The MIEBO difference

HOW MIEBO WORKS

MIEBO inhibits evaporation by forming an anti-evaporative layer1,2

Droplet with logo mark 1

Mimics key functions of natural meibum2,3

Droplet with logo mark 2

Promotes healing on the ocular surface1,2

Droplet with logo mark 3

May reduce friction4-6

  • Droplet with logo mark 1

    Mimics key functions of natural meibum2,3

  • Droplet with logo mark 2

    Promotes healing on the ocular surface1,2

  • Droplet with logo mark 3

    May reduce friction4-6

HOW MIEBO WORKS

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UNIQUE FEATURES

MIEBO contains only ONE ingredient1

  • Vehicle free
  • Preservative free
  • Steroid free
  • Water free
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LONG LASTING

Resides in tears for at least 6 hours (PK rabbit study)3,7*

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Detection of MIEBO in Tears
Detection of MIEBO in Tears
MIEBO PK chart MIEBO PK chart

F6H8, perfluorohexyloctane; PK, pharmacokinetic.

*The ocular distribution of perfluorohexyloctane (PFHO) was assessed following ocular topical dosing of radiolabeled 14C-PFHO in 2 studies of 14 Dutch-Belted rabbits. Rabbits received either a single instillation or repeated topical ocular doses. After the last instillation, ocular tissues were collected at multiple time points through 24 hours and radioactivity in the individual collected tissues was measured by liquid scintillation counting. Levels of 14C-PFHO were observed in the tears through at least 6 hours in both studies. The clinical significance of this data has not been established.7

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QUICK AND EVEN SPREADING

Due to low surface tension1,8,9

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The above animations are illustrative of a single drop of MIEBO or saline applied from identical pipettes to a glass eye model.9

Formulations containing water may have a brief residence time of 3-5 minutes on the ocular surface and a high surface tension that hinders spreading.9,10

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SCIENCE OF MIEBO

The MIEBO molecule forms a monolayer at the air-liquid interface of the tear film1

Due to its unique structure, perfluorohexyloctane has dual affinity for air and lipids.1,2,6,8

Molecular composition of MIEBO vs tear film lipid layer Molecular composition of MIEBO vs tear film lipid layer
Science Behind MIEBO Flashcard image

Get the facts on how the active—and only—ingredient in MIEBO works1

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MIEBO is the ONLY Rx eye drop with preclinical data supporting evaporation inhibition2

In an in vitro study, MIEBO inhibited evaporation more effectively than natural human meibum2

Mean Evaporation Rates of Saline With Meibum Lipids and/or MIEBO*

Bar graph of mean evaporation rates of saline with meibum lipids and/or MIEBO*

There was no significant difference between the evaporation rate (Revap) of saline with only MIEBO layered on top compared with both meibum lipids and MIEBO layered on top (P>0.5).2

The clinical significance of this data has not been established.

Droplet with callout: MIEBO was 4x MORE EFFECTIVE at inhibiting evaporation vs meibum lipids[2]

Study design: The inhibitory effect of MIEBO vs meibum on the Revap of saline was evaluated in an in vitro model. Meibum lipids were collected from a single healthy volunteer. The Revap of saline was measured gravimetrically at 35 °C after layering either a single drop of MIEBO or the collected human meibum lipids to approximate the tear lipid layer in vivo over the top of 1 mL saline in a plastic container with a surface area approximating that of the human ocular surface. Evaporation rates are presented as standard error of the mean.2

*Percentage values are percent inhibition of the Revap of saline. Numbers in parentheses are the number of determinations. P values to test for significance were measured using the t test.2

The exact mechanism of action for MIEBO in DED is not known.1

In an in vitro study, MIEBO inhibited evaporation more effectively than artificial tears2

Mean Evaporation Rates of Saline With Artificial Tears or MIEBO*

Bar graph of mean evaporation rates of saline with artificial tears or MIEBO*
  • At 100 μL, MIEBO inhibited the evaporation rate of saline by 81% (P<0.0001)2
  • The addition of various artificial tear eye drops at 100 μL had no influence on the evaporation rate of saline (P≥0.13 vs saline alone)2

The clinical significance of this data has not been established.

Droplet with callout: MIEBO significantly INHIBITED THE EVAPORATION RATE of saline, unlike artificial tears[2]

Study design: The Revap of saline was measured following application of either MIEBO or different OTC artificial tears. The Revap was measured gravimetrically at 25 °C using an analytical balance after layering 100 μL of MIEBO or artificial tears on the surface of 1 mL of saline in a container with a surface area similar to that of the human ocular surface. Evaporation rates are presented as standard error of the mean.2

All brand names and trademarks used herein are the property of their respective owners; Systane Ultra (Alcon, Fort Worth, Texas), Systane Balance (Alcon, Fort Worth, Texas), Soothe XP (Bausch + Lomb, Bridgewater, New Jersey). No clinical efficacy is implied.

