Topical insulin drops: Successful treatment for refractory persistent corneal epithelial defects

Article

The use of topical insulin eye drops led to a successful resolution of PEDs in 9 of 11 cases in the study.

Asian senior woman putting eye drop, closeup view of elderly person using bottle of eyedrops in her eyes, sick old woman suffering from irritated eye, optical symptoms, health concept (Adobe Stock / Satjawat)

The authors reported that 9 of the 11 eyes (82%) fully re-epithelized in a mean time of 62.3 ± 34.6 days (range, 14–112). Of the remaining 2 patients, the PED decreased in size from 12.25 mm2 to 4.5 mm2 and 1 did not respond. Among the patients who achieved full re-epithelization, the defects did not recur. (Adobe Stock / Satjawat)

A research team in the United Kingdom reported that topical insulin eye drops resolved refractory persistent epithelial defects (PEDs) in 9 of 11 cases in which they were tested.1 Shafi Balal, MD, was the first study author from Moorfields Eye Hospital and the UCL Institute of Ophthalmology, both in London.

The authors evaluated this treatment approach in a prospective, single-center case series from March 2020 to September 2021. The investigators explained that all patients were prescribed insulin eye drops for refractory PEDs that failed to achieve resolution of their PEDs despite receiving maximal standard medical treatment, including serum eye drops. The insulin eye drops were instilled 4 times/day. The patients were evaluated at 2-week intervals by full slit-lamp examination and serial anterior segment photography. The primary end point was resolution of the epithelial defects.

The study included 11 eyes of 10 patients (mean age, 45.4 years) that were treated with insulin eye drops. The mean follow-up was 195.7 ± 114.3 days after re-epithelization. The most common cause of the PEDs was chemical injury (n = 5, 60%). The mean size of the PED at baseline was 41.3 ± 55.2 mm2.

The authors reported that 9 of the 11 eyes (82%) fully re-epithelized in a mean time of 62.3 ± 34.6 days (range, 14–112). Of the remaining 2 patients, the PED decreased in size from 12.25 mm2 to 4.5 mm2 and 1 did not respond. Among the patients who achieved full re-epithelization, the defects did not recur.

“This study showed that the use of topical insulin eye drops led to a successful resolution of PEDs in 9 of 11 cases. We demonstrate the use of insulin for closure of PEDs in chemical eye injuries. Larger controlled studies are required to further evaluate this novel therapy,” the authors commented.

Reference

1. Balal S, Din N, Ashton C, Ahmad S. Healing of chemical injury–related persistent corneal epithelial defects with topical insulin. Cornea. 2023;42:1000-1004; doi:10.1097/ICO.0000000000003145

Recent Videos
In 2 weeks, the study participant's dry eye symptoms improved from 76 to 43 on a 0-100 rating scale, according to Marc-Matthias Schulze, PhD, Dipl Ing.
Eye care practitioners reported moderate to high satisfaction with lifitegrast's ability to improve signs of dry eye, according to Melissa Barnett, OD, FAAO, FSLS.
Neda Gioia, OD, CNS, FOWNS, details the positive feedback gained so far from other optometrists that have been prescribing the NutriTears supplement to their dry eye patients.
Damaris Raymondi, OD, FAAO, highlighted the importance of building patient-doctor trust to learn about these practices, which can include non-traditional treatments like chamomile or manuka honey eye drops.
Noreen Shaikh, OD, Magdalena Stec, OD, FAAO, and Brenda Bohnsack, MD, PhD, emphasize that collaboration and communication are key to proper diagnosis and treatment.
Cecilia Koetting, OD, FAAO, DipABO, cited data from a recent student that found that presbyopia treatment with 0.4% pilocarpine led to up to 86% of patients achieving 20/40 or better.
Kerry Giedd, OD, MS, FAAO, was 1 of 20 investigators around the country for a study evaluating the daily disposable contact lens.
According to A. Paul Chous, MA, OD, FAAO, optometrists have an important opportunity to educate patients in their chairs about diabetes.
David Geffen, OD, FAAO, gave a poster presentation titled "Revolutionizing Comfort: Unveiling the Potential of Perfluorohexyloctane Eyedrops for Contact Lens Wearers" at this year's Academy meeting.
Jessica Steen, OD, FAAO, Dipl-ABO, discussed ophthalmic considerations for patients undergoing treatment with antibody drug conjugates for gynecologic cancers at this year's conference.
© 2024 MJH Life Sciences

All rights reserved.