Eyeworld

JUNE 2022 | EYEWORLD | 77 R by Ellen Stodola Editorial Co-Director About the physicians Y. Ralph Chu, MD Chu Vision Institute Bloomington, Minnesota George Waring IV, MD Waring Vision Institute Mt. Pleasant, South Carolina D rops that temporarily relieve the symptoms of presbyopia are an ex- citing new technology, with the first product approved in this space late last year. Two physicians shared their early experience with Vuity (pilocarpine hydro- chloride ophthalmic solution, Allergan). George Waring IV, MD, started using Vuity in his practice earlier this year. Prior to that, he served as principal investigator for the GEMINI 1 and GEMINI 2 FDA clinical trials. Vuity, Dr. Waring said, is approved for those with age-related, blurry near vision. Presbyopia is a common progressive condition that affects most adults over age 40, and this is the first and only FDA-approved eye drop to treat it. As the aging lens changes, we now have more and more treatments for the various stag- es of lens dysfunction, he said, adding, "Vuity falls into treatment for the mild/earliest forms of presbyopia and lens dysfunction." The drop is currently approved for once- a-day dosing, and it has a rapid onset of about 15 minutes. Vuity improves near vision without reducing distance vision for up to 6 hours with a single dose. "We anticipate that some patients may elect to use the drop more often, but that has yet to be studied formally and is considered off label," he said. Y. Ralph Chu, MD, has been using the prod- uct since being involved in the Phase 3 clinical trial. "We had early experience through the clin- ical trial, then we were one of the first sites to get it in December once it became available," he said, adding that he has had a great experience with it in his practice. Vuity is indicated for mild to moderate pres- byopes (around J3 to J6). Those patients can be counseled appropriately and get excellent results, he said. Dr. Chu added that this a great bridging technology and way to expose patients to eyecare who may not have seen an eye doctor for some time. "This is a huge opportunity to engage these patients because as cataract sur- geons, we know that these people will eventual- ly be coming to our doors." Dr. Chu has found that a number of patients have come to him already seeking out Vuity because of what they've seen in the media. Pres- byopia is a surgical market, he said, and there has not been a good procedure for the mild to moderate presbyope in their 40s, and people have been looking for that. One important factor is setting patient expectations. Dr. Chu suggested that physicians start with the patients who are mild to moder- ate presbyopes, with J5 or better near vision. It makes sense, he added, because the clinical trial showed 3 lines of improvement for 6–10 hours. He noted that these patients may not be the ones calling in to initially inquire about the product. "The first ones to call in are usually the older patients who have been suffering the longest," he said. "They're in their 60s, and they have very poor Jaeger vision, and it's a differ- ent counseling process." It's not that the drop doesn't work for them, Dr. Chu added, but they may not get to that functional range without reading glasses. Pilocarpine formulation The Vuity drop uses pilocarpine that has been specifically formulated for the treatment of presbyopia. "Pilocarpine has been around for more than 100 years, so it's a well-known ophthalmic therapeutic," Dr. Waring said. The concentration was carefully studied, as was the proprietary vehicle with the pHast technology, which he said made a difference in the efficacy and tolerability. "Relative to historic formulations of pilocar- pine, the pHast technology allows the molecules Incorporating presbyopia drops into practice: Early experience with Vuity continued on page 78 Vuity improves near vision without reducing distance vision for up to 6 hours with a single dose. Source: Allergan

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