January 30, 2026
2 min watch
Key takeaways:
- Qlosi reduced pupil diameter without significantly impacting ciliary muscles or lens thickness.
- Pilocarpine 2% yielded a statistically significant change in ciliary muscle thickness.
WAIKOLOA, Hawaii — A study found that Qlosi demonstrated positive pupil diameter reductions without yielding significant changes in ciliary muscle response, according to a speaker at Hawaiian Eye 2026.
In a presentation, Florence Cabot, MD, of Bascom Palmer Eye Institute in Miami, shared data that compared the impact of Qlosi (pilocarpine hydrochloride ophthalmic solution 0.4%, Orasis Pharmaceuticals), pilocarpine 2% and balanced salt solution (BSS) on pupil diameter, ciliary muscle thickness and lens thickness. The study enrolled 10 participants with less than 4 D of myopia, ages 45 to 64 years, each of whom received OCT imaging before and after receiving each treatment. Patients underwent three treatment sessions, where they were treated with BSS, Qlosi and pilocarpine 2%, respectively.
Across 45,000 OCT images, pilocarpine 2% showed a “statistically significant” change in ciliary muscle thickness (near vision: –20.4 µm, P < .05; far vision: –15.1 µm) and lens thickness (near vision: 23.2 µm, P < .001; far vision: 14.4 µm, P < .01), “especially at near [vision],” Cabot told Healio. This corresponded with pupil diameter reductions of –1.11 mm at near vision and –1.04 mm at far vision (P < .001).
Qlosi yielded significant reductions in pupil diameter (near vision: –0.52 mm, P < .01; far vision: –0.53 mm, P < .01); however, there were no significant changes in ciliary muscle thickness (near vision: 2.4 µm; far vision: –2.3 µm) or lens thickness (near vision: 6.3 µm; far vision: 10.5 µm).
The ciliary muscle movement at near with Qlosi “was indistinguishable from the BSS control,” Cabot said in a press release from Orasis.
“In terms of pupil diameter, the pilocarpine shows a concentration-dependent effect on the pupil diameter, meaning the pilocarpine 2% has a greater effect on pupil diameter constriction than the pilocarpine 0.4%,” she told Healio.
In her presentation, Cabot emphasized that pilocarpine 2% was the only formulation tested that showed a statistically significant impact on ciliary muscle thickness and a residual lens accommodative effect.
“Further studies are needed, of course, but it looks like the pilocarpine concentration has a different effect on the accommodation and accommodative process,” she told Healio.
Sources/Disclosures
Source:
Cabot F. Miotic eyedrops for presbyopia: Emerging therapies. Presented at: Hawaiian Eye 2026; Jan. 17-23, 2026; Waikoloa, Hawaii.
Disclosures:
Cabot reports receiving grant support and grant funding from Orasis Pharmaceuticals.
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