*Numbers in parentheses are the number of determinations. P values to test for significance vs saline alone were measured using the t test.2

MIEBO has a slow rate of evaporation11

Graph outlining evaporation rates of perfluorohexyloctane vs perfluorobutylpentane
Droplet with callout: <1.5% OF MIEBO EVAPORATED in 1 hour vs 93% with an SFA that has a shorter chain length[11]

Semifluorinated alkane (SFA) evaporation rate at physiological temperature in an in vitro gravimetric assay (n = 3; mean ± standard error of the mean).11

Study design: The evaporation rate of MIEBO and perfluorobutylpentane was assessed gravimetrically by placing 500 μL in a preweighed tissue culture dish, which was then incubated at 35 ± 3 °C to mimic body temperature. The percentage of MIEBO and perfluorobutylpentane that evaporated per unit time was obtained by weighing the sample immediately after each addition and 0.5, 1, 2, 4, and 24 hours after incubation. All samples were tested in triplicate.11 The clinical significance of this data has not been established.

MIEBO is the ONLY Rx eye drop for dry eye disease that directly targets tear evaporation1

In Vitro Evaporation Flashcard image

See MIEBO evaporation results from an in vitro study

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Efficacy

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*Required fields.

By submitting your information, you consent to receive communications containing information and educational resources about MIEBO, as well as other communications from Bausch + Lomb. By submitting your information, you confirm that you have read and agree with the terms of our Privacy Policy and Legal Notice.

INDICATION

MIEBO® (perfluorohexyloctane ophthalmic solution) is indicated for the treatment of the signs and symptoms of dry eye disease.

IMPORTANT SAFETY INFORMATION

  • MIEBO should not be administered while wearing contact lenses. Contact lenses should be removed before use and for at least 30 minutes after administration of MIEBO
  • Instruct patients to instill one drop of MIEBO into each eye four times daily
  • The safety and efficacy in pediatric patients below the age of 18 have not been established
  • The most common ocular adverse reaction was blurred vision (1% to 3% of patients reported blurred vision and conjunctival redness)

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Click here for full Prescribing Information for MIEBO.

References: 1. MIEBO. Prescribing Information. Bausch & Lomb, Inc. 2. Vittitow J, Kissling R, DeCory H, Borchman D. In vitro inhibition of evaporation with perfluorohexyloctane, an eye drop for dry eye disease. Curr Ther Res Clin Exp. 2023;98:100704. doi:10.1016/j.curtheres.2023.100704 3. Sheppard JD, Nichols KK. Dry eye disease associated with meibomian gland dysfunction: focus on tear film characteristics and the therapeutic landscape. Ophthalmol Ther. 2023;12(3):1397-1418. doi:10.1007/s40123-023-00669-1 4. Tauber J, Berdy GJ, Wirta DL, Krösser S, Vittitow JL; GOBI Study Group. NOV03 for dry eye disease associated with meibomian gland dysfunction: results of the randomized phase 3 GOBI study. Ophthalmology. 2023;130(5):516-524. doi:10.1016/j.ophtha.2022.12.021 5. Sheppard JD, Kurata F, Epitropoulos AT, Krösser S, Vittitow JL; MOJAVE Study Group. NOV03 for signs and symptoms of dry eye disease associated with meibomian gland dysfunction: the randomized phase 3 MOJAVE study. Am J Ophthalmol. 2023;252:265-274. doi:10.1016/j.ajo.2023.03.008 6. Schmidl D, Bata AM, Szegedi S, et al. Influence of perfluorohexyloctane eye drops on tear film thickness in patients with mild to moderate dry eye disease: a randomized controlled clinical trial. J Ocul Pharmacol Ther. 2020;36(3):154-161. doi:10.1089/jop.2019.0092 7. Krösser S, Spencer E, Grillenberger R, Struble C, Eickhoff K. Ocular and systemic distribution of 14C-perfluorohexyloctane following topical ocular administration to rabbits. Poster A0383 presented at: Association for Research in Vision and Ophthalmology Annual Meeting; April 29-May 3, 2018; Honolulu, HI. 8. Meinert H, Roy T. Semifluorinated alkanes – a new class of compounds with outstanding properties for use in ophthalmology. Eur J Ophthalmol. 2000;10(3):189-197. doi:10.5301/EJO.2008.1838 9. Agarwal P, Khun D, Krösser S, et al. Preclinical studies evaluating the effect of semifluorinated alkanes on ocular surface and tear fluid dynamics. Ocul Surf. 2019;17(2):241-249. doi:10.1016/j.jtos.2019.02.010 10. Ahmed S, Amin MM, Sayed S. Ocular drug delivery: a comprehensive review. AAPS PharmSciTech. 2023;24(2):66. doi:10.1208/s12249-023-02516-9 11. Agarwal P, Scherer D, Günther B, Rupenthal ID. Semifluorinated alkane based systems for enhanced corneal penetration of poorly soluble drugs. Int J Pharm. 2018;538(1-2):119-129. doi:10.1016/j.ijpharm.2018.01.019

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INDICATION AND IMPORTANT
SAFETY INFORMATION

INDICATION

MIEBO® (perfluorohexyloctane ophthalmic solution) is indicated for the treatment of the signs and symptoms of dry eye disease.

IMPORTANT SAFETY INFORMATION

  • MIEBO should not be administered while wearing contact lenses. Contact lenses should be removed before use and for at least 30 minutes after administration of MIEBO
  • Instruct patients to instill one drop of MIEBO into each eye four times daily
  • The safety and efficacy in pediatric patients below the age of 18 have not been established
  • The most common ocular adverse reaction was blurred vision (1% to 3% of patients reported blurred vision and conjunctival redness)

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Click here for full prescribing Information for MIEBO.