Eye Drop Review Part 4: Redefining Relief with Novatears
DRY EYE DROPS
Welcome back!
In our previous reviews, we have explored the entire Systane Family of drops using Systane Ultra as a benchmark and compared it to Systane Hydration, Systane Gel, Systane Complete and Systane Balance. I also gave a quick summary of the anatomy of the tear films and the different layers. Now we will move on to another family of drops, Novatears (Miebo/EvoTears) and Novatears + Omega 3.
NovaTears/NovaTears + Omega 3 Product Information
Active Ingredients: Perfluorohexyloctane, NovaTears + Omega 3 also contains Omega 3 sourced from algae
Preservative: Preservative-free
Target Patients: Suitable for mild to moderate sufferers, especially those with evaporative dry eye and meibomian gland dysfunction.
Contact Lenses: Not suitable for contact lens use.
Equivalent in US is Miebo, and equivalent in Europe is EvoTears
How perfluorohexyloctane works: Most drops use hydrophilic (water-loving) compounds like HP-Guar or Hyaluronate previously mentioned, to help attract and retain water. However, NovaTears goes against the trend and is purely an oily solution that contains no water. It is designed to spread evenly across the eye surface and act to replenish the lipid layer. It has very strong spreading ability, meaning that even a small drop will spread evenly all over the eye, whereas other drops, like Systane Ultra, become less spreadable once it is on the eye as they become more viscous. And Unlike Systane Complete, which is an emulsion, therefore may not mix perfectly, NovaTears only contains one ingredient and therefore has no problems with mixing. And in the case of NovaTears + Omega 3, since Omega-3 is a fatty acid, it will also dissolve perfectly in perfluorohexyloctane.
One of NovaTears' most unique properties, which no other eyedrops can do, is that it helps dissolve other lipids. This means it can help to dissolve solidified meibum or oil in the meibomian glands. Meibomian gland dysfunction is the main cause of evaporative dry eyes. Meibomian glands are located on the lid margin, and they release an oil, called meibum, onto the surface of the eye. This oil forms the lipid layer in the tear film, which covers the watery layer underneath and prevents it from drying up too quickly. A 2017 research study found that after using NovaTears 4 times a day for 6 weeks greatly reduced the number of blocked glands and the quality and quantity of the oil released onto the eye were greatly improved, and therefore improved patients' dry eye symptoms.
Furthermore, when used with other drops that are poorly soluble drops, such as cyclosporine. NovaTears can help to increase corneal residence time and corneal penetration, making these drops work more effectively.
Our Verdict: NovaTears is our preferred treatment option for evaporative dry eyes compared to Systane Complete or Systane Balance. NovaTears + Omega 3 is even better than NovaTears; however, what makes me hesitate to recommend this is that its bottle works differently from a typical bottle. You have to squeeze the bottle first, then release, for the drop to come out. This may be harder for elderly patients.
For patients with both aqueous-deficient dry eyes and evaporative dry eyes, we can use a more hydrating drop like Systane Hydration to replenish the aqueous layer, and use Novatears to seal the surface and prevent it from drying up too quickly. For patients using more powerful drops like cyclosporine drops, NovaTears can enhance the effect of those drops by helping them penetrate into the eye.
A Note from the Author
Thank you for taking the time to read my review. As an optometrist based in Australia, I aim to provide practical and well-researched information.
It is important to note that clinical studies on eye drops are usually funded by the company that makes them. Therefore, I encourage you to consider the findings with a discerning eye. More importantly, what works for one person might not work for another, and what doesn't work for you might work for someone else. Such is the nature of dry eye treatments.
This website is currently a work in progress, and I plan to add more visuals, including pictures and videos, and links to where you can purchase these products in the future. Please keep in mind that product names and availability may vary in your country.
References
AFT Pharmaceuticals Australia. (n.d.). NovaTears®. Retrieved from https://www.aftpharm.com/au-en/products/novatears/
AFT Pharmaceuticals Australia. (n.d.). NovaTears®+ Omega-3. Retrieved from https://www.aftpharm.com/au-en/products/novatears-omega-3/
Agarwal, P., Scherer, D., Gunther, B., & Rupenthal, I. (2018). Semifluorinated alkane based systems for enhanced corneal penetration of poorly soluble drugs. International Journal of Pharmaceuticals, 538(1-2), 119-129. https://doi.org/10.1016/j.ijpharm.2018.01.011
Steven, P., Augustin, A. J., Geerling, G., Kaercher, T., Kretz, F., Kunert, K., Menzel-Severing, J., Schrage, N., Schrems, W., Krösser, S., Beckert, M., & Messmer, E. M. (2017). Semifluorinated alkane eye drops for treatment of dry eye disease due to meibomian gland disease. Journal of Ocular Pharmacology and Therapeutics, 33(9), 678-685. https://doi.org/10.1089/jop.2017.0042