Aceclidine-based miotic improves both near, distance vision
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Key takeaways:
- LNZ100 improved near vision by at least two lines in 91% of participants.
- LNZ100 also improved distance vision.
- More than 99% of participants achieved less than 2 mm pupil response.
INDIANAPOLIS — An aceclidine-based miotic may improve both near and distance vision in presbyopic patients as a result of its pupil selectivity, according to research presented at Academy 2024.
“What might be surprising to some is not only did we not lose distance vision, but we actually improved distance vision with that sub-2 mm pupil, which is in some cases contrary to other things you may have heard about,” S. Barry Eiden, OD, FAAO, medical director for professional relations at LENZ Therapeutics, said.
In the phase 3, randomized, double-masked, crossover, multicenter CLARITY study, Eiden and colleagues assessed the effectiveness of LNZ100 (aceclidine 1.75%; LENZ Therapeutics), a treatment in development for presbyopia.
Participants were aged 45 to 75 years (mean age, 55 years), with a refractive range of –4.00 D and +1.00 D and baseline near visual acuity of 20/50 or worse. The study population included post-LASIK patients.
The researchers measured pupil size before and 1 hour after administration of LNZ100, with the total number of measurements exceeding 14,800.
Within 30 minutes of treatment with LNZ100, 91% of participants achieved at least a two-line improvement in near vision, which continued for up to 3 hours, Eiden said.
In addition, 71% of participants had at least a three-line improvement, and more than half achieved five lines or greater improvement.
Further, 99.6% of participants achieved less than 2 mm pupil response, with only one participant failing to reach below 2 mm pupil size.
Distance vision also improved, with the peak falling between 1.5 mm and 1.75 mm.
“How could it be that this drop does so well not only at near, but also at distance?” Eiden said. “It’s based on its pupil selectivity. The fact that it doesn’t significantly stimulate the ciliary muscle means it’s not going to cause the myopic shift that everyone would be concerned about.”
Most adverse effects were mild, with less than 4% discontinuing treatment as a result of adverse events. While some participants reported experiencing a headache, 33% of those participants no longer experienced it after 2 days of use, and 70% of them no longer experienced a headache by day 28.
“You want to advise there might be a chance you would get a mild headache for the first couple of days, maybe even up to a week or two, but it’s going to go away,” Eiden said.
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Eiden SB, et al. Analysis of pupil size impact on near and distance vision improvement following administration of aceclidine, a pupil-selective miotic. Presented at: Academy 2024; Nov. 6-9, 2024; Indianapolis.
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