Omega 3 fatty acids help heal the cornea

[littlemermaid]

Study by University of California, San Diego, Department of Ophthalmology, Shiley Eye Center http://clinicaltrials.gov/ct2/show/NCT01059019 Dry eye and persistent epithelial defects (PEDS) following LASIK and PRK are one of the most common conditions encountered by refractive surgeons and their patients today... when the epithelium fails to re-grow over a defect within the expected time course. The causes of PED are diverse, with several definite etiologies' including dry eyes, limbal stem cell deficiency... and neurotrophic problems... Reports of clinical efficacy of anti-inflammatory therapies for treatment of dry eye disease provide direct proof of the principle that inflammation is involved in the etiology of dry eye disease. Research has shown that the omega-3 polyunsaturated fatty acids are some of the most effective natural anti-inflammatory agents available. The active ingredients in omega 3, EPA (Eicosapentanoic acid) which is a 20 carbon omega 3-fatty acid with 5 double-bonds, and DHA (docosahexanoic acid) which is 22 carbon omega-3 fatty acid with 6 double bond, both found in certain fish oils enhance the conversion of COX (cyclooxygenase) to prostaglandin E3. A natural anti-inflammatory agent, prostaglandin E3 competitively inhibits the effects of the arachidonic acid conversion to prostaglandin E2, a highly inflammatory substance. Prostaglandin E3 also inhibits the synthesis of TNFα and IL-1β, both of which are inflammatory leukotrienes, also by competitive inhibition. By decreasing inflammation and stimulating aqueous tear production in rabbits cAMP has been shown to stimulate aqueous tear secretion in dry eye. Furthermore, by decreasing inflammation and augmenting oil and water layers of the tear film, omega-3 supplementation with fish oil rich in EPA may improve both the lipid and aqueous component of the tear film. This may improve surgical outcomes by stabilizing the tear film, reducing epithelial defects and promoting wound healing

Results reported: http://www.modernmedicine.com/modern...07&auid=276109 Omega-3 fatty acid supplementation results in substantially faster healing when used as an adjunctive therapy before and after PRK (photorefractive keratectomy). The cornea re-epithelialized faster, the vision recovered faster, and the tear break-up time improved in patients randomly assigned to omega-3 fatty acid supplementation (equivalent to 750mg of omega 3 fatty acids (both EPH and DHA), 1000mg of Flaxseed oil, and about 183 IU of vitamin E per day).

[Hopeful2]

Thank you for this review!

It sounds like, at 8 months post lasik, I may be struggling with PEDS. I am using fish oils and curcumin to help manage inflammation. . . sounds like I need to boost my consumption of vitamin E. I have heard somewhere that increased consumption of fish oil, results in an increased need for vitamin E.

Thanks again for this informative post

[littlemermaid]

'Dry eye and persistent epithelial defects (PEDS) following LASIK and PRK are one of the most common conditions encountered by refractive surgeons and their patients today. They are associated with significant clinical morbidity in patients...'

Important to collect evidence on understanding, behaviour and perception of the risks, and this is apparent to us in research like this. In case they don't enumerate risk for individuals pre-surgery, or identify/test for contraindicated pre-existing systemic conditions that they already recognise as risk. It looks like the industry think they're fixing preexisting dry eye in patients temporarily to enable the go-ahead for refractive surgery.

Here is relevant current thinking from Hawaiian Eye 2012 on the importance of controlling ocular surface disease before cataract surgery http://www.osnsupersite.com/view.aspx?rid=91616 'Ocular surface disease can skew keratometry measurements and lead to suboptimal outcomes. A systematic, patient-specific approach to assessment and treatment is essential to maximizing outcomes.' 'Six ocular surface conditions merit strict preoperative management: meibomian gland dysfunction, evaporative eye disease, aqueous tear deficiency, anterior basement membrane dystrophy, ocular allergy and pterygium/corneal scarring.'

Study would have been even more use with some confocal microscopy on the surface rather than a quick look and some photos, apologies if they did do this. Good that they working and publishing on the healing though.

The oils + vit E was Theratears. LM also likes Ascenta NutraSea fishoils + vit D3 (with a view to improving and regulating inflammatory pathways). See Wikipedia 'inflammation'.

Wishing you very good healing, Hopeful2. Your lovely positive karma is reaching us across the Atlantic