Indications And Efficacy Of Topical Insulin In Ocular Surface Disease.
Published 2024 - 42nd Congress of the ESCRS
Reference: PO906 | Type: Free paper | DOI: 10.82333/ct3t-wy52
Authors: Ekaterina Teslenko Vylegzhanin 1 , Jose Gálvez-Olortegui* 2 , Ana Señaris González 1 , María Fernández García 1 , Marta Álvarez Coronado 1 , Begoña Baamonde Arbaiza 1
1Ophtalmology department,Hospital Universitario Central de Asturias,Oviedo,Spain, 2Ophtalmology department,Hospital Universitario Central de Asturias,Oviedo,Spain;Evidence Based Ophthalmology Unit (Oftalmoevidencia),Scientia Clinical and Epidemiological Research Institute,Trujillo,Peru
Purpose
Describe the indications of topical insulin in our center. Report results regarding visual acuity (VA) and symptomatology improvement. Indicate the drugs and the time of administration of these prior to the installation of insulin eye drops. Describe the surgical procedures performed before the eye drops.
Setting
The mechanism by which insulin may improve epithelization is not fully known. Insulin-like growth factors (IGF) play a central role in growth, differentiation and proliferation of corneal epithelial cells. The main indication for using topical insulin is the persistent epitelial defect, however, it is being used in other ocular surface diseases.
Methods
A retrospective review of 25 patients (27 eyes) with indication of insulin eye drops has been performed in our center. The main results were the indication of topical insulin, the time of use of eye drops, the final VA, the symptomatology, the drugs and the time of administration of these previously to the insulin eye drops, the surgical interventions carried out before the topical insulin.
Results
Topical insulin has been indicated in 25 patients. The mean age was 63.6 years. The most frequent indication was persistent epithelial defect (PED) (40%). Other indications were graft-versus-host disease (GVHD) (12%), severe dry eye disease (DED) (12%), superficial punctate keratitis (SPK) (12%), cicatricial keratoconjunctivitis (4%) and alteration of epithelization (4%). The mean time of treatment with insulin eye drops was 3.62 months. The average time with other treatments before this was 25.48 months. In 100% of the cases, previous treatments were performed before the installation of topical insulin, in 16% a surgical treatment was performed (amniotic membrane graft). The improvement in VA was observed in 24%.
Conclusions
Topical insulin is an effective and safe treatment for eye surface diseases. An improvement in VA and symptomatology is achieved even in the face of the failure of other known treatments, so it can be considered as a first-choice treatment. Although its main indication is PED, it is also being used in GVHD, SPK, DED, cicatricial keratoconjunctivitis and alterations of epithelization.