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Presentation type	E-poster
Title	Topical insulin for ocular surface restoration: a retrospective observational cohort study

Purpose	To summarize the results of a retrospective study on topical insulin use in treatment of various ocular surface pathologies.
Methods	A multicentric retrospective observational cohort study, conducted in the ophthalmology departments of the university hospitals of Brussels and Ghent. The study included 56 eyes treated with insulin eye drops for various ocular surface pathologies, from October 2023 to March 2025. Data on patients' demographics, clinical outcomes and symptoms were collected to evaluate the effect of topical insulin for treating ocular surface diseases as a primary objective, with treatment success defined as subsiding of clinical signs and symptoms allowing discontinuation of topical insulin without need for alternative treatments.
Results	Patients were treated for various ocular surface diseases, most commonly neurotrophic keratopathy (NK) (53.6%), followed by dry eye disease (DED) (16.1%) and graft versus host disease (GVHD) (12.5%). Significant clinical improvement was seen in NK grade 2 (100%) and 3 (92%). Improvement in symptoms was observed more frequently in NK grade 1 (83.3%) and GVHD (71.4%), but clinical improvement in these groups was less favorable. For DED, both clinical improvement and symptom improvement were low. Persistent epithelial defects (PED) of various causes (mainly NK) responded well to topical insulin, with complete closure in 76% of cases and partial closure in 17%.
Conclusion	Topical insulin treatment is a promising, safe and affordable option for ocular surface diseases, especially NK and PED unresponsive to conventional therapy. However, larger randomized trials are needed to confirm these results.
Conflict of interest	No

Authors 1

Initials	M
Last name	Lammens
Department	UZB
City	Jette

Authors 2

Initials	I
Last name	Krolo
Department	UZB
City	Jette

Authors 3

Initials	S
Last name	Oellerich
Department	UZB
City	Jette

Authors 4

Initials	D
Last name	Roels
Department	UZG
City	Ghent

Authors 5

Initials	S
Last name	Ni Dhubhghaill
Department	UZB
City	Jette