A routine eye ointment, widely used in post-operative care, is now linked to serious damage in glaucoma implants, prompting new glaucoma treatment concerns for patient safety. Researchers from Nagoya University in Japan discovered that petrolatum-based ointments can cause the PRESERFLO MicroShunt device to swell and rupture, findings with significant implications for standard eye treatments globally.
Glaucoma, a chronic eye disease, affects an estimated 76 million people worldwide, often leading to irreversible vision loss due to elevated pressure inside the eye. The MicroShunt implant offers a modern, less invasive solution compared to traditional surgeries, designed to improve fluid drainage and reduce the need for ongoing medication for many patients.
However, this recent discovery, detailed on ScienceDaily, and published in Graefe’s Archive for Clinical and Experimental Ophthalmology, reveals a critical vulnerability. The implant’s material, a styrenic thermoplastic elastomer, surprisingly reacts to hydrocarbon- and oil-based substances, which are common in many eye ointments.
This inherent affinity allows petrolatum components to penetrate the device’s structure. Once absorbed, these oils can cause the implant to swell significantly, leading to changes in its original shape and compromising its crucial mechanical strength. Such structural degradation directly impedes the device’s ability to function as intended, raising serious glaucoma treatment concerns for patients and clinicians.
The hidden risk of common ointments
Ophthalmologist and Assistant Professor Ryo Tomita of Nagoya University Graduate School of Medicine, the study’s first author, observed ruptures in swollen MicroShunts during surgery. This alarming finding sparked a collaborative investigation with engineering researchers at the university to understand the material’s degradation at a microscopic level. Their combined clinical and laboratory findings confirm direct contact with petrolatum-based ointments as the primary culprit, fueling ongoing glaucoma treatment concerns.
The PRESERFLO MicroShunt manufacturer explicitly warns against direct contact with petrolatum-based materials in its instructions for use. Despite this crucial guidance, the warning is not always widely recognized or consistently followed in various clinical settings globally, according to the research. This oversight means many patients may unknowingly be exposed to a risk that could compromise their vision-saving implants.
Clinical evidence and future implications for glaucoma care
The clinical analysis involved seven glaucoma patients whose MicroShunt implants were later removed for various reasons. A clear pattern emerged based on the implant’s exposure. Three patients whose implants were exposed outside the conjunctiva and treated with petrolatum-based ointment showed noticeable swelling, with two ultimately rupturing.
Conversely, three implants that remained fully covered by the conjunctiva and received no such ointment maintained their original, intact structure. An additional case, where an exposed MicroShunt received no ointment, also showed no damage, further strengthening the link between the ointment and implant failure. This evidence is crucial for addressing current glaucoma treatment concerns effectively.
This compelling evidence underscores the urgent need for updated post-operative protocols and enhanced clinician education. Dr. Tomita emphasized that raising awareness among medical professionals is crucial to prevent similar problems and ensure the longevity of these vital devices. The findings suggest a reevaluation of standard eye care practices for patients with these implants.
The unexpected vulnerability of glaucoma implants to routine eye ointments presents a significant challenge for ophthalmologists and patients alike. Moving forward, a concerted effort is required to educate medical professionals about this specific risk and to explore safer, non-petrolatum-based alternatives for post-surgical care. Ensuring the long-term integrity of these vital implants is paramount to preserving the vision of millions affected by glaucoma worldwide, mitigating future glaucoma treatment concerns.
