Topical Insulin Therapy in Patients with Persistent Epithelial Defect Post-severe Corneal Ulceration

Abstract

Objective: To determine the effect and safety of topical insulin treatment in patients with persistent corneal epithelial defect.

Methods: An exploratory, pre-experimental before-after study was carried out with patients diagnosed with persistent epithelial defect after corneal ulcer treated at the Cornea Service of the Cuban Institute of Ophthalmology Ramón Pando Ferrer from September 2023 to May 2024.

Results: Patients older than 69 years of age (38.9 %), male sex (55.6 %) and left eye involvement (66.7 %) predominated. Epithelial defects of 3.1 to 5 mm and 7 mm accounted for 33.3 % with a mean of 5.2 ± 2.6 mm. 72.2 % developed corneal vascularization. The same percentage achieved total healing with a mean of 19.4 ± 10.1 days. Healing time in PED ≤ 3 mm was 14.8 ± 5.7 days and increased with increasing defect size. The mean healing time was 15.0 ± 0.0 days for patients with avascular corneas and 20.2 ± 10.9 days in vascularized corneas. Initial best corrected visual acuity was finger-count light perception in 72.2 % and decreased to 50.0 % at the conclusion of treatment. No patients reported adverse effects.

Conclusions: Insulin eye drops have a stimulatory effect on the healing of persistent post corneal ulcer epithelial defects without adverse effects.