Corneal Therapies Come and Go

Hot Topic

The Ebb and Flow of Research in Corneal Disease

There are two announcements this week that may have slipped through the cracks!

First, EyeDura Therapeutics has announced a collaboration with the Singapore Eye Research Institute (SERI) to advance the development of its insulin-based topical therapy for neurotrophic keratitis (NK). The company is now conducting preclinical efficacy studies using SERI’s research infrastructure and specialized models to validate the safety and effectiveness of their sustained-release formulation. Because the therapeutic is designed to maintain efficacious drug levels with a single drop, lasting 7 days or more, it could substantially reduce the dosing burden compared with conventional frequent-drop regimens. If successful, this approach may help improve patient adherence, reduce treatment costs, and widen access to a more convenient option for NK management—currently a disease with limited and often laborious treatment options.

In contrast, Kala Bio has decided to terminate the development of its investigational eye drop, KPI-012, which was intended for the treatment of persistent corneal epithelial defect (PCED). The company’s phase 2b CHASE trial, a randomized, masked, vehicle-controlled study conducted over 56 days, failed to show a statistically significant benefit in corneal healing (measured by fluorescein staining) with either the 3 U/mL or 1 U/mL dose compared with vehicle in the 79 patients enrolled. Although safety was favorable and consistent with earlier trials, efficacy was insufficient to justify further investment. As a result, Kala is now exploring strategic alternatives, implementing cost-saving measures, and considering workforce reductions.

Well, research takes, and research gives. I was excited about Kala’s investigational PCED drug, as it offered an unbelievable amount of promise in my clinic. Corneal erosions and various PCEDs are commonplace in my dry eye center, and I’ve had my eye on this potential treatment for quite some time. I was also hoping it would breathe new life into Kala, as it was one of my favorite startups back when Eysuvis (now owned by Alcon) launched.

In contrast, EyeDura Therapeutics has announced that it will move forward with its insulin-based topical treatment for NK. This is exciting for any practitioner who sees dry eye patients—which means everyone. NK is an orphan disease that isn’t all that rare, once you start looking for it. Kudos to Dompé Pharmaceutical for their ongoing education and messaging about the importance of keeping this in mind when examining our patients’ corneas. The treatment of NK with insulin has been a topic of discussion in dry eye practitioner circles, with many trying their hand at it off-label. I’ll be following this one closely!

OUTSIDE THE LANE

Avoid Sugary Drinks!

A new study presented at the 2025 United European Gastroenterology Week conference in Berlin revealed that even moderate consumption of sugary and artificially sweetened drinks is linked to an increased risk of metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease. The research found that drinking just 9 ounces of sugary beverages daily raises the risk of MASLD by 50%. At the same time, the same amount of diet soda increases the risk by 60%. MASLD, characterized by fat accumulation in the liver, is the most common liver disease globally and can progress to severe conditions like cirrhosis, resembling damage from heavy alcohol use. The study highlights that both sugar-sweetened beverages and their diet alternatives, often perceived as healthier, pose significant risks to liver health. This adds to existing concerns about soda, as ingredients such as high-fructose corn syrup and carbon dioxide contribute to health issues, with fructose particularly noted for promoting liver fat accumulation.

Amid growing scrutiny of dietary habits, the current administration has pushed for changes, such as replacing artificial dyes with cane sugar in American sodas, as seen in Coca Cola’s recent reformulation. However, the study suggests even these changes may not mitigate the risks posed by both sugary and diet drinks. As the health implications become clearer, experts recommend opting for water to quench thirst and consuming soda, including diet varieties, in moderation to protect liver health.

My Two Cents

I’m obsessed with hydration, and most of you know the in-depth research I conducted on the topic when formulating the Dry Eye Drink. With proper sleep and hydration, I am absolutely convinced that many ailments would be alleviated and improved. Now, don’t get me wrong, I am a fan of an ice-cold Coca Cola and am guilty of having a few of them each week, even though I understand just how toxic they are to my body. If you’re someone who has a nasty habit of drinking a sugary soda or two a little too often, consider replacing it with something else! In addition to water and the Dry Eye Drink, I’ve also developed an affinity for flavored sparkling water, particularly Topo Chico Sabores Blueberry with Hibiscus. Check it out; it’s not bad when you crave that carbonation.

CAN YOU RELATE

How often do we hear the term life hack? Heck, we offer our patients life hacks every day—a contact lens that lets our presbyopes see distance, intermediate, and reading; lenses that you can hardly feel and then throw away each day; or even contact lens prices in our offices that are actually cheaper than those shady online retailers.

What about glasses that don’t have bifocal lines and aren’t those thick lenses? We offer our patients things that, to us, are normal and trivial but to them are life hacks and total lifestyle upgrades. Oh, and don’t forget about those two new presbyopia drops that, for some of your patients, could also be an incredible upgrade!

I bring this up because I recently purchased and installed something in my home that has completely transformed my life. It’s a calendar. Not just any calendar, though—it’s a Skylight digital calendar. This 27-inch monstrosity is mounted on my wall and syncs all my calendars onto one large screen that allows me to see exactly what’s happening this week and the rest of the month. It also has various other features. For example, last night I completely forgot that I had a dinner meeting planned with some business associates until I looked at that screen on the wall and quickly realized I had somewhere to be…10 minutes ago! This purchase has now turned into a habit of searching my calendar multiple times a day to remind me what’s going on. I know many of you would say, “Well, look at your phone, Josh; your calendars are there too!” True. However, given my personality, I often look at my phone to check my calendar but then see a new Facebook or Gmail notification, and then the doomscrolling starts with no calendar checking.