Published online Jun 15, 2023. doi: 10.4239/wjd.v14.i6.930
Peer-review started: December 27, 2022
First decision: February 8, 2023
Revised: March 14, 2023
Accepted: April 24, 2023
Article in press: April 24, 2023
Published online: June 15, 2023
Diabetic keratopathy (DK) is one of the complications of diabetes mellitus. In diabetic patients, any corneal epithelial defect or ulcer takes longer to heal and persists longer. Treatment with topical insulin (TI) is effective in treating DK.
Insulin is an effective factor in wound healing. The ability of systemic insulin to rapidly heal burn wounds has been reported for nearly a century, but only a few studies have been performed on the effects of TI on the eye.
The aim of the study is to review clinical and experimental animal studies providing evidence for the efficacy of TI to heal corneal wounds.
To evaluate the efficacy of TI application on corneal wound healing, the published literature was reviewed systematically for publication. The available data was then thoroughly reviewed.
Eight articles in total, comprising four animal studies and four clinical studies, were identified and discussed. According to the studies conducted, TI is effective for corneal re-epithelialization in patients with diabetes based on corneal wound size and healing rate.
Treatment with TI is effective in treating DK. It offers many advantages, including excellent tolerability, availability, cost-effectiveness and, most importantly, safety when applied to the human eye, without adverse events. Further studies are needed to enhance our knowledge and understanding of TI in the healing of DK.
TI promotes corneal wound healing and was not associated with adverse effects in any of the published cases. More studies are needed to determine its stability in normal saline and in artificial tear (AT) of various types, and the advantage of combining TI with AT to increase its contact time and reduce the need for frequent dosing warrants further study.