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In contrast, the study group included NK cases treated with TI [1 unit per drop] four times daily, in addition to the previously mentioned treatment. The primary outcome measure was time to epithelial healing. Secondary outcome measures included any adverse effect of TI or the need for amniotic membrane transplantation (AMT). During the study period, 19 patients with a mean age of 49.3\u2009\u00b1\u20098.6 years received TI versus 18 controls with a mean age of 52.5\u2009\u00b1\u200910.7 years. Corneal epithelial healing was significantly faster in the TI-treated group compared to controls, with a mean difference of 12.16 days (95% CI 6.1\u201318.3, P\u2009=\u20090.001). Survival analysis indicated that the insulin-treated group had 0% and 20% of NK stages 2 and 3, respectively, that failed to achieve corneal epithelial healing, compared to 20% and 66.7% for the control group (P\u2009&lt;\u20090.001). In the control group, two eyes required AMT due to progressive thinning. Additionally, three patients in the control group, progressing to stage 3 NK, were switched to TI, achieving healing after a mean of 14 days. No adverse effects were reported in the TI-treated group. Our study suggests that TI can effectively and safely promote the healing of NK after DV.<\/jats:p>","DOI":"10.1038\/s41598-024-60699-y","type":"journal-article","created":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T08:02:20Z","timestamp":1715673740000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Topical insulin in neurotrophic keratopathy after diabetic vitrectomy"],"prefix":"10.1038","volume":"14","author":[{"given":"Taher K.","family":"Eleiwa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed A.","family":"Khater","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdelrahman M.","family":"Elhusseiny","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,5,14]]},"reference":[{"issue":"4","key":"60699_CR1","doi-asserted-by":"publisher","first-page":"717","DOI":"10.1002\/jcp.25623","volume":"232","author":"L Mastropasqua","year":"2017","unstructured":"Mastropasqua, L., Massaro-Giordano, G., Nubile, M. & Sacchetti, M. 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