ophthalmic surgery, may offer a safer and effective alternative by restoring eye volume and intraocular pressure.
In a prospective pilot series, researchers led by Karla Orsine Murta Dias from Moorfields Eye Hospital NHS Foundation Trust, London, assessed the visual and anatomical outcomes of intravitreal HPMC injections in patients with chronic structural ocular hypotony. Chronic hypotony remains a vision-threatening condition with few effective treatment options and no established standard of care for restoring ocular anatomy in eyes with visual potential.
The study included eight patients with structural hypotony lasting longer than three months, defined by an intraocular pressure below 6.5 mm Hg. All participants had clear corneas, unobstructed visual axes, and demonstrable visual potential. Patients received repeated intravitreal HPMC injections at doses ranging from 70 µL to 1400 µL, administered every two to four weeks. Treatment continued until intraocular pressure stabilized between 10 and 15 mm Hg, axial length was restored toward pre-morbid values, or symmetry with the fellow eye was achieved. Patients were followed for 12 months after the initial injection.
The authors noted that this is the first prospective case series to apply a structured, protocol-based approach to intravitreal HPMC use in chronic hypotony. The findings suggest that HPMC injections can improve visual acuity, increase intraocular pressure, and restore ocular anatomy in selected patients with visual potential.
Despite these encouraging results, the small sample size and lack of a control group limit the strength of the conclusions. The researchers emphasized the need for randomized controlled trials to validate these findings and establish standardized treatment pathways. Nevertheless, intravitreal HPMC appears to be a promising, low-cost therapeutic option for managing chronic structural ocular hypotony and preserving vision.
Orsine Murta Dias K, Yang E, Calcagni A, et alNovel therapeutic strategies to restore vision in ocular hypotony (STRETCH): results from a prospective pilot seriesBritish Journal of Ophthalmology Published Online First: 11 January 2026. doi: 10.1136/bjo-2025-327866
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