Study: Topical Insulin results in Refractory Neurotrophic Ke
The purpose of this study was to evaluate the clinical outcome of patients with refractory neurotrophic keratopathy (NK) in stages 2 and 3 treated with topical insulin.

Retrospective analysis was done of eyes with NK in stages 2 and 3 refractory to standard medical and/or surgical treatment which were treated with topical insulin (1 unit per mL). This treatment was applied 4 times per day and was continued until the persistent epithelial defect (PED) or ulcer resolved. The primary outcome of the study was the complete reepithelialization of the PED or persistent ulcer.

--21 eyes were included in this study, and 90% achieved complete reepithelialization of the PED and/or persistent ulcer within 7 to 45 days of follow-up.

--The mean number of days until complete reepithelialization was significantly lower in NK stage 2 (18 ± 9 days) when compared with NK stage 3 (29 ± 11 days).

--The best-corrected visual acuity improved significantly in both NK stage 2 and NK stage 3. No side effects were reported during the follow-up.

These findings show that topical insulin drops in NK resistant may serve as a beneficial treatment. Due to its low cost and excellent accessibility, this therapy can be quite useful.