Annals of the Russian academy of medical sciencesAnnals of the Russian academy of medical sciencesВестник Российской академии медицинских наук0869-60472414-3545"Paediatrician" Publishers LLC1805410.15690/vramn18054OPHTHALMOLOGY: CURRENT ISSUESАКТУАЛЬНЫЕ ВОПРОСЫ ОФТАЛЬМОЛОГИИReview ArticleEffectiveness and Safety of Local Insulin Therapy in the Treatment of Corneal Epithelial Defects (Literature Review)Эффективность и безопасность местной инсулинотерапии в лечении эпителиальных дефектов роговицы (обзор литературы)https://orcid.org/0009-0005-4002-75281304-6874ShlenkinaOlga A.ШлёнкинаОльга Александровна
Russian Federation

Resident

ординатор

olgashlenkina034@gmail.comhttps://orcid.org/0000-0001-9155-87365779-2406MedvedevIgor B.МедведевИгорь Борисович
Russian Federation

MD, PhD, Professor

доктор медицинских наук, профессор

glazmed@list.ruhttps://orcid.org/0000-0002-5475-03986487-5793PokrovskyDmitry F.ПокровскийДмитрий Федорович
Russian Federation

MD, PhD, Assistant Professor

кандидат медицинских наук, доцент

dfpokrovskiy@gmail.comPirogov Russian National Research Medical University (Pirogov Medical University)Российский национальный исследовательский медицинский университет имени Н.И. Пирогова070720258021311372801202521042025Copyright ©; 2025, "Paediatrician" Publishers LLCCopyright ©; 2025, Издательство "Педиатръ"2025"Paediatrician" Publishers LLCИздательство "Педиатръ"https://vestnikramn.spr-journal.ru/jour/article/view/18054

This study analyzes the effectiveness and safety of local insulin therapy in the treatment of corneal epithelial defects (ED). Methods. An analytical study of all available publications on this topic was conducted using PubMed, eLibrary, CENTRAL and manual search. Our criteria were met by 19 scientific articles. Result. This retrospective included 428 eyes. Patients without diabetes accounted for 36%, and patients with diabetes type 1 or 2 accounted for 64%. The size of the corneal ED at the beginning of therapy varied in different studies from 2.2 ± 1.3 to 65.8 ± 20.0 mm2. In 94% of cases, complete epithelialization occurred, while the remaining 6% showed a decrease in ED size. The duration of treatment ranged from 60 hours to 62.3 ± 34.6 days. The healing rate averaged 1 month when instillation of insulin drops was used 4 times a day at a low concentration of 0.5–1.0 IU/ml. As a solvent, the greatest effect was achieved with the use of artificial tears. Conclusion. Local insulin therapy in real clinical practice makes it possible to achieve early healing of corneal ED, without causing side effects. This method of treatment allows you to reduce medical costs, as well as the volume of medical care.

В статье проанализированы эффективность и безопасность применения местной инсулинотерапии в лечении эпителиальных дефектов (ЭД) роговицы. Проведено аналитическое исследование всех имеющихся публикаций по данной теме, используя PubMed, eLIBRARY, CENTRAL и ручной поиск. Нашим критериям соответствовало 19 научных статей. В данный ретроспективный метаанализ включено 428 глаз. Пациенты без сопутствующего сахарного диабета составили 36%, пациенты с выставленным диагнозом сахарного диабета 1 или 2 типа — 64%. Размеры ЭД роговицы в начале терапии варьировались в разных исследованиях от 2,2 ± 1,3 до 65,8 ± 20,0 мм2. В 94% случаев произошла полная эпителизация, у остальных 6% отмечалось уменьшение размеров ЭД. Продолжительность лечения варьировалась от 60 ч до 62,3 ± 34,6 дня. Скорость заживления в среднем составила 1 мес при использовании инстилляций инсулиновых капель 4 раза/день в низкой концентрации 0,5–1,0 МЕ/мл. В качестве растворителя наибольший эффект достигался при применении искусственной слезы. Терапия местным инсулином позволяет добиться скорейшего заживления ЭД роговицы, не вызывая развития побочных эффектов. Данный метод лечения дает возможность снизить медицинские затраты, а также объемы медицинской помощи.

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