Varenicline Nasal Spray for the Treatment of Dry Eye Disease Following Corneal Collagen Crosslinking
Language
English
Publication Date
5-1-2025
Journal
Ophthalmology and Therapy
DOI
10.1007/s40123-025-01118-x
PMID
40088395
PMCID
PMC12006605
PubMedCentral® Posted Date
3-15-2025
PubMedCentral® Full Text Version
Post-print
Abstract
Introduction: To evaluate the safety and effectiveness of a varenicline solution nasal spray 0.03 mg (VNS) in reducing signs and symptoms of dry eye disease following corneal collagen cross-linking (CXL).
Methods: Subjects undergoing CXL were randomized to VNS (study) or vehicle (control) twice daily and initiated treatment with VNS 28 days prior to the procedure with continued use for 28 days following the procedure. After starting treatment, subjects were seen on the day of surgery and postoperatively at days 2, 3, 4, 7 and 28. The primary outcome measure was the change in the National Eye Institute Visual Function Questionnaire (NEI-VFQ)-25, a dry eye questionnaire, from baseline to day 28. The second primary outcome measure was the mean area change of corneal epithelial healing following the CXL procedure. The secondary outcome measures for this study were the eye dryness score (EDS), degree of fluorescein staining and supplemental artificial tear usage.
Results: Twelve subjects were enrolled in the study group and eight in the control group. At day 28, the NEI-VFQ-25 questionnaire demonstrated an improvement from baseline in the study group and a reduction in the control group, but the between-group comparison was not statistically significant (p > 0.05). There was a directional trend toward faster mean change of epithelial healing in the study group, but the difference was not statistically significant at any time point. There were four total adverse events, all of which were mild in nature and resolved without sequelae.
Conclusions: VNS is an attractive treatment option for patients following CXL. Patients hoping to avoid punctal occlusion or additional use of topical medications following a procedure such as CXL may be well suited for a neurostimulator treatment option like VNS that spares the ocular surface.
Keywords
Dry eye disease, Dry eye syndrome, Varenicline, Neurostimulation, Ocular inflammation, Ocular pain, Collagen cross-linking, Cornea wound healing, Keratoconus, Cornea ectasia
Published Open-Access
yes
Recommended Citation
Ferguson, Tanner J; Durgan, David; Whitt, Travis; et al., "Varenicline Nasal Spray for the Treatment of Dry Eye Disease Following Corneal Collagen Crosslinking" (2025). Faculty, Staff and Students Publications. 8804.
https://digitalcommons.library.tmc.edu/baylor_docs/8804
Comments
Trial registration: Registered with clinicaltrials.gov (NCT05136924).