Re-esterified Omega-3 Supplement Improved Dry Eye After Cataract Surgery

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Researchers review 2-months of use to show the potential benefits of re-esterified triglyceride omega-3 fatty acid supplementation.

The re-esterified triglyceride form of omega-3 supplements significantly improved non-specific typical dry eye following cataract surgery without complications, according to a study published in the British Journal of Ophthalmology.

The prospective comparative cohort study included 66 patients who reported new-onset non-specific typical dry eye 1 month after cataract surgery. Patients were randomly assigned into a control or omega-3 group, receiving omega-3 fatty acid supplements for 2 months, as well as an artificial teardrop. 

The reason for using this particular type of omega-3 supplementation? “The re-esterified triglyceride (rTG) form of omega-3 is not only better tolerated with fewer gastrointestinal side effects, but it is also better absorbed than the [ethyl ester] EE form of omega-3,” investigators report.

Both before and after rTG omega-3 supplementation, ocular surface parameters (Schirmer’s test, tear break-up time, corneal staining score and matrix metalloproteinase-9 (MMP-9)) and subjective questionnaire results (Ocular Surface Disease Index (OSDI)) and Dry Eye Questionnaire [DEQ]) for dry eye were measured/administered.

Researchers found that 2 months after patients received rTG omega-3 supplementation, they had an improvement in the Oxford score, which was lower in the omega-3 group than the control. Also lower in the omega-3 group: the ratio of the increasing matrix metalloproteinase-9 test (MMP-9) level. Another improvement was in subjective symptom scores of OSDI and DEQ in the omega-3 group (p<0.05).

“The results from this study demonstrated that oral ingestion of re-esterified omega-3 supplement for 8 weeks significantly improved the signs and symptoms of non-specific typical dry eye after uncomplicated cataract surgery,” investigators report.

“The beneficial effects of rTG omega-3 might be related to decreased inflammation of the ocular surface rather than increased secretion of tears. Dietary supplementation of re-esterified omega-3 could be added to postoperative management after cataract surgery to improve postsurgical dry eye syndrome,” they write.

A potential study limitation is the lack of a placebo in the control group, which could have affected the observed response. “A subsequent, prospective, randomized, placebo-controlled study with a large population and a long follow-up period would give a better explanation of the effect of the rTG type of omega-3 on management of dry eye disease.”


Park J, Yoo Y, Shin E, et al. Effects of the re-esterified triglyceride (rTG) form of omega-3 supplements on dry eye following cataract surgery. Bri J Ophthalmol. Published online September 11, 2020. doi: 10.1136/bjophthalmol-2020-317164