New Alternatives For Corneal Wound Healing & Treatment Of Corneal Surface

To describe the results and effects of a topical insulin for the treatment of patients with persistent epithelial defects refractory to traditional treatment in a serie of patients with cronic ocular surface deffects.

All patients were treated at Zaldivar Institute, Mendoza, Argentina. The drops were prepared in the institution´s pharmacy.

100 patients were evaluated in this retrospective study, the drops were prepared in the institution´s pharmacy under safety standards, using a flow hood. Regular insulin of 1 IU/mL, (100 IU/mL) was diluted in a poly- ethylene glycol and polypropylene glycol base. Patients were treated with insulin eye drops four times a day. Bacteriological examinations of the eye drops were performed at 7, 14 and 30 days to assess the persistence of sterility of the eye drops.

100 % of the patients treated presented a complete healing of the epithelial defect.The mean age of this study group was 62.2 years  (11 to 82 years old), 65% of the patients were female. The mean time of epithelization and reconstitution of the ocular surface was 10.8±7.9 days (range 4 - 45).  The persistent epithelial defects included different causes, 14% due to herpetic eye diseases, 56 % after ocular surgery, bullous keratopathy 10%, 14 % chronic keratitis,  5 % corneal dystrophy,  and 1% Stevens Johnson. The average time of use of the eye drops was 57 days (30 - 120). No adverse drug reactions were reported. No recurrences of persistent epithelial defect were observed.

Topical insulin accelerates corneal re epithelization and contributes to the reconstitution of the ocular surface. The insulin drop use is safe and reproducible.