Treating socket discharge and discomfort: a crossover randomised trial of vitamin A ointment, low-dose steroid eyedrops and artificial tears

PURPOSE: This study evaluated the effects of artificial tears, vitamin A ointment and low-dose steroid drops on chronic irritation and discharge in anophthalmic patients wearing ocular prostheses. It also aimed to identify patient subgroups that may benefit from specific regimens. METHODS: This prospective, crossover randomised trial used a Williams design with 40 ocular prostheses wearing participants aged 16 years or older who experienced chronic discharge or discomfort.Each participant underwent four 2-week intervention periods: artificial tears, vitamin A ointment, low-dose steroids (fluorometholone) and no medication as a control, separated by 2-week washout periods. Visual analogue scale questionnaires assessed discharge and irritation frequency and severity. Data were analysed using linear mixed models with Bonferroni correction for multiple comparisons and subgroup analyses were descriptive. RESULTS: In the total group, vitamin A ointment most consistently improved all outcome parameters: irritation frequency (-1.766, 95% CI (-2.857 to -0.675), p