Cornea · 8 authors, 3 centres
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A case report describes a 40-year-old man with severe, treatment-resistant neurotrophic keratopathy who was treated with a combination of insulin eye drops and a novel therapeutic contact lens (Hyper-CL). The combined therapy led to complete healing of the large corneal epithelial defect within 20 days.
This is a case report of a 40-year-old man with stage III neurotrophic keratopathy refractory to multiple prior therapies, including autologous serum. The primary outcome was the healing of a large central corneal epithelial defect (7 x 4 mm). Over 20 days of combined therapy, the epithelial defect progressively reduced in size and completely healed, with best-corrected visual acuity improving from 0.01 to 0.05. Conjunctival hyperemia also decreased. No changes in corneal sensitivity were noted. A key limitation is that this is a single-case study, making it impossible to determine the individual contributions of the insulin drops versus the contact lens or their synergistic effect. The authors conclude the combination appears safe and effective for rapid healing in severe, high-risk NK but state that randomized trials are needed.
