Insulin Eye Drops and Epithelial Healing After Corneal Cross-linking

The Effect of Topical Insulin Eye Drops On Corneal Epithelial Wound Healing After Corneal Collagen Cross-linking in Keratoconus Management: A Paired-Eye Study

The goal of this clinical trial was to learn if topical insulin eye drops affected corneal epithelial wound healing after corneal collagen cross-linking. The main questions it aimed to answer were:

Does topical insulin accelerate corneal epithelial healing after corneal collagen cross-linking? Does it affect post-operative pain?

Participants were all diagnosed as having bilateral progressive Keratoconus and were already scheduled for bilateral cross-linking:

Post-operatively, they were asked to apply insulin eye drops in one eye only (4 times daily) in addition to the prescribed routine post-operative treatment which was applied to both eyes.

They were also asked to come for follow-up visits on post-operative day 1,2,3,5 and 7 or until complete corneal wound healing.

The epithelial defect was measured in each eye and the participants were asked to report the degree of pain they felt in each eye at each visit until complete epithelial healing.

Inclusion Criteria:

- Patients above 18 years old diagnosed with bilateral progressive Keratoconus with central corneal thickness more than 400 microns at thinnest location.

Exclusion Criteria:

• Patients with signs of infectious keratitis (bacterial, fungal, protozoal or mixed poly-microbial).
• Patients with a history of herpetic keratitis or having diminished corneal sensation.
• Patients with severe dry eye, apical corneal scarring, hydrops, a history of corneal surgery, or ophthalmic disease other than keratoconus.
• Single eyed patients.
• Patients on systemic treatment involving steroids or immune-compromised patients.
• Patients who cannot be monitored with frequent visits as required in the study protocol.
• Pregnant and nursing females.