Dry eye syndrome (DES) or keratoconjunctivitis sicca is an eye disease caused by the chronic lack of lubrication and moisture of the eye. The pathogenesis of DES involves the over-expression and over-activity of corneal Matrix Metalloproteinase 9 (MMP-9). We propose herein a new, non-symptomatic approach for the treatment of DES based on the inhibition of MMP-9 by a new highly soluble molecule, designed as PES_103 that has been shown to inhibit MMP-9 both in vitro and in vivo. The efficacy of PES_103 in vivo and the potential benefits of this treatment in restoring tear production were studied in this work using an animal model of reduced lacrimation. PES_103 did not show any significant corneal toxicity.Matrix metalloproteinases (MMPs) are a family of zinc containing hydrolases with a broad proteolytic specificity and large structural similarity [1]. These enzymes are involved in the degradation of several extracellular proteins including extracellular matrix components (ECM) and play a crucial role in tissue remodelling and in the regulation of different cellular activities [2]. An aberrant MMPs activity often promotes an excessive degradation of the ECM and could be responsible for the genesis of diseases such as inflammation, angiogenesis and cancer [3]. Recently, relevant ocular disorders such as proliferative diabetic retinopathy and dry eye syndrome (DES), or keratoconjunctivis sicca, have been associated with a significant increase in the concentration and activity of MMPs in the tear fluid [4-6]. In particular, DES has been associated with the over-expression and increased activity of corneal Matrix Metalloproteinase-9 (MMP-9 or Gelatinase B) [7], which has been shown to be both a marker and a promoter of eye dryness [8]. According to the work of Pflugfelder et al. [9], MMP-9 knockout mice do not develop DES, whereas the topical administration of active MMP-9 to such mice significantly increased corneal epithelial permeability.The 2007 Report of the Dry Eye WorkShop (DEWS) defined dry eye as an eye disease that results mostly in symptoms of discomfort, visual disturbance and tear film instability, with potential damage to the ocular surface that affects about 20% of the American population and 75% of the over-65-year population [10,11]. DES can be caused by a decrease in tear production or an increase in tear film evaporation, hence being represented by reduced lacrimation models. Persistent dryness, burning and a sandy-gritty eye irritation are the most common symptoms associated with DES and, in general, get worse as the day goes on [12]. Generally, both eyes are affected by DES and the physical damage occurs mainly at the corneal level. The aetiology of this syndrome is manifold, from the normal ageing process, to the effects of different drugs [13], to climatic factors together with daily routines and working-related features, such as standing in front of a computer screen, the use of air conditioning or of contact lenses [14,15]. DES is even a symptom of many systemic diseases. In particu...