Omega‐3 fatty acids in the management of dry eye disease—An updated systematic review and meta‐analysis.

Purpose: The purpose of this study was to examine the effectiveness of omega‐3 fatty acids in comparison to a placebo in the management of dry eye disease. Methods: A systematic literature search was performed including randomised controlled trials (RCTs) comparing omega‐3 versus placebo in the management of dry eye disease in human subjects. There were no language or time restrictions. Eligible trials were assessed for bias and assigned a risk‐of‐bias score. Data extraction was carried out using a standardised data extraction form, and meta‐analysis was performed using a random effects model for continuous data. The outcome measures were Ocular Surface Disease Index (OSDI) scores, tear breakup time (TBUT) measurements, corneal staining and Schirmer's score. Statistical heterogeneity was defined as substantial if the I2 test achieved a value >60%. Results: Eight parallel RCTs including 1107 subjects met eligibility criteria. None of the included studies achieved low risk of bias. Data synthesis demonstrated an improvement in the mean change in OSDI score from baseline to final assessment. Omega‐3 supplementation conferred no evident improvement in corneal staining, TBUT or Schirmer's score. There was considerable statistical heterogeneity in all four outcome measures. Conclusions: This updated systematic review and meta‐analysis indicates that omega‐3 supplementation improves subjective symptoms in patients with dry eye disease. [ABSTRACT FROM AUTHOR]