Real World of Ophthalmology

Real World of Ophthalmology

Source:

Loh J. Presbyopia: The fountain of youth is flowing. Presented at: Real World Ophthalmology; April 2, 2022 (virtual meeting).

Disclosures: Loh reports consulting/advising for Allergan and having financial ties to other companies developing presbyopia drops.
April 27, 2022
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Certain patients may be better suited for presbyopia drops

Source:

Loh J. Presbyopia: The fountain of youth is flowing. Presented at: Real World Ophthalmology; April 2, 2022 (virtual meeting).

Disclosures: Loh reports consulting/advising for Allergan and having financial ties to other companies developing presbyopia drops.
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More options are on the way to treat patients with presbyopia, according to a presentation at Real World Ophthalmology.

Jennifer Loh, MD, said more than 120 million people in the United States have presbyopia, and about 16% of them do not have adequate correction.

Jennifer Loh

“Ten percent of presbyopic patients were willing to trade 5% off their life in order to get rid of their presbyopia,” she said. “That’s obviously a pretty big deal.”

Allergan received FDA approval for Vuity (pilocarpine hydrochloride ophthalmic solution 1.25%) in October 2021, and at least seven other companies are developing drops to treat presbyopia.

Although there are other treatments available, Loh said patients are looking for ways to reduce their dependence on glasses, and surgical options often come with a trade-off. Patients have shown great interest in the potential of presbyopia drops, with 88% indicating they were interested — a percentage that remains consistent across all age, gender and income groups.

Loh said most presbyopia drops control the pupil to create a pinhole effect to increase depth of field and improve near vision. The drops need rapid onset and good duration along with efficacy, safety and convenience, she said.

There are several groups of good candidates for presbyopia drops, including emmetropes, who are least comfortable with vision correction surgery. Post-LASIK emmetropes and hyperopes could also experience a benefit to their distance and near vision, Loh said. Finally, pseudophakes might benefit, including those with monofocal IOLs who could use a drop instead of readers and those with premium IOLs who might want additional near vision beyond what their implanted lenses provide.

Loh said patients with long axial length or a history of retinal tear might not be the best fit for presbyopia drops.

“I would say they are more like relative contraindications,” she said. “It’s not necessarily that you cannot use a miotic in someone with a long axial length or history of retinal tear, but I think it’s important to perform a thorough exam and, of course, counsel our patients.”