Effects of adjuvant omega-3 fatty acid supplementation on dry eye syndrome following cataract surgery: A randomized clinical trial

Abstract

PurposeTo investigate the effect of omega-3 polyunsaturated fatty acid supplement on qualitative and quantitative subjective (ocular surface disease index [OSDI]) and objective (Schirmer's test, tear break up time [TBUT], and tear osmolarity) dry eye indices after cataract surgery.MethodsIn this randomized clinical study, 61 eyes of 48 patients complaining of new onset dry eye symptoms after phacoemulsification were enrolled. Subjects were randomly allocated into two groups using urn randomization. Controls received conventional treatment. The treatment group received omega-3 dietary supplement in addition to conventional therapy.ResultsThere was no significant difference between the control and treatment groups in pre-treatment indices of Schirmer (3.50 ± 3.13 and 2.96 ± 3.39, respectively, P = 0.582), TBUT (6.67 ± 1.36 and 4.87 ± 2.22, respectively, P = 0.687), osmolarity (316.66 ± 8.50 and 315.4 ± 17.06, respectively, P = 0.906), and OSDI (32.99 ± 19.03 and 35.32 ± 18.99, respectively, P = 0.635).Mean pre-treatment OSDI in the control group was 32.99 ± 19.03, which improved significantly after treatment to 25.43 ± 14.49 (P = 0.003). The mean pre-treatment OSDI in the treatment group was 35.32 ± 18.99 (range: 7.5–77.77), which improved significantly after treatment to 16.31 ± 13.72 (range: 2.77–47.22) (P < 0.001). OSDI improvement was significantly higher in the treatment group than the control group (P = 0.026).TBUT improved in both the control and treatment groups after treatment (P < 0.001). However, TBUT was affected significantly more in the treatment group compared with the control group (P = 0.038).Mean tear film osmolarity in the control group was 316.67 ± 8.50 (range: 308–325), which improved insignificantly after treatment to 311.33 ± 6.35 (range: 304–315) (P = 0.157). Mean pre-treatment tear film osmolarity in the treatment group was 315.40 ± 17.06 (range: 279–340), which improved significantly after treatment to 296.90 ± 14.39 (range: 260–310) (P < 0.001). Also, post-treatment Schirmer results between the two groups were not statistically significant (P = 0.155).ConclusionOmega-3 dietary supplements have an additive effect on tear film indices of patients with dry eye syndrome after phacoemulsification.

Cataract surgery and dry eye disease: A review

“…There is evidence to suggest that omega-3 fatty acid supplementation may improve the signs and symptoms of DED, with a recent meta-analysis of randomized controlled trials by Giannaccare et al indicating that omega-3 supplementation may be effective in the management of DED. 133 In the context of DED post-cataract surgery, a RCT by Mohammadpour et al 134 indicated that compared to controls receiving conventional postoperative treatment, patients receiving omega-3 supplements (1000 mg 8 hourly for 1 month) after cataract surgery had better OSDI scores and higher TBUTs, suggesting that this may be a useful adjunctive therapy for those patients with newly diagnosed DED after cataract surgery as well as for those with pre-existing DED undergoing surgery.…”

The Protective Effect of Polyunsaturated Fatty Acids against Dry Eye Disease: A Literature Review

“…The intake of ω3 PUFAs also accelerated epithelial healing, improved TBUT, and facilitated visual recovery after photorefractive keratectomy [58]. Oral supplementation of ω3 PUFAs was associated with additional improvements in tear stability and osmolarity as well as symptoms associated with DED after phacoemulsification surgery [59]. Park et al [60] demonstrated that oral supplementation of EPA and DHA for 2 months might improve ocular surface symptoms and inflammation, rather than tear secretion, in DED after cataract surgery.…”

Evaluation of the Protective Effect of an Ophthalmic Viscosurgical Device on the Ocular Surface in Dry Eye Patients during Cataract Surgery

“…Based on these mechanisms, methods to reduce the extent of corneal incision, operation time, exposure to causal factors listed above, and manipulation of the cornea during surgery have been proposed [12]. Reports have indicated that common treatments of dry eye syndrome such as ocular surface anti-inflammatory treatment [13], artificial tears, and omega-3 fatty acid ingestion [14] improve symptoms to a certain extent [15], but a confirmed treatment method that prevents and improves patient discomfort is not yet known.…”