Study results have long shown that miotics can help improve near vision by contracting the iris sphincter, thus reducing pupil size. Mild contraction of the ciliary muscle with some agents, including pilocarpine, may also increase accommodation. To evaluate the safety and efficacy of pilocarpine and oxymetazoline eye drop combinations for presbyopia treatment for 0-28 days, researchers compared various combinations of pilocarpine and oxymetazoline, ranging from 0% to 1.5% and 0% to 0.125%, respectively, with placebo drops. Among all the combinations tested, 1.0% pilocarpine/0.05% oxymetazoline and 1.5% pilocarpine/0.125% oxymetazoline achieved optimal mesopic uncorrected near visual acuity improvement from baseline, with 51.7% and 41.9% of patients receiving these combinations, respectively, achieving at least a three-line improvement at 1 hour on day 28. No clinically significant loss in corrected distance visual acuity was observed. The study authors note that oxymetazoline did not significantly contribute to the safety or efficacy of the studied combinations.
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