Supplements Shown to Improve Vision

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Supplementation Enhances Vision of Pre and Post Cataract Surgery Patients

By Mihir Parikh, MD

When vision is restored with successful cataract surgery and intraocular lens implantation, patients generally expect to have good vision for the rest of their lives. However, population studies do not necessarily support that assumption. A leading cause of permanent vision loss in the developed world is age-related macular degeneration (AMD), and the risk of AMD increases with advancing age. The elevated risk of AMD over time, coupled with longer life expectancy in the developed world, results in more years of life post cataract surgery. Thus, good vision throughout life may not be a foregone conclusion.

The Importance of Macular Function
AMD damages central vision because it affects the macular anatomy, and the loss of central vision can greatly affect a patient’s life. Physicians typically advise patients to control diabetes, blood pressure, and cholesterol to help maintain macular health. In addition, they often recommend smoking cessation, regular exercise, and eating a nutrient-dense, balanced diet. Yet, eyecare professionals should be providing a better explanation of the disease process and making more meaningful recommendations.

Recent Research
Published data suggests that the level of pigment found in the macula impacts the function of central vision and is associated with its ability to maintain a healthy state. The three pigments naturally found in the macula are lutein (L), zeaxanthin (Z), and meso-zeaxanthin (MZ). The function of these pigments is to filter short wavelength light and protect the macula from undergoing oxidative changes. Filtering short wavelength light (blue light) improves contrast sensitivity and visual function in low light and high light scatter conditions. Neutralizing oxidative changes to the deeper layers of the retina slows the inflammatory cascade, which is responsible for triggering the AMD process. Thus, it is advantageous to optimize the macular pigment density in the retina for all patients, but especially as part of ongoing treatment post cataract surgery.

The Central Retinal Enrichment Supplementation Trials (CREST) demonstrated in a double-blind, placebo-controlled, randomized trial that supplementing macular pigment in normal subjects with low macular pigment level increases contrast sensitivity.⁴ All three macular pigments were supplemented at a MZ:L:Z ratio of 10mg:10mg:2mg over a 12-month study period. Furthermore, a second trial in the CREST studies followed non-advanced AMD subjects given an AREDS2 formulation supplemented with meso-zeaxanthin also at the MZ:L:Z 10:10:2-mg ratio compared with subjects given the AREDS 2 formulation without MZ. In this double-blind, randomized, controlled trial over a 2-year period, supplementing with all three macular pigments (10:10:2-mg ratio) naturally found in the macula, the non-advanced AMD patients showed statistically significant improvement in contrast sensitivity, less glare, faster photo-stress recovery, and improved reading speeds.⁵ The findings of both studies demonstrate that replenishing all three macular pigments improved central vision in normal patients and those with early AMD.

Vision For Life
Recommending nutritional supplementation to maintain, optimize, and protect vision should be an important consideration for all cataract and refractive lens exchange patients. Vision for life starts before cataract surgery and continues for a lifetime.

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