Eyeworld

50 | EYEWORLD | SUMMER 2025 C ORNEA Contact Gupta: preeyakgupta@gmail.com Sheppard: docshep@hotmail.com Starr: drstarr@gmail.com Relevant disclosures Gupta: Alcon, Azura, Bausch + Lomb, Harrow, Sight Sciences, Tarsus Sheppard: AbbVie, Bausch + Lomb, Bio-Tissue, Claris Bio, Dompe, Noveome Starr: AbbVie, Alcon, Aldeyra, Azura, NuVissa pulsation, and eye drops that target evaporation (e.g., perfluorohexyloctane). Dr. Gupta said the product has finished Phase 3 trials. "What's super novel about this is it's being studied for the treatment of MGD," she said, noting that there is not currently a specific treatment option for MGD. The product is an ointment/gel that's applied to the eyelids only twice a week, and it works by breaking the disulfide bonds in keratin to allow it to be less viscous. Phase 2 data showed improvements in signs and symptoms of MGD. Dr. Sheppard called this option a "very intel- ligent reformulation of a cutaneous medication." He added that selenium sulfide has been used in dermatology for a long time. In this application, it would be applied to the lid margin to reduce keratinization and allow for better mechanics with the meibomian gland secretions. Other dry eye pipeline therapies Another novel therapy that Dr. Starr is looking forward to is the NuVissa plasma pen. "While not a medication, I am excited to start using the NuVissa plasma pen for in-office, non-surgical treatment of conjunctivochalasis, a very com- mon dry eye disease masquerader," he said. "The non-contact Corneal Esthesiometer Brill [Brill Engines] has recently been intro- duced in my practice and has been a game changer in the routine workup of my ocular surface and corneal disease patients," Dr. Starr said. "Technicians can quickly assess corneal sensation without disrupting the epithelium or ocular surface, allowing me to diagnose and treat neurotrophic keratitis and neuropathic cor- neal pain much earlier in the disease process." Other dry eye products in the pipeline in- clude Surface Ophthalmics' SURF-100 (targeting chronic dry eye disease), SURF-200 (targeting acute dry eye), and SURF-201 (targeting pain and inflammation following ocular surgery); RegeneRx's RGN-259, described as a Tβ4-based sterile and preservative-free eye drop, as a novel treatment for dry eye disease and neurotrophic keratitis (NK); and Tear Solutions' Lacripep, which is a synthetic polypeptide and was found to be effective in a 2-year trial looking at prima- ry Sjögren's. Stuart Therapeutics' ST-100 is a collagen mimetic peptide that repairs damaged helical collagen. Over time, inflammatory issues can damage integrity of collagen, and there have been indications of sign and symptom relief in the Phase 2 trial, Dr. Sheppard said. The company announced earlier this year that it had completed a Phase 3 trial. Glaukos also has a product in development, GLK-301, which Dr. Sheppard noted is a topical gel for the lids containing pilocarpine, a para- sympathomimetic secretagogue. Localizing this in a sustained delivery vehicle so you have a constant low dose makes sense, he said, and this approach of placing it on the eyelid and letting it percolate on the surface in a continu- ous first order kinetics fashion may be practical because many people do not like putting drops in the eye. Dr. Gupta said she's excited about all the options in the dry eye pipeline, noting that many are targeting different things, which is a step in the right direction. She said it's great to have newer versions of cyclosporine, and all treatments are welcome, but it's particularly exciting to have novel pathways because not everyone improves with just cyclosporine. Editors' note: The products and companies dis- cussed are a representation of some of the many in the dry eye space. This is not an exhaustive list of every dry eye product and company. continued from page 49 Regarding "Changing mindsets: current solutions and what's ahead," Jonathan Rubenstein, MD, EyeWorld Cataract Editorial Board member, said two recent changes he's made in his practice have been implanting the Light Adjustable Lens (LAL, RxSight) and taking steps to get involved in corneal endothelial cell injection therapies. CHANGING M I N D S E T S

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