BLOG: The secret is out about Lacrifill
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Key takeaways:
- Lacrifill is a cross-linked variant of hyaluronic acid gel.
- It increases tear retention in patients with dry eye disease who have insufficient tear volume.
You know when you’ve got really good news about something super cool that’s gonna make a lot of your favorite people really happy, and you have to keep it a secret?
You almost burst every time you bump into one of those BFFs and can’t let them in on it.
That’s what it’s been like for me since last spring and the ASCRS meeting when I first heard about Lacrifill. My meeting with the CEO of the company that developed Lacrifill was little more than a “meet and greet” and a teaser; very little information about the device was actually shared. With the sale of Visant to Nordic Pharma, which plans to make and market Lacrifill, we can now talk about this gem.
Lacrifill is a cross-linked variant of hyaluronic acid gel. It has FDA 510(k) clearance and a specific billing code. This means that we can use it and bill for it the minute it hits the street. It is meant to be injected into the lower puncta in order to increase tear retention in those dry eye disease (DED) patients with insufficient tear volume, lasts up to 6 months and can be repeated with little to no risk. The original patent holder (first filing 2009) and developer is John P. Fezza, MD, an oculofacial plastic surgeon practicing at the Center for Sight in Sarasota, Florida. He published the sentinel Lacrifill article in Clinical Ophthalmology in 2018. Sixty-three patients with signs of DED had canalicular occlusion achieved with 0.2 mL injections of Lacrifill in the lower punctum of both eyes. At 3 months, all had statistically significant improvement in corneal staining as well as Schirmer (average increase 3.67 mm) and tear breakup time (average increase 87%).
Where will Lacrifill fit in our protocols? Well, the no-brainer is in preop prep for cataract and laser refractive surgeries. Inject Lacrifill and you get up to 6 months of increased tear retention, longer than almost every dissolving punctal plug and without the potential hassle of following “permanent” plug extrusion. As the gel dissolves, it is possible that the hyaluronic acid may even provide some lubrication itself. How about a combination of Lacrifill and Tyrvaya (varenicline solution nasal spray 0.03 mg, Viatris)? Increase the amount of natural tears with all the inherent benefits with Tyrvaya and then increase the ocular surface contact time with gel occlusion. You heard that here first!
Nordic Pharma is headed up by president Phil Gioia, former vice president of sales for Bausch + Lomb pharma back in the days of Brent v1.0, and chief commercial officer Jai Parekh, MD, who always seems to be lending his expertise to the hottest of the hot dots in eye care pharma and whose involvement makes me intensely curious about what other jewels these folks have on the way. I have been stoked about Lacrifill for months and can’t wait to get my hands on it.
Keeping secrets this good is hard!
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