Use of Topical Insulin to Treat Refractory Neurotrophic Corneal Ulcers.

Gamm Lab // Michael Struck // Neal Barney // Publications // Sarah Nehls // Nov 01 2017

PubMed ID: 28742619

Author(s): Wang AL, Weinlander E, Metcalf BM, Barney NP, Gamm DM, Nehls SM, Struck MC. Use of topical insulin to treat refractory neurotrophic corneal ulcers. Cornea. 2017 Nov;36(11):1426-1428. doi: 10.1097/ICO.0000000000001297. PMID 28742619

Journal: Cornea, Volume 36, Issue 11, Nov 2017

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.