EyeWorld Asia-Pacific June 2020 Issue

PHARMACEUTICALS 54 EWAP JUNE 2020 also correlated with dry eye symptoms. For these, Dr. >À w`Ã Ìi> ÌÀii > ÕÃivÕ ÃÌÀ>Ìi}Þ° À° -i««>À` w`Ã hypochlorous acid preparations useful for Demodex . Emerging agents Dr. Sheppard estimates there are nearly three dozen different companies working on other medical therapies for dry eye conditions. “The nearest to approval is CyclASol from Û>µ] ÜVÃ > VÞVÃ«Ài preparation in a truly unique vehicle,” Dr. Sheppard said. CyclASol is a water-free, semi- yÕÀ>Ìi` >>i Ì>Ì «À`ÕViÃ a 20-microliter drop. As a water- free preparation, it requires no preservative with a lower risk of infection, Dr. Sheppard said. “Also, it turns out that Ìi ÃiyÕÀ>Ìi` >>iÃ alone in a higher molecular weight preparation have a direct effect on meibomian glands that can alleviate meibomian gland-related ocular surface lid disease,” he said. There is also promise for hyaluronic acid. It is approved as a prescription topical agent for dry eye in Japan, Dr. Sheppard noted. However, repeated failures have occurred in trying to obtain approval in the U.S. Other ophthalmic lubricating preparations that include hyaluronic acid are Oasis Tears (Oasis Medical), Blink (Johnson & Johnson Vision), and Refresh Relieva (Allergan), Dr. Sheppard said. Another avenue is a uniquely delivered compound being explored by Oyster Point Pharma. This product, a nicotinic agonist nasal spray, targets the upregulation of natural tear production, similar to the TrueTear (Allergan) approach, but the latter relies on intranasal electrical stimulation. “It’s based on a common pathway feeding these trigeminal neuroreceptors that induce the production of normal tears,” Dr. Sheppard Ã>`° º/i w> ÕÀÞ Ã Ì ÞiÌ] but the data are becoming more and more promising.” Dr. Sheppard said he is hopeful that one or more of these options may eventually expand the pharmacologic arsenal available to eyecare providers with truly synergistic modalities. EWAP Editors’ note: Dr. Galor is associate professor of ophthalmology, Bascom Palmer Eye Institute, Miami, Florida, and has relevant interests with Allergan, Novaliq, and Shire. Dr. Sheppard is professor of ophthalmology, microbiology, and molecular biology, Eastern Virginia Medical School, Norfolk, Virginia, and he declared relevant interests with AbbVie, Aldeyra, Allergan, Bausch + Lomb, Novaliq, Noveome, Oasis Medical, Oyster Point Pharma, Novartis, and Sun Pharmaceutical. Study shows better IOP – from page 52 1992–2013. The investigators attributed the differences in glaucoma development to diminished surgery-induced damage to the anterior chamber angle and trabecular meshwork, and to the reduced postoperative use of steroids. The 10-year probability of loss of vision related to glaucoma was highest after PKP (3.6%), compared to DSAEK (1%) and ALK (2.1%) ( P =.036). 1 “In the postoperative period, endothelial keratoplasties when compared to penetrating keratoplasties provide lower IOP and less need for topical steroids at most postoperative time points up to 2 years,” Dr. 6Õ Ã>`° º7i Ã>Ü Ã}wV>Ì reduction in the need for glaucoma drops or glaucoma surgery at the 2-year follow-up. This information may be used to help guide surgical decision making and postoperative care considerations. Limitations of the study include small sample size, single center study, patients lost to follow-up, as well as differences in age and gender between groups. Future studies can expand on numbers as well as provide matched comparisons.” EWAP Reference 1. Borderie VM, et al. Incidence of intraocular pressure elevation and glaucoma after lamellar versus full- thickness penetrating keratoplasty. Ophthalmology . 2016;123:1428–1434. Editors’ note: Dr. Vu is in practice at the department of ophthalmology, Gavin Herbert Eye Institute University of California, Irvine, Irvine, California, and FGENCTGF PQ TGNGXCPV ƂPCPEKCN KPVGTGUVU