Eye drops for presbyopia: Hundreds of millions live with presbyopia, age-related difficulty focusing up close, typically managed with reading glasses or surgery. Now, ophthalmologists say a twice-daily eye drop regimen could offer another option.
At the European Society of Cataract and Refractive Surgeons (ESCRS) meeting in Copenhagen, researchers reported that a biphasic drop combining pilocarpine (to constrict the pupil and contract the focusing muscle) with diclofenac (an anti-inflammatory) improved near vision in most users, with benefits sustained for two years.
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In a study of 766 adults in Argentina who used the drops upon waking and again approximately six hours later, participants were assigned to versions containing 1%, 2%, or 3% pilocarpine, alongside a fixed dose of diclofenac.
Most people could read additional lines on near-vision charts after treatment, with improvements sustained for two years. In the 1% group (148 participants), nearly all achieved at least two extra Jaeger lines; in the 2% group (248 participants), 69% managed three or more extra lines; and in the 3% group (370 participants), 84% reached three or more extra lines.
“Our most significant result showed rapid and sustained improvements in near vision for all three concentrations,” said Dr Giovanna Benozzi, director of the Centre for Advanced Research for Presbyopia in Buenos Aires. “One hour after the first drops, patients improved by an average of 3.45 Jaeger lines.” She added that 99% of patients in the 1% group reached optimal near vision (=2 extra lines) and that focusing improved at all distances.
Investigators said the therapy could suit people who find glasses inconvenient or who are unwilling or unable to undergo surgery. Reported side effects were generally mild and included temporary dim vision, instillation irritation, and headache.
