Clinical Experience and Integration of New Dry Eye Disease Therapies in the Clinic

In this segment, the expert panel reflects on the rapid evolution of dry eye therapeutics and the impact of newer pharmacologic options on clinical practice. The faculty note that, early in their careers, cyclosporine 0.05% was the only available prescription therapy. In contrast, modern care now includes advanced formulations such as cyclosporine 0.1% and perfluorohexyloctane—innovations they consider transformative for both clinicians and patients.

The experts explain that perfluorohexyloctane belongs to a novel class of semifluorinated alkanes with unique physical properties, including the ability to act as a non-aqueous, preservative-free carrier for hydrophobic drugs like cyclosporine. They describe how its molecular structure enables enhanced penetration and prolonged residence time on the ocular surface.

The panel emphasizes that these related but distinct agents play different therapeutic roles: one primarily reduces evaporation and stabilizes the tear film, while the other delivers targeted immunomodulation. Treatment selection is individualized based on disease severity, inflammatory burden, osmolarity, meibomian gland status, and patient symptoms.

They also discuss practical considerations such as symptom questionnaires, osmolarity and MMP-9 testing, and the heavy influence of insurance requirements on prescribing patterns. Despite these challenges, the experts highlight that faster onset of action with contemporary cyclosporine formulations has significantly improved adherence and patient satisfaction.