{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T21:48:50Z","timestamp":1790027330863,"version":"4.0.1"},"reference-count":33,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T00:00:00Z","timestamp":1753228800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Ophthalmology"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Persistent epithelial defects (PEDs) are challenging corneal conditions with prolonged non-healing. Commonly associated with dry eye disease and neurotrophic keratopathy, PEDs can lead to severe complications. Topical insulin has emerged as a therapeutic option, promoting epithelial healing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched Medline, Embase, Web of Science, and Cochrane Library databases following PRISMA guidelines for studies reporting topical insulin for PEDs of any etiology and corneal epithelial defect (CEDs) post-vitrectomy. Healing time, complete wound healing (CWH), epithelization failure (EF), and epithelial healing rate were our analysis outcomes. Statistical analyses employed random-effects models and I\u00b2 statistic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirteen studies involving 390 eyes were included. Mean healing time for all conditions was 20.68 days (95% CI: 11.60, 29.76) with significant heterogeneity. The pooled CWH rate was 94% (95% CI: 0.87, 0.98), with an odds ratio of 5.41 favoring topical insulin over the control group. EF was low at 5% (95% CI: 0, 0.13), and the epithelial healing rate was 0.82\u2005mm\u00b2\/hour (95% CI: 0.02, 1.62). Subgroup analyses revealed variations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Topical insulin is effective in corneal wound healing, demonstrating high CWH rates and low failure rates. Further well-controlled studies are needed to validate these findings and assess long-term outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11206721251361649","type":"journal-article","created":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T07:05:40Z","timestamp":1753254340000},"page":"2321-2335","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Impact of topical insulin as a therapeutic intervention for corneal wounds: A comprehensive systematic review and meta-analysis"],"prefix":"10.1177","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-7948-154X","authenticated-orcid":false,"given":"Dillan Cunha","family":"Amaral","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Universidade Federal do Rio de Janeiro"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4203-6856","authenticated-orcid":false,"given":"Carolina","family":"Carvalho Soares Valentim","sequence":"additional","affiliation":[{"name":"University of Louisville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7282-9131","authenticated-orcid":false,"given":"Lidia","family":"Cheidde","sequence":"additional","affiliation":[{"name":"Pontifical Catholic University of S\u00e3o Paulo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1333-1893","authenticated-orcid":false,"given":"Laura","family":"Cheidde","sequence":"additional","affiliation":[{"name":"City University of S\u00e3o Paulo, S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7598-6482","authenticated-orcid":false,"given":"Pedro Paulo","family":"Ladeira J\u00fanior","sequence":"additional","affiliation":[{"name":"City University of S\u00e3o Paulo, S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8924-9171","authenticated-orcid":false,"given":"Elizabet Taylor Pimenta","family":"Weba","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina, Universidade Estadual da Regi\u00e3o Tocantina do Maranh\u00e3o, Imperatriz, MA, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3685-9530","authenticated-orcid":false,"given":"Kenzo Ogasawara","family":"Donato","sequence":"additional","affiliation":[{"name":"University of Fortaleza"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helv\u00e9cio Neves Feitosa","family":"Filho","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Bahiana School of Medicine and Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8174-8082","authenticated-orcid":false,"given":"Jaime","family":"Guedes","sequence":"additional","affiliation":[{"name":"Wills Eye Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9610-5768","authenticated-orcid":false,"given":"Ricardo Noguera","family":"Louzada","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Universidade Federal do Rio de Janeiro"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,7,23]]},"reference":[{"key":"e_1_3_3_2_2","first-page":"163","article-title":"Persistent corneal epithelial defects: a review article","volume":"8","author":"Vaidyanathan U","year":"2019","unstructured":"Vaidyanathan U, Hopping GC, Liu HY, et al. 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