Perfluorohexyloctane ophthalmic solution for the treatment of dry eye disease: a narrative review

Introduction Dry eye disease (DED) is a common ocular disorder that adversely affects patients’ quality of life and daily functioning. Perfluorohexyloctane (PFHO) ophthalmic solution is the first prescription eye drop in the United States that directly targets tear film evaporation. This review synthesizes current evidence on the physiochemical properties, anti-evaporative action and clinical evidence for PFHO.Areas covered This review describes the chemical properties of PFHO and explores how these properties relate to the mechanism of action, efficacy, and tolerability of PFHO in DED. PFHO has been shown in clinical trials to be well tolerated and to provide rapid symptom relief, as well as sustained improvement in signs and symptoms of evaporative DED.Expert opinion PFHO ophthalmic solution is water-free, preservative-free, pH-free, thermally and chemically stable, and biologically inert; does not scatter or absorb visible light (thus, it has a low likelihood of causing visual disturbance on instillation); has high oxygen-carrying capacity; is slow to evaporate; and is a liquid that spreads well over an aqueous surface and barrier at the air – tear film interface that inhibits evaporation of the tear film. These properties contribute to the favorable tolerability, safety, and efficacy of PFHO in patients with DED.