AS WE ENTER THE HOLIDAY season and wrap up the year, it’s exciting to receive the news that we have a second FDA approval for presbyopia and another option for treating presbyopia with a drop!

Qlosi^TM (pronounced Close-E), from Orasis Pharmaceuticals, is a preservative-free drop that utilizes pilocarpine 0.4% as its active ingredient for the treatment of presbyopia. It will be interesting to see how this preservative-free, near neutral-pH, low-dose drop performs in the real world when it becomes available in the first half of 2024. As evidenced in Qlosi’s 2 phase 3 clinical trials, the effectiveness of Qlosi will be balanced by the low adverse event profile. It will be exciting to watch the launch of this new product and to see our options for our patients grow.

In addition to medical therapies, we look forward to other refractive options to help our patients’ vision, whether options to improve ocular surface disease or devices and surgical procedures to help reduce presbyopia. The more we discover regarding presbyopia treatments and how they fit into eye care and address our patients’ unmet refractive needs, the more next-generation options we will refine and uncover.

We continue to be amazed and honored by the experts in our field, as you will see in this issue. Continued research is ongoing in this exciting, albeit sometimes frustrating, field, as we continue to strive for improvement.

This issue begins with a discussion of some of the recently released Qlosi clinical trial data, and then takes a look at some successful uses of Vuity, as patient selection becomes more understood and critically important in the pharmacologic treatment of presbyopia. This month’s Presbyopia Practice Pearls looks at using artificial intelligence to attract patients, and the ongoing Presbyopia by the Numbers series takes a deep dive into the economics of spectacle correction for presbyopia patients. We have articles on the importance of maintaining a balanced tear film and overall ocular surface optimization prior to cataract surgery, as well as a great look at using vitrectomy as a refractive procedure. You can catch up on the EVO implantable collamer lens advancements as an alternative to refractive surgery and the extended depth of focus EVO Viva, which is already making waves and being used by our European colleagues. We round out the issue with an interesting discussion of diabetic implications in refractive error, of course focusing on presbyopic patients, and with part 3 in the series on biomechanics and kinematics in the aging eye. Finally, the issue wraps up with another Clinical Case Corner discussing the often-overlooked hyperopic surgical consultation! ■

Chief Co-Editors

Jennifer Loh, MD, and Jacob Lang, OD

Dr. Loh is a board-certified ophthalmologist practicing in Miami, FL, with a focus on cataract- refractive surgery and dry eye disease. She is founder and medical director of her practice, Loh Ophthalmology Associates, which she started in 2016. Dr. Loh also spends her time as a clinical and surgical attending physician for the Larkin Hospital Ophthalmology Residency program. She is a graduate of Indiana University School of Medicine, where she completed both medical school and an ophthalmology residency.

Dr. Lang is the lead optometrist at Associated Eye Care in Minnesota and is the director of the practice’s ocular disease residency program. He specializes in cornea and ocular surface diseases, as well as therapeutic contact lenses and surgical comanagement. He is also adjunct clinical faculty at the Illinois College of Optometry, The Ohio State University, and Salus University.