TOPICAL INSULIN TREATMENT FOR EPITHELIAL DEFECTS IN PATIENTS WITH SEVERE DRY EYE DISEASE AND NEUROTROPHIC KERATITIS

To evaluate topical insulin treatment in patients with epithelial defects because of severe dry eye disease and neurotrophic keratitis, who had not responded to conventional treatment.

The study was done at Hospital La Fe, Valencia, Spain.

We performed a prospective non-randomized hospital-based study. Patients undergoing topical treatment with insulin eye drops four times a day to treat persistent epithelial defects due to severe dry eye disease and neurotrophic keratitis. The healing rate of the epithelial defect was evaluated as well as the decrease in its size.

Twenty patients were treated with insulin eye drops four times a day. They had persistent epithelial defects refractory to multiple medical treatments, including artificial tears, bandage contact lens, autologous serum, 0.1% cyclosporine A and plasma rich in growth factors (PRGF-Endoret). 

Each patient was date for checking at a week, at 15 days and at a month, with complete corneal re-epithelialization within 7 to 30 days.

Insulin eye drops can be a good treatment for patients with persistent epithelial defects despite using conventional treatment. It promotes corneal re-epithelialization and healing. In addition to re-epithelialization and healing, this treatment is tolerated very acceptable manner, with few adverse effects; it is not as expensive as other treatments and its production is not very complicated, having good availability.