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Table 2 Comparison of recent studies on fatty-acid supplementation for dry eye treatment

From: The role of lipids in corneal diseases and dystrophies: a systematic review

Study

Sample size

Dose

Study variables

Duration of study

Outcomes

Gatell-Tortajada [45]

1419 patients (74.3% women, mean age 58.9 years)

3 capsules/day of nutraceutical formulation (Brudysec® 1.5 g)

Dry eye symptoms, conjunctival hyperemia, tear breakup time (TBUT), Schrimer I test, Oxford grading scheme

12-week prospective study

Symptoms improved significantly, artificial tear use decreased Schirmer test score, TBUT increased significantly, increase in patients grading 0–I in Oxford scale and decrease of those grading IV–V

Epitropoulos et al. [46]

105 subjects (ω-3 [n = 54]) (control [n = 51])

Randomized to receive 4 softgels containing 1680 mg of EPA/560 mg of DHA or control of 3136 mg of linoleic acid

Measure tear osmolarity, (MMP-9), (TBUT), (OSDI), fluorescein corneal staining, schirmer score, meibomian gland dysfunction (MGD) stage and ω-3 index

12 week prospective study measured at baseline, week 6, and week 12

Statistically significant reduction in tear osmolarity in the ω-3 group vs. control, increase in ω-3 index levels and TBUT ω-3 group significant reduction in MMP-9 positivity versus control group, OSDI scores decreased significantly in ω versus control group

Malhotra et al. [49]

60 patients with moderate MGD were allocated alternately to treatment and control groups

Both received warm compresses, lid massage, and artificial tear substitutes. Treatment group also received oral supplements of 1.2 g ω-3 FAs per day

To assess improving contrast sensitivity (CS) of patients with moderate meibomian gland dysfunction (MGD)

12 week prospective study. All parameters were recorded at baseline and at 12 weeks

Ocular surface disease index, tear break-up time, ocular surface staining, and meibum quality and expressibility improved significantly more so treatment group

Deinema et al. [50]

54 participants were randomized into 3 groups and received 1 of 3 interventions

Placebo (olive oil 1500 mg/day), krill oil (945 mg/day [EPA], + 510 mg/day [DHA], or fish oil (1000 mg/day EPA + 500 mg/day DHA) for 90 days, with monthly study visits

To assess the efficacy of 2 forms of oral long-chain ω-3 essential fatty acid supplements, phospholipid (krill oil) and triacylglyceride (fish oil), for treating DED

3 month prospective study, parameters were measured at baseline and at 90 days

Tear osmolarity reduced in krill oil and fish oil supplements, OSDI score was significantly reduced in krill oil group only, Relative improvements in tear breakup time and ocular bulbar redness, compared with placebo, for both forms of ω-3 EFAs