Crystal Brimer, OD

Perfluorohexyloctane for Dry Eye Disease and Patient Satisfaction with Crystal Brimer, OD

2025 American Optometric Association Conference

 in Minneapolis, MN, Crystal Brimer, OD, Dry Eye Equation, presented her study analyzing patient satisfaction with perfluorohexyloctane (PFHO) prescriptions for 

PFHO is a physically and chemically inert synthetic compound approved in 2023 for the treatment of DED, targeting tear evaporation. Its low surface tension, high biocompatibility, and high lipid affinity all make PFHO highly suitable for ocular applications.

Brimer and colleagues identified patients ≥18 years newly initiating PFHO from September to November 2023. Using the IQVIA Longitudinal Prescription Claims database, investigators assessed baseline demographic, index prescription, and clinical characteristics, and compared these data against new initiators of common alternative cyclosporine ophthalmic emulsion .05% (CsA).

“A lot of the time, I think practitioners, we get in habits of doing something over and over,” Brimer told 

. “But the assumption there is that the refill rate correlates to the patient’s success and happiness.”

The team investigated 7209 patients initiating PFHO and 75,871 initiating CsA over 60 days following the index date. The PFHO cohort had a younger mean (Standard Deviation [SD]) age than CsA patients (60.6 [14.3] versus 66.6 [13.3] years), and most patients were female (79.9% in the PFHO cohort, 80.4% in the CsA cohort).

A higher proportion of PFHO patients received their index prescription from an optometrist, received a prescription for ≤30 days, and received it by mail than CsA patients. Baseline DED medication use was also much higher among PFHO (46.6%) than CsA (8.1%) patients, which investigators suggest may indicate potential dissatisfaction with prior therapy.

Notably, <40% of all patients who initiated PFHO or CsA had a DED diagnosis.

“The other thing that was really noticeable was the percentage that had actually been diagnosed with dry eye: in both groups, it was less than 40%,” Brimer told 

. “So, I think that comes back to us, and whether we’re having those discussions with the patients to really let them know that this is a real disease.”

Several clinical characteristics were also indicated during the study as potential comorbidities, such as cataracts (15.3% versus 17.8%), open-angle glaucoma or ocular hypertension (10.1% versus 10.5%), and blepharitis (5.8% versus 3.2%). Brimer also expressed interest in the 12-14% of patients with underlying anxiety and the roughly 10% with depression.

“One thing I wish had been in there was sleep disorders, because you would have seen that be elevated as well,” Brimer said.

Ultimately, investigators concluded that, among patients with a ≤30 day supply of their index prescription, PFHO patients exhibited a higher 60-day refill rate than patients taking CsA. This may indicate a higher patient satisfaction with PFHO than CsA.

Brimer also encouraged clinicians to start being proactive with diagnosis and care, emphasizing that proactive care often results in better outcomes for patients than reactive.

“Make the diagnosis and make the patient aware that this is not just going to go away,” Brimer said. “I am a huge advocate of proactive care instead of reactive care, and I think part of what the poster showed is that we’re not as heavily weighted towards the proactive as we could and should be for the best outcomes for our patients.”

Brimer C, et al. Early Adoption and Utilization of Perfluorohexyloctane for Dry Eye Disease. Abstract presented at the 2025 American Optometric Association Conference in Minneapolis, MN, June 25-28, 2025.

Ballesteros-Sánchez A, De-Hita-Cantalejo C, Sánchez-González MC, et al. Perfluorohexyloctane in dry eye disease: A systematic review of its efficacy and safety as a novel therapeutic agent. Ocul Surf. 2023;30:254-262. doi:10.1016/j.jtos.2023.10.001

Videos

Brimer sat down with HCPLive to discuss her presentation of a study analyzing the refill rates of PFHO and common alternative cyclosporine ophthalmic emulsion .05%.

Experts discuss treating dry eye with procedural therapies, focusing on common in-office and at-home treatments.

Exploring Procedural Treatments for Dry Eye

Exploring Procedural Treatments For Dry Eye

Watch the video version of this episode here. 

Crystal Brimer, OD

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