*Correspondence, Davide Romano: email@example.com
Introduction Topical insulin eye drops have been shown to promote corneal epithelium healing in case of persistent epithelial defect (ED), especially in neurotrophic cases. The use of insulin eye drops in other infectious keratitis is limited in the literature. The aim was to evaluate whether insulin eye drops may be useful in case of ED in infective keratitis.
Methods 5 patients with culture proven infective keratitis and ED were recruited. The infections were: HSV-1 (n=1), Pseudomonas aeruginosa (n=2), Acanthamoeba (n=1) and Stenotrophomonas maltophilia (n=1). Each patient was commenced on daily topical insulin at a concentration of 1 units/ml (Humulin S in lubricant eye drops), 1 drop four times a day for 30 days. Evaluation of the ED was performed at slit-lamp, measuring the horizontal and vertical margins of the ED, at baseline, and week 1,2,3 and 4. Resolved ED was defined as no fluorescein staining present at follow-up.
Results Complete healing of the ED occurred only in the case of previous HSV-1 keratitis. The patient was noted to not be using any other topical treatments other than insulin eye drops. In the other 4 cases, the ED was still present at week 4, albeit reduced to 80% of the original size. We observed that in these 4 cases, the patients were still using topical steroids and/or topical antibiotics and/or topical polyhexanide.
Conclusion Insulin eye drops may be helpful in cases of post-infective keratitis ED and non-concomitant use of any other drops, which may interfere or cause epithelial toxicity.
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