Changes in accommodation parameters associated with administration of pirenoxine in ophthalmic solution: a prospective clinical study

Background: age-related weakening of ocular accommodative function, known as presbyopia, causes persistent functional visual impairment and undermines quality of life. Despite continuous improvement in optical and surgical methods to manage this condition, scientific interest persists in pharmacological approaches intended to modulate biochemical and biomechanical characteristics of the lens. Pirenoxine is considered as a potential agent promoting stabilization of the lens protein structures. However, its impact on human accommodative capabilities is still underinvestigated. Aim: to analyze changes in accommodative reserve indicators in individuals aged 30 to 55 years during a 3-month course of instillations of 0.005% ophthalmic pirenoxine solution. Materials and Methods: within the framework of a prospective multicenter clinical study, 185 patients (370 eyes) aged 30–55 years (average age: 43.8±6.5 years) were examined. 0.005% pirenoxine solution was instilled to all the subjects by one drop three times daily for 90 days. As the main evaluation parameters, a position of the near visual point (NVP) and absolute accommodation value (accommodative reserve) were recorded at baseline and on Day 90. Results: after the follow-up period, a statistically significant but clinically insignificant shift of the NVP towards the eye was recorded (29.36 cm vs 30.15 cm at baseline). The accommodative reserve indicator did not demonstrate reliable changes, and it met instrumental error range. No significant changes in clinical refraction were identified. Conclusion: a 3-month pirenoxine instillation in patients aged 30–55 years with incipient cataract leads to a significant, but marginal clinical change in NVP and, what is more important, to stabilization of accommodative reserve. Thus, pirenoxine can be considered as both an anticataract drug and an agent to preserve accommodative function at early stages of age-related lens alterations (dysfunctional lens syndrome). Randomized, placebo-controlled studies should be conducted to confirm these effects and to identify long-term outcomes. KEYWORDS: presbyopia, treatment, pirenoxine, accommodation, refraction. FOR CITATION: Borisov F.G., Loskutov I.A., Abakarov S.A. Changes in accommodation parameters associated with administration of pirenoxine in ophthalmic solution: a prospective clinical study. Russian Journal of Clinical Ophthalmology. 2026;26(1):25–30 (in Russ.). DOI: 10.32364/2311-7729-2026-26-1-4