Topical Regular Insulin Eye Drops For The Treatment Of Refractory Corneal Ulcers

to evaluate the efficacy and safety of topical regular insulin eye drops in promoting corneal healing in refractory corneal ulcers.

This was a prospective observational study conducted over a one-year period in the Ophthalmology Department of the University Hospital of Annaba, Algeria.

A prospective observational study was conducted over a period of one year in the ophthalmology department. Patients presenting with refractory corneal ulcers unresponsive to conventional treatment were included. Topical regular insulin eye drops were administered, and patients were followed to evaluate epithelial healing time, improvement of corneal defects, and potential adverse effects.

All patients underwent ocular surface evaluation, a complete ophthalmologic examination, corneal OCT analysis, and a comprehensive laboratory workup.

The protocol involved instilling one drop of regular insulin (one unit) twice daily, with evaluation of BCVA, OSDI, and corneal healing at day 7, day 30, and day 90

Seventeen patients were included followed during 90 days. The mean age was 45 years (range 22–65), with a male-to-female ratio of 3:1. The underlying etiologies were diabetes (n=4), dry eye disease (n=5), previous anterior segment surgery (n=3), and post-herpetic keratitis (n=5).

Best-corrected visual acuity (BCVA) was <1/10 in 10 patients, 1/10–4/10 in 5 patients, and >4/10 in 2 patients. At the end of follow-up, BCVA improved by ≥2 lines in 13 patients, with satisfactory corneal healing in all cases. No notable adverse effects were observed.

Topical administration of regular insulin appears to improve best-corrected visual acuity and promote corneal healing in patients with refractory corneal ulcers, without notable side effects. These results suggest that topical insulin could be a safe and effective therapeutic option for difficult-to-treat corneal ulcers.