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Effect of Manuka Honey on Eyelid Wound Healing: A Randomized Controlled Trial

Malhotra, Raman F.R.C. (Ophth.); Ziahosseini, Kimia F.R.C. (Ophth.); Poitelea, Cornelia F.R.C. (Ophth.); Litwin, Andre F.R.C. (Ophth.); Sagili, Suresh F.R.C. (Ophth.)

Ophthalmic Plastic and Reconstructive Surgery: July/August 2017 - Volume 33 - Issue 4 - p 268–272
doi: 10.1097/IOP.0000000000000743
Original Investigations

Purpose: To report outcomes of a randomized trial on the role of “active” Manuka honey on eyelid surgical wound healing.

Method: Prospective, randomized, single-blinded study was performed for patients undergoing bilateral upper blepharoplasty. Vaseline was applied 4 times a day to both sides for 6 weeks and in addition, one eyelid was randomized to receive Manuka honey twice daily. Postoperative wounds were graded by a masked observer at 1 week, 1 month, and 4 months using Manchester scar scale and a modified eyelid scar grading scale. Patients scored symptoms, expressed preferred side, and of any problems they experienced using honey. Standard photographs were graded by 2 independent assessors.

Results: Fifty-five patients were randomized. One week after surgery, 46 (29 women, 17 men, mean age 68 years, median 69, range 49–85) were available for analysis. There was a trend toward distortion of the surrounding skin being less (1.6 vs. 1.8, p = 0.07) and the scar being less palpable (1.8 vs. 2.0, p = 0.08) on the Manuka-treated side. Patients reported the scar on the Manuka side to have less stiffness (1.3 vs. 1.6, p = 0.058). At 1 month, all 3 grading scales showed no difference between the 2 sides. At 4 months, scar grading scales showed no differences; however, patients reported scar pain to be significantly less on the Manuka-treated side than control (0.48 vs. 1.9, p = 0.005). Thirty-one of 46 patients believed the scars were similar on both sides, 11 preferred the honey-treated side, and 4 preferred the control.

Conclusion: Upper eyelid scars treated with or without Manuka honey heal well, without significant difference when assessed by validated scar grading scales; however, honey may provide subjective benefits early, postoperatively.

Randomised study suggests Manuka honey may provide subjective benefits early, post-blepharoplasty.

Corneoplastic Unit, Queen Victoria Hospital, East Grinstead, United Kingdom

Accepted for publication May 12, 2016.

The authors have no financial or conflicts of interest to disclose.

Address correspondence and reprint requests to Raman Malhotra, F.R.C. (Ophth.), Corneoplastic Unit, Queen Victoria Hospital, East Grinstead, West Sussex RH19 3DZ, United Kingdom. E-mail:

© 2017 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.