Efficacy of Manuka honey eye drops in managing dry eye disease after cataract surgery: a prospective controlled study

Background To evaluate the efficacy of Leptospermum spp (Manuka) honey eye drops in improving dry eye symptoms and reducing ocular inflammation after cataract surgery, compared to sodium hyaluronate eye drops. Methods A prospective controlled study including 53 eyes undergoing cataract surgery was conducted. Patients were consecutively allocated to Manuka eye drops (n = 25) or sodium hyaluronate (n = 28). Subjective symptoms were assessed using the Ocular Surface Disease Index (OSDI) and CATQUEST-SF9 questionnaires. Objective parameters included non-invasive tear break-up time (NIBUT) and conjunctival redness measured with the Keratograph ® 5M. Assessments were performed preoperatively and at 1 day, 1 week, and 1 month. Results A total of 53 eyes from 53 patients (18 males and 35 females) were analyzed, with a mean age of 72.1 ± 7.6 years. At 1 month, the Manuka group showed a greater reduction in OSDI score compared to the control group (-27.3 ± 20.3 vs -4.3 ± 17.4). After adjustment for baseline OSDI and sex, OSDI remained significantly lower in the Manuka group (adjusted mean difference: -18.7; 95% CI: -28.8 to -8.7; p = 0.007). Conjunctival redness was also lower in the Manuka group at 1 month (adjusted mean difference: -0.56; 95% CI: -0.91 to -0.21; p = 0.014). No significant differences were observed in NIBUT between groups. Conclusion Manuka eye drops were associated with greater improvement in postoperative dry eye symptoms and reducing ocular surface inflammation compared to sodium hyaluronate. These findings should be interpreted with caution and considered hypothesis-generating.