AAOpt 2026: Perfluorohexyloctane ophthalmic solution and contact lens wear

Shane Kannarr, OD, spoke with Optometry Times about a 30-day study of perfluorohexyloctane ophthalmic solution (PFHO) eye drops used while patients wore contact lenses. The main finding, as presented in the poster “Prospective Open-Label Trial Evaluating Concomitant Use of Perfluorohexyloctane Ophthalmic Solution With Contact Lens Wear” during the AAOpt 2026 meeting, is that the drops worked "remarkably well": patients were more comfortable and saw better, and there were no safety concerns.

The phase 4, multicenter, prospective, open-label trial’s primary end point was change from baseline at day 30 in the Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8). The maximum score was 37, with higher scores indicating greater contact lens–related symptoms.

Why researchers ran the study

About 45 million people in the US wear contact lenses, and 30–50% of them get dryness or discomfort. Lenses can disrupt the eye's tear film balance and rub against the eye. Often, the underlying cause is evaporative dry eye disease. PFHO is the only FDA-labeled treatment for that condition. But its label says not to use it with lenses in and to wait 30 minutes before putting lenses back in. That clash between the treatment and lens wear is the gap the study set out to test.

How they measured it

According to Kannarr, comfort was measured with CLDEQ questionnaires, a standard survey of contact lens dry eye symptoms. Safety was checked by staining the cornea and the conjunctiva to look for surface damage. Additionally, patients were checked at 7, 14, and 30 days.

What they found

All 3 key measures got better: general lens discomfort or dryness, discomfort at the end of the day, and blurry or changing vision late in the day. Improvements showed up by day 7 and kept growing through day 30 rather than leveling off. The speaker found this the most surprising result. Patients could wear their lenses longer overall, and longer while still comfortable. About 10% more patients could see 20/16 or better (the transcript says "2016") by day 30. Staining stayed the same or got somewhat better, so the drops appear safe to use with lenses.

Who PFHO is for

The best candidates are the 30–50% of wearers who get uncomfortable by the end of the day, especially when evaporative dry eye is likely part of the problem. The number of contact lens wearers in the US has stayed flat for decades because new wearers are balanced out by people who quit, and discomfort is the leading reason people quit. The study covered hydrogel and silicone hydrogel lenses, both lenses replaced on a schedule and daily disposables. That makes PFHO a broad tool that treats the underlying cause, instead of just switching lenses.

Tips for clinicians

Eye care providers usually see patients right after they've put in fresh lenses, which hides how the lenses feel later in the day. Kannarr recommends:

• Using CLDEQ questionnaires to find out how the lenses feel across the whole day.
• Treating evaporative dry eye early rather than waiting.
• Combining medication and lens choices to keep current wearers in lenses, which could turn a flat market into a growing one.