Combined use of insulin eye drops and cross-linked hyaluronic acid canalicular gel for the management of severe neurotrophic keratopathy.

Filippo Lixi, Camilla Bianchi, Claudia Corda, Mario Verdiglione, Giulia Coco, Giuseppe Giannaccare

Abstract readCase Reports

In one paragraph

Article in American journal of ophthalmology case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

6 authors.

Filippo LixiEye Clinic, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy.

Camilla BianchiEye Clinic, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy.

Claudia CordaEye Clinic, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy.

Mario VerdiglioneCompounding Pharmacy, Farmacia Europea, Catanzaro, Italy.

Giulia CocoOphthalmology Unit, Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy.

Giuseppe GiannaccareEye Clinic, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: To describe the outcome of a novel combined therapeutic approach encompassing topical insulin eye drops and cross-linked hyaluronic acid canalicular gel in a case of severe recalcitrant neurotrophic keratopathy (NK) complicated by keratolysis. Case presentation: A 52-year-old male presented with a recalcitrant Mackie stage III post-herpetic NK in the right eye, characterized by a large persistent epithelial defect (PED) (area of 49.7 mm Conclusions: The combined use of topical insulin and cross-linked hyaluronic acid canalicular gel allowed achievement of complete corneal healing in a case of severe recalcitrant NK complicated by keratolysis. The regenerative properties of insulin eye drops were enhanced by the concomitant insertion of the occlusive device. This approach represents a rational, accessible, and well-tolerated therapeutic strategy that warrants further investigation in prospective controlled studies.

Indexed as

Canalicular gelLacrifillNeurotrophic keratopathyPersistent epithelial defectTopical insulin

Identifiers

PMID42569539

DOI10.1016/j.ajoc.2026.102637

PMCPMC13450577

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