Keratoconjunctivitis sicca affects nearly 16 million individuals in this country, and more than 85% of those cases involve meibomian gland dysfunction, the primary cause of excessive tear evaporation. It is a common condition that can significantly impair the quality of life for those with severe disease. When ocular symptoms such as inflammation and damage occur, more advanced interventions may be necessary than using artificial tears and avoiding corneal drying. A first-in-class treatment option to aid in managing the effects of meibomian gland dysfunction has been approved, giving providers a new means to help stabilize the critical tear film in patients with evaporative keratoconjunctivitis sicca.
The mucosa of the ocular surface is reliant on the specialized components in tears, which lubricate and protect it. Homeostasis of the tear film is vital, as an imbalance in the quality or amount of tears can trigger uncomfortable and damaging issues with the eye's surface. There are three important layers in the tear film. Epithelial goblet cells are responsible for the mucin layer, which is the innermost layer that aids tears' ability to stick to the ocular surface. Lacrimal glands produce aqueous secretions that provide necessary moisture and nourishment for the eyes. Keeping tears from too-rapid evaporation and aiding in creating the smooth optical surface is the lipid layer produced by meibomian glands.
Meibomian glands are located near the eyelashes along the edges of the eyelids. Their oily secretions, known as meibum, are essential to tears. If a blockage or other meibomian gland irregularity or dysfunction occurs that causes impairment of meibum secretions, it may lead to evaporative dry eye disease. Symptoms of the disorder include pain, gritty feeling, blurry vision, or other discomfort or sight disturbances. If eyes do not have adequate tears, the risk of infection, corneal ulcers, and even vision loss can be greater. Reduction of this risk is crucial and, until recently, has been an unmet need for patients with evaporative keratoconjunctivitis sicca.
A new approval for a first-in-class treatment with a novel mechanism of action has the potential to address that need. The FDA granted approval to
Miebo (perfluorohexyloctane) ophthalmic solution for the treatment of the signs and symptoms of dry eye disease. Perfluorohexyloctane is a semifluorinated alkane liquid administered as an eye drop. Its inert, slightly amphiphilic, and non-aqueous qualities help reduce tear instability stemming from meibomian gland dysfunction. Perfluorohexyloctane forms a layer over the natural tear film, functioning similarly to meibum to reduce tear evaporation. Microbial growth is impossible in perfluorohexyloctane, so no preservative is needed in the solution. This benefits patients with chronic eye conditions, as preservatives are often related to increased eye irritation.
The ability to more directly address issues related to the effects of evaporative tear dysfunction is a positive advancement in treating patients with chronic dry eye. It is a helpful innovation that can aid providers in determining optimal care for these patients. Stay informed about emergent drug information, including ocular therapeutics, by
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