There was a significant increase in TBUT [ 3.3 2 ( 1.5 ) ] and Nelson grade [ 0.7 2 ( 0.6 ) ] in the O3FA group ( P < 0.0001 ) as compared with 0.3 2 ( 0.6 ) and 0.1 2 ( 0.4 ) in the placebo group ( P = 0.164 and 0.094 , respectively ) .