OBJECTIVES:

Dry Eye Disease (DED) is a chronic, multifactorial disease of the ocular surface. Existing prescription medications for DED primarily focus on increasing tear production or reducing inflammation. Perfluorohexyloctane (PHO) ophthalmic solution (MIEBO), the first and only prescription eye drop for DED that directly targets tear evaporation was introduced in September of 2023. The purpose of this study was to describe clinical and demographic characteristics of early adopters of PHO and patients starting other DED medications.

METHODS:

Adults (≥18 years) in the Veradigm Network Electronic Health Record (VNEHR) Database initiating DED treatment with either perfluorohexyloctane, cyclosporine ophthalmic solution 0.05% (CYC-S) (Restasis), lifitegrast (LFT) (Xiidra), and cyclosporine ophthalmic emulsion 0.09% (CYC-E) (Cequa) from September 2023 to December 2023 were selected. Patients with a record for their index medication in the 12-months prior to index were excluded.

RESULTS:

A total of 12,204 patients were included; 1,539 PHO, 7,381 CYC-S, 2,463 LFT, and 821 CYC-E. A majority were female (80.2%), mean age 67.3, however 69.6% of CYC-S patients were over 65 versus 55.7-57.8% of those initiating other agents. About half of the patients had a recorded DED diagnosis in the prior 12 months; 68% PHO, 44% CYC-S, 50% LFT, and 68% CYC-E. The most common ocular comorbidities were cataract (16.6%), followed by glaucoma (4.9%). Only 4% of CYC-S patients had used a prior DED medication compared to 9% of LFT, 19% of CYC-E, and 28% of PHO.

CONCLUSIONS:

Early adopters of PHO were slightly younger and had a higher proportion of patients with a DED diagnosis compared to other agents. PHO tended to have more treatment-experienced patients in the 12 months prior to initiation, potentially highlighting a subgroup of the patient population who were waiting for a new treatment option for evaporative DED in addition to inflammation.