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Use of Topical Insulin to Treat Refractory Neurotrophic Corneal Ulcers

Overview
Journal Cornea
Specialty Ophthalmology
Date 2017 Jul 26
PMID 28742619
Citations 24
Authors
Angeline L Wang
Eric Weinlander
Brandon M Metcalf
Neal P Barney
David M Gamm
Sarah M Nehls
Michael C Struck
Affiliations
Soon will be listed here.
Abstract

Purpose: To report the clinical course of 6 patients with refractory neurotrophic corneal ulcers that were treated with topical insulin drops.

Methods: Retrospective chart review of patients who had neurotrophic corneal ulcers or epithelial defects refractory to standard medical and surgical treatment. Insulin drops, prepared by mixing regular insulin in artificial tears with a polyethylene glycol and propylene glycol base at a concentration of 1 unit per milliliter, were prescribed 2 to 3 times daily.

Results: Six patients, aged 2 to 73 years, developed neurotrophic corneal ulcers refractory to a range of medical and surgical treatments, including bandage contact lens, amniotic membrane grafting, and permanent tarsorrhaphy. Each patient was administered topical insulin drops with complete corneal reepithelialization within 7 to 25 days.

Conclusions: Topical insulin may be a simple and effective treatment for refractory neurotrophic corneal ulcers. Further study is required to determine the clinical efficacy and side effect profile of insulin drops.

Citing Articles

Long-term Results of Topical Insulin Treatment for Persistent Corneal Epithelial Defects.

Almeida J, Costa T, Vivas M, Monteiro C, Vaz F, Silva D J Ophthalmic Vis Res. 2025; 19(4):397-404.

PMID: 39917454 PMC: 11795001. DOI: 10.18502/jovr.v19i4.13977.

Enhancing Corneal Sensitivity in Diabetic Patients Through an Innovative Ophthalmic Solution: In Vivo and Vitro Results.

Scarinci F, De Simone G, Ciancimino C, Caggiano C, Pocobelli G, Di Masi A J Clin Med. 2025; 14(1.

PMID: 39797325 PMC: 11721187. DOI: 10.3390/jcm14010245.

Assessment of insulin-degrading enzyme inhibitor for the treatment of corneal erosion in a rat model.

Issac L, Dolev D, Irit B, Assaf D, Levy I Graefes Arch Clin Exp Ophthalmol. 2024; .

PMID: 39714747 DOI: 10.1007/s00417-024-06717-1.

Topical Insulin for Neurotrophic-Related Epithelial Defects: Where do We Stand? A Systematic Review.

Wouters C, Saelens I, Delbeke H J Curr Ophthalmol. 2024; 36(1):9-22.

PMID: 39553318 PMC: 11567610. DOI: 10.4103/joco.joco_32_24.

Assessment of corneal nerve regeneration after axotomy in a compartmentalized microfluidic chip model with automated 3D high resolution live-imaging.

Bonneau N, Potey A, Blond F, Guerin C, Baudouin C, Peyrin J Front Cell Neurosci. 2024; 18:1417653.

PMID: 39076204 PMC: 11285198. DOI: 10.3389/fncel.2024.1417653.

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