Topical Insulin Used Alone Or In Combination With Therapeutic Hyper-Cl Soft Contact Lens For Refractory Cases Of Neurotrophic Keratopathy
Published 2024 - 42nd Congress of the ESCRS
Reference: PO840 | Type: Free paper | DOI: 10.82333/dz82-9v42
Authors: Alessandra Mancini* 1 , Maura Mancini 2 , Vincenzo Scorcia 1 , Pasquale Aragona 2 , Andrea Taloni 1 , Luca Bifezzi 1 , Maria Angela Romeo 1 , Lorenzo Rijillo 1 , Domenico Chisari 1 , Giuseppe Giannaccare 3
1Department of Ophthalmology,University Magna Graecia of Catanzaro,Catanzaro,Italy, 2Ophthalmology Clinic,University of Messina,Messina,Italy, 3Eye Clinic, Department of Surgical Sciences,University of Cagliari,Cagliari,Italy
Purpose
This study aims at reporting the successful clinical outcomes achieved in refractory cases of neurotrophic keratopathy (NK) through the utilization of insulin eye drops alone or in conjunction with the therapeutic Hyper-CLTM soft contact lens.
Setting
In this prospective open-label, uncontrolled case series conducted at three University Centers in Italy (“Magna Graecia” University of Catanzaro, University of Cagliari, University of Messina) consecutive patients with refractory NK were included.
Methods
This prospective open-label uncontrolled case series conducted in three University Centers included consecutive patients with NK refractory to conventional treatment. Insulin eye drops (1 unit per mL) were prescribed 4 times a day in all cases, and a new Therapeutic Hyper-CLTM soft contact lens (EyeYon Medical, Ness Ziona, Israel), designed to act as a drug reservoir, was applied when appropriate. Data about stage and duration of NK, corneal sensitivity, previous treatments, rate and speed of healing, changes of NK area over time (using imageJ software) were collected.
Results
Nine eyes of 8 patients affected by NK (stage II and stage III) refractory to conventional medical therapy were included. All patients received topical insulin, while Therapeutic Hyper-CLTM was also applied in 3 cases. At T0, the mean area of the corneal epithelial defect was 21.84 (±18.35) mm2 while corneal sensitivity was absent in 8 out 9 cases. Complete corneal re-epithelialization occurred in 9 out 9 cases (100%) after a mean time interval of 24.11 (±8.86) days. No statistically significant difference in the reduction rates of corneal ulcer areas was found between patients who use only insulin versus patients who wore also Hyper-CLTM (p=0.55). Neither adverse events nor episodes of NK recurrence during follow-up visits were reported.
Conclusions
Topical insulin, when used alone or in combination with the therapeutic Hyper-CL soft contact lens, represents as an easy to obtain, inexpensive and effective treatment for refractory NK.