Using eye drops to manage presbyopia

Dr Maria Romero, chief medical officer of Precision Eye Care in Baltimore, delivered a presentation exploring the use of aceclidine 1.44% eye drops for presbyopia at the European Society of Cataract and Refractive Surgeons Congress (ESCRS) (11-15 September, Excel London).

Romero reported on the outcomes of a study involving 61 patients with presbyopia who used aceclidine 1.44 % eye drops for presbyopia. The mean age of the patients in the study cohort was 54.

The study found that the eye drops took around 25 minutes to take effect, with the effect lasting for seven hours on average.

Speaking with OT at ESCRS, Romero shared that vision improved in 87% of study participants.

“Most patients experienced a fast and lasting effect,” she said.

Within the study group, fewer than one in three (28%) of patients requested a refill of the eye drops.

Side effects experienced within the study cohort included red eyes, brow aches and headaches.

“On a positive note, there were no severe adverse effects,” Romero shared.

She added that the overall patient satisfaction rating was an average score of 8.4 out of 10.

Romero observed that people with lighter irises within the study gave the eye drops a lower rating.

“Not because the eye drops were less effective, but because the pupil became small and the iris was noticeably red,” she said.

“We had one patient who said, ‘People thought I was wearing lenses for Halloween’,” she said.

Describing how the eye drop works, Romero explained that aceclidine 1.44% is a muscarinic agonist that causes the pupil size to decrease.

“It doesn’t restore accommodation – there is no increase in the optical power of the eye,” she highlighted.

“Decreasing pupil size decreases the optical aperture, decreasing the circle of blur and increasing the depth of focus,” Romero added.

Asked what the advantages of using eye drops for presbyopia area, Romero noted that some patients prefer to be glasses-free without undergoing surgery.

“There are activities that are difficult to perform with glasses, like going to the gym, swimming or going to the beach,” she said.