Last week the FDA approved Cequa, a new prescription eye drop to treat dry eyes. There are already two other FDA approved drops to treat dry eye on the market, Restasis and Xiidra. Cequa becomes the third option. The active ingredient in Ceque is cyclosporine, which is the same active ingredient in Restasis. Dry eye has an inflammatory basis in many cases and cyclosporine inhibits production of T-cells, which are part of the inflammatory response. Xiidra, by contrast, blocks the binding of T-cells to the surface of the eye. Cequa differs from Restasis in that the concentration of cyclosporine is nearly double that found in Restasis and also Cequa has a  ‘nanomicellar’ formulation which the manufacturer claims improves the drug’s ability to penetrate the aqueous layer (water layer) of the tears on the eye. There have not yet been any head to head studies to compare how well Cequa works versus Restasis or Xiidra. Clincially, we have found that both Restasis and Xiidra can minimize the dry eye associated with LASIK and PRK and we hope that Cequa will do the same. Like Restasis and Xiidra, Cequa is an eye drop that is taken twice daily.