Qlosi vs Pilocarpine: Pupil & Ciliary Muscle Effects in Presbyopia – 2026 Study

Qlosi vs Pilocarpine: Pupil & Ciliary Muscle Effects in Presbyopia – 2026 Study

January 31, 2026 discoverhiddenusacom Health

New research presented at Hawaiian Eye 2026 is shedding light on the effects of different miotic eyedrops used to treat presbyopia, the age-related loss of near vision. A study conducted by Florence Cabot, MD, of Bascom Palmer Eye Institute in Miami, compared Qlosi (pilocarpine hydrochloride ophthalmic solution 0.4%), pilocarpine 2%, and a balanced salt solution, focusing on their impact on pupil diameter, ciliary muscle thickness, and lens thickness.

Key Findings of the Study

The study, which involved 10 participants aged 45 to 64 with less than 4 D of myopia, utilized Optical Coherence Tomography (OCT) imaging to assess changes before and after treatment. Researchers analyzed approximately 45,000 OCT images. The results indicated that Qlosi effectively reduced pupil diameter without causing significant changes in ciliary muscle response. In contrast, pilocarpine 2% demonstrated a “statistically significant” change in ciliary muscle thickness.

Did You Know? The study enrolled participants with less than 4 D of myopia, a specific inclusion criterion designed to focus on the effects of the eyedrops in a defined population.

Impact on Ciliary Muscle and Pupil Diameter

Specifically, pilocarpine 2% resulted in a near vision ciliary muscle thickness change of –20.4 µm (P < 0.001), while Qlosi showed a near vision pupil diameter reduction of –0.52 mm (P < 0.001). Dr. Cabot noted that the ciliary muscle movement with Qlosi was comparable to that of the balanced salt solution control. She also highlighted a concentration-dependent effect of pilocarpine on pupil diameter, with the 2% formulation causing greater constriction than the 0.4% Qlosi.

Expert Insight: The observed difference in ciliary muscle response between the two pilocarpine formulations suggests that concentration plays a crucial role in how these medications affect the eye’s natural accommodation process.

Dr. Cabot emphasized that pilocarpine 2% was the only formulation tested that showed a statistically significant impact on both ciliary muscle thickness and residual lens accommodation. She stated that further research is necessary to fully understand the differing effects of pilocarpine concentrations on accommodation.

Frequently Asked Questions

What was the primary focus of this study?

The study compared the impact of Qlosi, pilocarpine 2%, and a balanced salt solution on pupil diameter, ciliary muscle thickness, and lens thickness in participants with presbyopia.

What was the key difference observed between Qlosi and pilocarpine 2%?

Qlosi reduced pupil diameter without significantly impacting ciliary muscles, while pilocarpine 2% yielded a statistically significant change in ciliary muscle thickness.

Where were the findings presented?

The findings were presented at Hawaiian Eye 2026, held in Waikoloa, Hawaii, from January 17-23, 2026.

As research continues, it will be important to see how these findings translate into long-term clinical outcomes and influence treatment decisions for individuals experiencing presbyopia.