A routinely used eye surgery gel has helped restore vision in people affected by a rare condition that can lead to blindness, according to scientists in London.
Researchers at Moorfields Eye Hospital found that hydroxypropyl methylcellulose (HPMC) — a low-cost gel already widely used in eye operations — successfully improved sight in seven out of eight patients suffering from hypotony.
Hypotony is caused by abnormally low pressure inside the eyeball, leading to a change in its shape and, often, severe vision loss. Around 100 people in the UK develop the condition each year, and until now treatment options have been limited and problematic.
Eye pressure restored after year-long treatment
Following 12 months of fortnightly injections of HPMC, doctors observed that the eye returned to its normal shape in patients receiving the treatment.
The gel is clear and colourless and is typically used during eye surgery to help maintain the eye’s shape, protect its surface and prevent dryness. Harry Petrushkin, consultant ophthalmologist at Moorfields, said patients undergoing eye operations “will have had this gel in or on their eye at some point, but normally that gel is washed off or washed out at the end of surgery”.
He described HPMC as a “really safe” substance that is “not dissimilar to cosmetic fillers”.
“It fills the space, but in this context, it fills the space with something that’s transparent and see-through, and allows you to give a certain amount per patient to fill the eye up to the size it’s supposed to be,” he said.
“A bit like if you’re pumping up a ball, you can pump it up to exactly the right size, and then the eye can see much better.”
Safer alternative to silicone oil for hypotony patients
Hypotony can develop due to several underlying diseases, as well as trauma, inflammation or complications following surgery. Existing management plans, Mr Petrushkin said, “have had quite a lot of problems.”
The condition is currently treated by filling the eye with silicone oil, a substance that can be toxic and is “not great” as a long-term solution.
“The advantage of using a gel rather than silicone oil is that you can actually see through it much better,” he explained.
The findings, published in the British Journal of Ophthalmology, showed that regular HPMC injections not only corrected eye shape but also restored vision in seven patients, with “no serious side effects to date”. In some cases, injections were discontinued once the eye returned to its normal size.
Patients regain independence and quality of life
One participant, Nicki Guy, 47, has been treated by Mr Petrushkin since 2019 and took part in the study. She said she is now “so close to being able to drive again with my vision in my left eye.”
“If it stays like this for the rest of my life, I would just be exceedingly happy,” she said.
“I’ve been able to take my son skiing. I love taking photographs, so I can do that again.
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“There are still challenges with my vision as it is but, from where I was, it’s just phenomenal.”
So far, Moorfields has treated 35 patients with hypotony using this approach, and Mr Petrushkin said the “results are holding up”. He is now seeking funding for a larger clinical trial to compare different gels and determine which requires the fewest injections.
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