title: A randomized, double-masked study to evaluate the effect of omega-3 fatty acids supplementation in meibomian gland dysfunction.
abstract: BACKGROUND
  Dysfunction of the meibomian gland (MG) is among the most frequent causes of ophthalmological symptoms. The inflammation seen in meibomian gland dysfunction (MGD) is part of its pathogenesis, and evidence of the antioxidant-inflammatory properties of omega-3 fatty acids suggests this to be an appropriate treatment for MGD.
  
  
  OBJECTIVE
  We aimed to assess the effectiveness of omega-3 fatty acids versus placebo, in improving the symptoms and signs of MGD.
  
  
  METHODS
  We conducted a randomized and double-mask trial of 3 months duration. We enrolled 61 patients who presented with symptomatic MGD and no tear instability (defined as tear breakup time [TBUT] <10 seconds). Participants were randomly assigned to two homogeneous subgroups. For patients in group A, the study treatment included cleaning the lid margins with neutral baby shampoo and use of artificial tears without preservatives, plus a placebo oral agent. For patients in group B, the study treatment included cleaning the lid margins with neutral baby shampoo and use of artificial tears without preservatives, plus oral supplementation with omega-3 fatty acids. We performed the following tests: (1) TBUT; (2) Schirmer I test; (3) Ocular Surface Disease Index© (OSDI©; Allergan, Inc., Irvine, CA, USA); (4) MG expression; (5) evaluation of lid margin inflammation; and (6) interpalpebral and corneal dye staining.
  
  
  RESULTS
  After 3 months of evaluation, the mean OSDI, TBUT, lid margin inflammation, and MG expression presented improvement from the baseline values, in group B (P < 0.01, P < 0.001, P < 0.0001, P < 0.0001, respectively). The Schirmer test results were also improved and statistically significant (P < 0.01).
  
  
  CONCLUSIONS
  Oral omega-3 fatty acids, 1.5 grams per day, may be beneficial in the treatment of MGD, mainly by improving tear stability.
authors.affiliation: Department of Ophthalmology, Jiménez Díaz Foundation, Madrid, Spain.
authors.forename: Andrea
authors.initials: A
authors.lastname: Oleñik
authors.forename: Ignacio
authors.initials: I
authors.lastname: Jiménez-Alfaro
authors.forename: Nicolás
authors.initials: N
authors.lastname: Alejandre-Alba
authors.forename: Ignacio
authors.initials: I
authors.lastname: Mahillo-Fernández
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019587:Dietary Supplements; D004311:Double-Blind Method; D005141:Eyelid Diseases / Q000188:drug therapy*; D015525:Fatty Acids, Omega-3 / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008537:Meibomian Glands / Q000187:drug effects*; D008875:Middle Aged; D013030:Spain; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015525:Fatty Acids, Omega-3
keywords: blepharitis; dry eye; eye discomfort; ocular inflammation; surface disease
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