Manuka eye drops improve dry eye symptoms after cataract surgery compared to sodium hyaluronate

Photo by Ayanda Kunene / Unsplash

Frontiers in Medicine Published April 28, 2026 Medically reviewed April 28, 2026 DOI ↗ By Dr. Lars van Dijk, PhD · Surgical, Procedural & Diagnostic

Key Takeaway

Consider Manuka eye drops as a potential option for dry eye after cataract surgery, but interpret results cautiously as hypothesis-generating.

This prospective controlled study included 53 patients (18 males, 35 females) undergoing cataract surgery, with 53 eyes evaluated. The intervention group received Manuka eye drops (Leptospermum spp), while the comparator group received sodium hyaluronate eye drops. Follow-up occurred preoperatively and at 1 day, 1 week, and 1 month.

At 1 month, the Manuka group showed a greater reduction in OSDI score compared to the control group, with an adjusted mean difference of -18.7 (95% CI: -28.8 to -8.7; p = 0.007). Conjunctival redness was also lower in the Manuka group (adjusted mean difference: -0.56; 95% CI: -0.91 to -0.21; p = 0.014). However, non-invasive tear break-up time (NIBUT) showed no significant differences between groups.

Safety and tolerability data were not reported, including adverse events, serious adverse events, and discontinuations. The study's limitations include its small sample size and the authors note that findings should be interpreted with caution and considered hypothesis-generating.

For clinicians, these results suggest a potential benefit of Manuka eye drops for dry eye symptoms post-cataract surgery, but the evidence is preliminary. Further confirmatory studies are needed before considering clinical application.

Study Details

Study typeCohort

EvidenceLevel 3

PublishedApr 2026

View Original Abstract ↓

BackgroundTo 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.MethodsA 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.ResultsA 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.ConclusionManuka 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.