Fai Seng, Ahem Amin, Mustapha Mushawiathi, Mohd Noh Umi Kalthum, Bastion Mae-Lynn Catherine
Department of Ophthalmology, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
Asia Pac J Ophthalmol (Phila). 2017 Sep-Oct;6(5):418-424. doi: 10.22608/APO.201780. Epub 2017 Aug 22.
To determine the effect of topical insulin of 3 concentrations [0.5, 1, and 2 units per drop 4 times per day (QID)] on postoperative corneal epithelial wound healing in diabetic patients.
A double blind randomized controlled hospital-based study involving diabetic patients with postoperative corneal epithelial defect after vitreoretinal surgery.
Diabetic patients were randomized to 3 different concentrations of topical insulin (DTI 0.5, DTI 1, and DTI 2) or placebo in the control group (DNS). Primary outcome measure was the rate of corneal epithelial wound healing (mm² per hour) over pre-set interval and time from baseline to minimum size of epithelial defect on fluorescein stained anterior segment digital camera photography. Secondary outcome measure was any adverse effect of topical insulin. Follow-up was 1 month.
Thirty-two eyes of 32 patients undergoing intraoperative corneal debridement with resultant epithelial defect (8 eyes per group) were analyzed. DTI 0.5 was superior to other concentrations achieving 100% healing rate within 72 hours of treatment compared with 62.5% in DNS, 75% in DTI 1, and 62.5% in DTI 2. Statistically, DTI 0.5 achieved significant results (P = 0.036) compared with the diabetic control group (DNS) in terms of mean rate of corneal epithelial wound healing from maximum to minimum defect size. No adverse effect of topical insulin was reported.
Topical insulin 0.5 units QID is most effective for healing corneal epithelial defect in diabetic patients after vitrectomy surgery compared with placebo and higher concentrations. Topical insulin is safe for human ocular usage.
确定3种浓度[每滴0.5、1和2单位，每天4次（每日4次）]的局部胰岛素对糖尿病患者术后角膜上皮伤口愈合的影响。
一项基于医院的双盲随机对照研究，涉及玻璃体视网膜手术后角膜上皮缺损的糖尿病患者。
将糖尿病患者随机分为3种不同浓度的局部胰岛素组（DTI 0.5、DTI 1和DTI 2）或对照组的安慰剂组（DNS）。主要观察指标是在预设间隔内角膜上皮伤口愈合的速率（每小时平方毫米）以及从基线到荧光素染色眼前节数码相机摄影上皮缺损最小尺寸的时间。次要观察指标是局部胰岛素的任何不良反应。随访1个月。
分析了32例术中进行角膜清创术导致上皮缺损的患者的32只眼（每组8只眼）。DTI 0.5优于其他浓度，在治疗72小时内愈合率达到100%，而DNS组为62.5%，DTI 1组为75%，DTI 2组为62.5%。在统计学上，就角膜上皮伤口从最大缺损尺寸到最小缺损尺寸的平均愈合速率而言，DTI 0.5与糖尿病对照组（DNS）相比取得了显著结果（P = 0.036）。未报告局部胰岛素的不良反应。
与安慰剂和更高浓度相比，每滴0.5单位每日4次的局部胰岛素对糖尿病患者玻璃体切除术后角膜上皮缺损的愈合最有效。局部胰岛素用于人类眼部是安全的。
