Supplements I Recommend To My Patients Around the Time of Eye Surgery
For many with glaucoma it’s not possible to adequately control the condition with oral supplements and/or topical prescription medications. It may be necessary to consider surgical treatments in order to avoid additional loss of vision. I am often asked by my own patients whether there are any supplements that should be added or discontinued around the time of surgery.
What follows are some guidelines that I have found useful for my patients who are anticipating surgical treatment of glaucoma. Please note that these are guidelines I use when making personalized recommendations to my patients in whom I have a knowledge of both their glaucoma and general health conditions. These guidelines may not apply to you nor should they be considered medical advice. When adding any supplement or other medication prior to or early after surgery it is important to make your surgeon aware of this change as many supplements can interact with the healing process.
First – Supplements that Should be Discontinued Prior to Surgery
A number of supplements have anti-platelet/anticoagulant activity. Undesirable and potentially dangerous bleeding could occur if these supplements are being taken at the time of many eye surgeries. This is especially true for incisional glaucoma surgeries. “Incisional” just means that a cut is made with a blade.
Unless your surgeon specifically indicates otherwise, the following supplements should be discontinued prior to eye surgery:
- Black Currant
- Dan Shen (Salvia miltiorrhiza)
- Forskolin (Coleus)
- Ginkgo biloba
- Omega-3 Fatty Acids (combined DHA and EPA)
- May be OK if only DHA is taken
- Tumeric (Curcumin)
- Vitamin E[
- Wolfberry (Goji Berry)
Some eye surgeries (such as Laser Trabeculoplasty and “clear corneal” cataract surgery) do not damage blood vessels. With these surgeries it may be OK to continue using the supplements listed above if your surgeon agrees.
Supplements that May Prevent IOP “Spikes” After Surgery
Intraocular pressure (IOP) elevations (”spikes”) after eye surgery are common. Most people without glaucoma can tolerate moderate post-operative IOP elevations without fear of losing vision. This is not necessarily so in those with glaucoma. Optic nerves that have already been damaged are more likely to sustain additional damage by post-operative IOP elevations. Thus, it is important that IOP spikes be avoided or effectively blunted in those with glaucoma.
Melatonin has been shown to lower IOP, reduce anxiety, and enhance pain relief when taken prior to eye surgery. I recommend that my patients take 0.5-10mg of Melatonin with a sip of water the morning of planned cataract or glaucoma surgery.
Palmitoylethanolamide (PEA) has been demonstrated to prevent post-operative IOP elevation in those who have undergone YAG peripheral iridotomy. Although this supplement can be both expensive and difficult to find, for my patients who are at greatest risk of vision loss from post-operative IOP spike I will often recommend taking two capsules per day beginning two weeks prior to anticipated surgery.
Supplements that Work to Reduce Inflammation
All surgeries result in inflammation. This is the natural response of the body. With eye surgery, however, inflammation is seldom beneficial. It is for this reason that most eye surgeons will prescribe either steroid or non-steroidal anti-inflammatory drops to be used after surgery. The following supplements may also work to reduce inflammation after eye surgery. Take note, however, that as these may also have blood-thinning properties they should not be initiated until a few days to a week after surgery.
- Tumeric (Curcumin)
- Vitamin E
The decision to proceed with eye surgery is not one to be taken lightly. Even with a technically perfect surgery the final result will depend upon how the eye heals during the months after surgery. Thus, it is important to consider therapies that may decrease both IOP elevations as well as undesirable inflammation. It is equally important to discontinue supplements that might add risks due to such conditions as blood thinning. Given this, it’s important to let your surgeon know about your current and anticipated use of supplements.
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