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Abstract #128599 Published in IGR 25-3
Impact of topical insulin as a therapeutic intervention for corneal wounds: A comprehensive systematic review and meta-analysis
Amaral DC; Amaral DC; Amaral DC; Carvalho Soares Valentim C; Cheidde L; Ladeira Júnior PP; Weba ETP; Donato KO; Filho HNF; Guedes J; Guedes J; Guedes J; Louzada RN; Louzada RNEuropean Journal of Ophthalmology 2025; 0: 11206721251361649
BACKGROUND: Persistent epithelial defects (PEDs) are challenging corneal conditions with prolonged non-healing. Commonly associated with dry eye disease and neurotrophic keratopathy, PEDs can lead to severe complications. Topical insulin has emerged as a therapeutic option, promoting epithelial healing. METHODS: We searched Medline, Embase, Web of Science, and Cochrane Library databases following PRISMA guidelines for studies reporting topical insulin for PEDs of any etiology and corneal epithelial defect (CEDs) post-vitrectomy. Healing time, complete wound healing (CWH), epithelization failure (EF), and epithelial healing rate were our analysis outcomes. Statistical analyses employed random-effects models and I² statistic. RESULTS: Thirteen studies involving 390 eyes were included. Mean healing time for all conditions was 20.68 days (95% CI: 11.60, 29.76) with significant heterogeneity. The pooled CWH rate was 94% (95% CI: 0.87, 0.98), with an odds ratio of 5.41 favoring topical insulin over the control group. EF was low at 5% (95% CI: 0, 0.13), and the epithelial healing rate was 0.82 mm²/hour (95% CI: 0.02, 1.62). Subgroup analyses revealed variations. CONCLUSIONS: Topical insulin is effective in corneal wound healing, demonstrating high CWH rates and low failure rates. Further well-controlled studies are needed to validate these findings and assess long-term outcomes.
Faculty of Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
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