patient satisfaction rising as early as day three."
Clinical Applications
In clinical practice, Dr. Bacharach reported using perfluorohexyloctane as both a first-line and adjunctive therapy for dry eye disease. The medication's versatility and rapid action make it particularly valuable for addressing the full spectrum of dry eye symptoms.
The study's findings suggest that perfluorohexyloctane represents an important advancement in the treatment landscape for dry eye disease, offering patients the potential for immediate symptom relief—a significant benefit for a condition that can significantly impact quality of life and visual function.
Dr. Bacharach's relevant disclosures include relationships with Allergan, Bausch + Lomb, EyePoint, Injectsense, Insite, Ocular Therapeutix, and others.
