PDF(Pubmed)
Abstract：
Various etiologies, including diabetic keratopathy (DK), dry eye disease (DED), and neurotrophic keratopathy (NK), can disrupt corneal homeostasis, exacerbating corneal epithelial defects. Topical insulin has emerged as a promising therapy for promoting corneal wound healing and addressing underlying pathologies. This review systematically evaluates the efficacy of topical insulin across different corneal disorders. A literature review was conducted across the PubMed, Google Scholar, and Scopus research databases. The search resulted in a total of 19 articles, consisting of clinical trials, retrospective studies, and case reports. In DK, topical insulin accelerates corneal wound healing post-vitreoretinal surgery with lower concentrations showing higher outcomes when compared to conventional therapy, possibly due to improved epithelial stem cell migration. In comparison, the dry-eye disease results are inconclusive regarding patient-reported outcomes and corneal staining. For NK, topical insulin accelerates corneal wound healing and restores corneal nerve sensation. Other persistent epithelial defect (PED) etiologies that have been treated with topical insulin are infection, immune-mediated, mechanical and chemical trauma, and chronic ocular surface alterations. Although individual mechanisms for the benefits of topical insulin for each of these etiologies have not been studied, the literature demonstrates that topical insulin is efficacious for PEDs regardless of etiology. Future clinical trials need to be conducted to further evaluate optimal dosing, duration, and use of topical insulin for the restoration of the corneal surface.
摘要：
各种病因，包括糖尿病性角膜病变（DK），干眼症（DED），和神经营养性角膜病变（NK），会破坏角膜稳态，加剧角膜上皮缺损。局部胰岛素已成为促进角膜伤口愈合和解决潜在病理的有希望的疗法。这篇综述系统评估了局部胰岛素在不同角膜疾病中的疗效。在整个PubMed进行了文献综述，谷歌学者，和Scopus研究数据库。搜索结果共19篇文章,包括临床试验，回顾性研究,和病例报告。在DK,与常规治疗相比，局部胰岛素可在较低浓度的玻璃体视网膜手术后加速角膜伤口愈合，显示出更高的结局，可能是由于上皮干细胞迁移的改善。相比之下,关于患者报告的结局和角膜染色,干眼症的结果尚无定论.对NK来说,局部胰岛素加速角膜伤口愈合，恢复角膜神经感觉。其他用局部胰岛素治疗的持续性上皮缺损（PED）病因是感染，免疫介导的，机械和化学创伤,和慢性眼表改变。尽管尚未研究局部胰岛素对每种病因的益处的个体机制，文献表明,无论病因如何,局部胰岛素对PEDs均有效.需要进行未来的临床试验，以进一步评估最佳剂量。持续时间,以及使用局部胰岛素修复角膜表面。
