A once-daily, preservative-free combination of brimonidine and carbachol significantly improves near vision in people with presbyopia without compromising distance vision, with sustained effectiveness and good tolerability over 12 months, according to a presentation at the 2025 ASCRS Annual Meeting.
The randomized, masked, multi-center study enrolled 629 participants aged 45 to 80 with emmetropic presbyopia. During the first 6 months, participants received either the active treatment or a placebo. In the second half of the study, those originally on placebo crossed over to the active drop, while the others continued treatment.
Significantly more patients using the active drop achieved ≥3-line improvement in uncorrected near vision without losing distance vision, compared to placebo (P < 0.001). Benefits, including smaller pupil size and better reading speed, lasted up to 8 hours post-dose and were sustained over 12 months with no signs of reduced efficacy over time. Reports of eye redness were lower with the active drop, and the most common side effects were mild, including eye irritation and headache.
Participants also reported improved vision-related quality of life and expressed strong interest in regular use. No serious treatment-related adverse events occurred.
Reference
El-Harazi S, et al. Vehicle-Controlled Phase 3 Safety and Efficacy Evaluation of Preservative-Free Carbachol 2.75%/Brimonidine Tartrate 0.1% in Presbyopia. Presented at: American Society of Cataract and Refractive Surgery Annual Meeting; April 25–28, 2025; Los Angeles, CA.
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