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There were no language or time restrictions. Eligible trials were assessed for bias and assigned a risk\u2010of\u2010bias score. Data extraction was carried out using a standardised data extraction form, and meta\u2010analysis was performed using a random effects model for continuous data. The outcome measures were Ocular Surface Disease Index (OSDI) scores, tear breakup time (TBUT) measurements, corneal staining and Schirmer's score. Statistical heterogeneity was defined as substantial if the\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      test achieved a value &gt;60%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eight parallel RCTs including 1107 subjects met eligibility criteria. None of the included studies achieved low risk of bias. Data synthesis demonstrated an improvement in the mean change in OSDI score from baseline to final assessment. Omega\u20103 supplementation conferred no evident improvement in corneal staining, TBUT or Schirmer's score. There was considerable statistical heterogeneity in all four outcome measures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This updated systematic review and meta\u2010analysis indicates that omega\u20103 supplementation improves subjective symptoms in patients with dry eye disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aos.15255","type":"journal-article","created":{"date-parts":[[2022,9,23]],"date-time":"2022-09-23T02:19:17Z","timestamp":1663899557000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Omega\u20103 fatty acids in the management of dry eye disease\u2014An updated systematic review and\n                    <scp>meta\u2010analysis<\/scp>"],"prefix":"10.1111","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5172-0030","authenticated-orcid":false,"given":"\u00a0","family":"Ciara O'Byrne","sequence":"first","affiliation":[{"name":"Medical Retina Department Moorfields Eye Hospital  London UK"},{"name":"Royal College of Surgeons in Ireland (RCSI)  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"O'Keeffe","sequence":"additional","affiliation":[{"name":"Institute of Eye Surgery UPMC, Kildare Hospital  Kildare Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,9,22]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477\u20107525\u20109\u2010111"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.14744\/nci.2017.54036"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.04-1394"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1709691"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.17\u201023467"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/icl.0000000000000179"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0b013e318191b870"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003226\u2010200310000\u201000008"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtos.2017.05.011"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2019.01240"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1753\u20104887.1973.tb06008.x"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu11050942"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/opo.12365"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/02713683.2016.1233986"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/09286580600801044"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jconrel.2015.07.007"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtos.2017.05.008"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2019.01.026"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcjo.2019.05.012"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD010051.pub2"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2016.09.023"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.3945\/jn.111.142240"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD011016.pub2"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtos.2019.11.004"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/dtb.2016.1.0378"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0000000000000940"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/ico.0000000000001884"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol\u20102012\u2010302418"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399\u20105618.2010.00799.x"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1177\/2515841419870366"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d5928"},{"key":"e_1_2_6_33_1","volume-title":"Cochrane handbook for systematic reviews of interventions","author":"Higgins J. 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