Preoperative homeopathic agents or vitamins do not reduce postsurgical ecchymosis

This Ophthalmic Technology Assessment from the American Academy of Ophthalmology focuses on whether vitamins or homeopathic agents can help reduce or prevent ecchymosis following oculofacial surgery.

Study design

A systematic literature review of articles published between 1990 and 2020 was conducted, and the Academy’s Ophthalmic Technology Assessment Committee Oculoplastics and Orbit Panel evaluated the 11 identified studies for the efficacy and safety of homeopathic agents and vitamins in ecchymosis. A methodologist then rated the evidence level of these studies.

Outcomes

Of the 11 included studies, 9 found no or negligible benefit of homeopathic agents or vitamins vs. placebo. One study did show that patients taking oral Melilotus extract had less ecchymosis at postoperative day 7 than patients given placebo, but not at postoperative days 1 or 4. There were no serious side effects identified in any study group.

Limitations

Homeopathy is based on the concepts of treating “like with like” and using substances at a relatively dilute formulation, so that the “active ingredient” is often not detectable. In addition, the literature review focused only on Melitosis extract, Arnica montana, and vitamin K. Reviewing and assessing homeopathy studies might be thought to give these concepts more validity.

Clinical significance

This evidence-based guidance is helpful for clinicians in providing evidence to patients that the use of supplements perioperatively does not lead to reduced incidence of ecchymosis, and may simply cause them additional financial burden.