title: Topical insulin for healing of diabetic epithelial defects?: A retrospective review of corneal debridement during vitreoretinal surgery in Malaysian patients.
abstract: OBJECTIVE
  To investigate whether topical insulin improves healing rate of corneal epithelial erosions induced during vitreoretinal surgery in diabetics.
  
  
  METHODS
  We retrospectively reviewed case notes and serial post-operative photographs of 15 eyes of 14 patients who had corneal epithelial debridement performed during various vitreoretinal surgeries to improve one surgeon's view over a 10 month period in 2010.
  
  
  RESULTS
  Three groups were identified: DTI, comprising diabetics who received topical insulin 1 unit qds postoperatively (n=5); DCT comprising diabetics treated with conventional post-operative medications only (n=5) and NDCT comprising non diabetic patients on conventional post operative therapy (n=5). Only eyes in which the corneal epithelial defect had been serially photographed at time, t= 0, 12, 24, 36, 48, 60, 72 and 120 hours following commencement of topical medications were included. The size of the defect was calculated using local software. DTI eyes had a significantly smaller defect size at t= 24 (p=0.009), 36 (p=0.009), 48 (p=0.015) and 60 hours (p=0.005) compared to DCT eyes and had no statistical difference from NDCT eyes at all times in the Mann Whitney U analysis (p>0.05). In the diabetic operated bilaterally, the insulin treated eye re-epithelialised by 48 hours whereas fellow eye treated conventionally re-epithelialised in 72 hours.
  
  
  CONCLUSIONS
  Topical insulin or insulin eye drops 1 unit qds may be applied to the corneal surface to normalize the rate of healing of epithelial defects in diabetic patients undergoing epithelial debridement to improve the surgeon's view.
authors.affiliation: Universiti Kebangsaan Malaysia, Ophthalmology, Department of Ophthalmology, Hospital UKM, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Kuala Lumpur, Wilayah Persekutuan, Malaysia. maelynnbdr@gmail.com.
authors.forename: M L C
authors.initials: ML
authors.lastname: Bastion
authors.forename: K P
authors.initials: KP
authors.lastname: Ling
mesh_terms: D000287:Administration, Topical; D003316:Corneal Diseases / Q000601:surgery; D003646:Debridement; D003920:Diabetes Mellitus; D019573:Epithelium, Corneal; D006801:Humans; D007328:Insulin; D012189:Retrospective Studies; D057586:Vitreoretinal Surgery
chemical_list: D007328:Insulin