New 'filler' therapy offers hope to those blinded by condition
A Groundbreaking Medical Advance Offers New Hope for People with Rare Blindness
A recent medical breakthrough has brought new hope to individuals suffering from a rare and untreatable form of blindness. This innovation involves a low-cost gel injection that has successfully restored sight in some patients. The procedure works by normalizing the pressure within the eye, thereby improving vision. Specialists have described the treatment as "not dissimilar to cosmetic fillers" due to its mechanism.
The impact of this treatment is already profound. One participant in the study can now enjoy skiing with her son and is looking forward to regaining her driving license. The treatment targets hypotony, a condition that affects approximately 100 people in the UK annually. Hypotony is characterized by abnormally low eye pressure, which distorts the shape of the eye.
This pioneering research was led by London's Moorfields Eye Hospital, with support from the Moorfields Eye Charity. Patients received injections of hydroxypropyl methylcellulose (HPMC), a clear, colorless gel, directly into their eyes. HPMC is typically used in surgery to maintain the eye’s shape during operations or to coat its surface for protection and to prevent it from drying out.
Harry Petrushkin, a consultant ophthalmologist at Moorfields, explained:
“Everybody who’s ever had eye surgery 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. We don’t leave it inside the eye, but it’s actually a really safe substance if you are leaving it inside certain people’s eyes, and it allows it to act a bit like a filler. So, in many ways, it’s not dissimilar to cosmetic fillers.”
He continued:
“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. 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.”
Hypotony can be caused by “a number of different diseases,” according to Mr. Petrushkin, as well as trauma, inflammation, or complications after surgery. He noted that there has been no useful long-term management plan for hypotony until now.
The current standard treatment for hypotony has been to fill the affected eye with silicone oil. However, this can cause toxicity to the eye and is not great in the long term, according to Mr. Petrushkin.
He told PA:
“The fluid that fills our eyes is pretty similar to water in terms of seeing through it, whereas if you hold up a bottle of oil, it bends light more, and so if you’re trying to look through oil, your vision is going to be worse and very magnified. The advantage of using a gel rather than silicone oil is that you can actually see through it much better. And silicone oil, magical as it is, causes a lot of toxicity to the eye. So it has, up till now, been the gold standard but it’s not great.”
The research, published in the British Journal of Ophthalmology, included eight patients with hypotony whose eyes were injected with HPMC every couple of weeks. Experts found that injecting the affected eye with HPMC not only restored its shape but also restored sight in seven patients after 12 months of treatment. Vision was measured using sight charts, and there have been “no serious side effects to date,” Mr. Petrushkin said.
All patients needed regular check-ups during and after treatment, and in some cases, injections were able to be stopped after the eye was restored to its normal size.
Nicki Guy, 47, who has been under Mr. Petrushkin’s care since 2019 and participated in the study, shared her experience:
“I’m 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. I’ve been able to take my son skiing. I love taking photographs, so I can do that again. There are still challenges with my vision as it is, but from where I was, it’s just phenomenal.”
Mr. Petrushkin runs an all-day hypotony clinic at Moorfields—the only one of its kind in the world. Prior to this, he said patients would have been told “there’s nothing more we can do.” Speaking of Mrs. Guy, he said:
“She was a young patient who had a young family… I was just very frustrated that there was nothing that medicine could really do for her to keep her seeing. I’m lucky to work in a place with lots of amazing people, and we put our heads together, and thought that we would try injecting this gel, which is a gel that we’ve been using for decades.”
Moorfields has treated 35 hypotony patients in this way so far, and Mr. Petrushkin said the “results are holding up.” He is now applying for funding for a large clinical trial to test different gels. The goal is to figure out what gel involves injecting patients as few times as possible.
“Ideally, we’d be able to find a product which expands slowly, so that we can inject a bit, but it slowly expands so we’re not having to top it up,” Mr. Petrushkin added. “We’re working with bioengineers all over the world, but particularly at UCL, to develop products that do that.”
Mr. Petrushkin emphasized that this treatment is not a cure for blindness but could be used on people with other eye conditions. “This is a treatment which is amazing for people who have visual potential, as in you are capable of good vision, but your eye is currently not letting you achieve that. It’s not a treatment to bring back blindness, where there is no vision at all.”
He concluded: “My hope would be that as the project develops, and as our knowledge in this area expands—our knowledge is really rudimentary—we understand where we can intervene to stop people from losing vision altogether.”
