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Topical insulin for refractory persistent corneal epithelial defects.

David Diaz-Valle¹, Barbara Burgos-Blasco¹, Jose A Gegundez-Fernandez¹

¹Opthalmology Department and Health Research Institute (IdISSC), Hospital Clinico San Carlos, Madrid, Spain.

European Journal of Ophthalmology

|September 21, 2020

Summary

Insulin eye drops effectively promote corneal healing in persistent epithelial defects (PEDs) that resist standard treatments. This study found that topical insulin accelerated reepithelization, offering a well-tolerated and cost-effective therapeutic option.

Keywords:

Corneal epithelium corneal ulcer insulin persistent epithelial defect

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Area of Science:

Ophthalmology
Corneal Disease
Wound Healing

Background:

Persistent epithelial defects (PEDs) are a challenging clinical issue, often refractory to conventional therapies.
Understanding novel treatment strategies for PEDs is crucial for improving patient outcomes.

Purpose of the Study:

To evaluate the efficacy of insulin eye drops in treating persistent epithelial defects (PEDs) refractory to standard care.
To analyze the impact of insulin eye drops on corneal epithelization.

Main Methods:

A prospective, non-randomized hospital-based study included 21 patients with refractory PEDs.
Patients received insulin eye drops four times daily, with outcomes measured by PED closure rate and healing time.

Main Results:

81% of patients (17 out of 21) achieved reepithelization of their PEDs.
For those with successful closure, mean healing time was 34.8 days; remaining patients showed significant area reduction (91.5%).
Common PED etiologies included infectious keratitis, calcium keratopathy, and post-surgical defects.

Conclusions:

Topical insulin demonstrates potential in promoting and accelerating corneal reepithelization for refractory PEDs.
Insulin eye drops offer advantages such as good tolerance, accessibility, and cost-effectiveness.