Blindness and total ophthalmoplegia after aesthetic polymethylmethacrylate injection: case report

Silva, Marcus Tulius T.; Curi, André Luis Land

doi:10.1590/s0004-282x2004000500025

Cited by 78 publications

(47 citation statements)

References 3 publications

(3 reference statements)

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“…Local complications are well-documented and include granulomatous inflammatory reactions, erythema, itching, depigmentation, induration, ulceration, and tissue necrosis [4]. Vision loss secondary to retrograde embolization after cosmetic facial filler injection has also been described as a local complication [2,3]. Systemic complications are less frequent, and acute vision loss from non-facial aesthetic injections has not been documented previously.…”

Section: Discussionmentioning

confidence: 99%

“…Despite the convenience and simplicity of these office-based procedures, complications are possible, particularly when performed by inexperienced or unlicensed individuals. Ocular complications of dermal fillers are rare, but can occur secondary to retrograde flow in the ophthalmic artery [2,3]. This is the first reported case of acute bilateral vision loss and diffuse alveolar hemorrhage in the setting of cosmetic filler injection for gluteal augmentation.…”

Section: Introductionmentioning

confidence: 90%

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Purtscher-Like Retinopathy and Diffuse Alveolar Hemorrhage Caused by Soft Tissue Injection for Gluteal Augmentation

Huang

Williams

et al. 2015

J Clin Exp Ophthalmol

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Purpose: To describe a rare occurrence of acute vision loss and diffuse alveolar hemorrhage following a treatment of injectable gluteal cosmetic filler. Patient and methods:A 20-year-old female underwent a cosmetic injection of unknown components for gluteal augmentation. Within hours she developed progressive shortness of breath secondary to diffuse alveolar hemorrhage. She presented to ophthalmology 6 weeks later with a history of bilateral decreased vision. Clinical examination revealed cotton wool spots and retinal hemorrhages. Fluorescein angiography demonstrated macular vascular pruning and an enlarged foveal avascular zone. Results:The patient was observed and vision did not improve after 8 months of follow-up. Conclusion:These findings were attributed to a Purtscher-like retinopathy secondary to systemic inflammation induced by the filler and/or direct microembolization of the injected material or fat. To the best of the authors' knowledge, this is the first documented case of diffuse alveolar hemorrhage and ischemic bilateral vision loss in a patient undergoing gluteal augmentation with dermal filler.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 90%

Purtscher-Like Retinopathy and Diffuse Alveolar Hemorrhage Caused by Soft Tissue Injection for Gluteal Augmentation

Huang

Williams

et al. 2015

J Clin Exp Ophthalmol

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“…Not specified/ not known [120] PMMA in collagen or carboxymethyl-cellulose [16,19,54,55,58,59,121,122] Polyethyl methacrylate (copolymer HEMA and EMA) in hyaluronic acid…”

Section: Five-year Viewmentioning

confidence: 99%

Clinical data on injectable tissue fillers: a review

Vries

Geertsma

2013

Expert Review of Medical Devices

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Treatment with injectable tissue fillers for aesthetic purposes is increasingly popular. In parallel with this success, questions related to the safety of these treatments and the products involved are being raised more prominently. To gain insight in the safety aspects of injectable tissue fillers, we performed a literature review to collect studies reporting clinical data of injectable tissue fillers. We found several case reports where serious complications after more than three years are described. However, there are only a limited number of well-defined prospective clinical studies available with follow-up periods longer than three years. Furthermore, causes of complications, that is, treatment or product related, are often not specified in literature. Considering the intended functional period of fillers in combination with the known occurrence of long-term complications, there is a need for well-defined prospective clinical studies. In order to be able to discriminate between product failure (a product safety issue) or application methodology (a physician expertise or training issue), better identification of observed complications and whether they are product or treatment related, is needed. For the safe use of the fillers it is important that treatment with injectable tissue fillers is performed by a trained physician, who knows the product specifications and its applications. . Moreover, it is expected that due to increase in life expectancy, the demand for anti-aging treatments, like tissue augmentation with injectable tissue fillers, will grow [2]. Their success has been attributed to the fact that treatments with injectable tissue fillers are fast and appear to be relatively easy [2]. Only a relatively 'simple' subcutaneous injection is needed. Today, various injectable tissue fillers with different characteristics are available, for example, duration of the effect, material type and intended anatomical location.Although the application of an injectable tissue filler seems to be relatively simple and safe, reports of serious adverse effects have appeared in the literature [2][3][4][5][6][7][8]. Estimates of the occurrence of severe complications after treatment with various types of injectable tissue fillers range between 1:80 and 1:50,000 patients [9,10]. Adverse side effects can be caused by incorrect injection techniques (treatment related) or by the characteristics of the products (product related) [11,12]. Short-, mid-and long-term complications can be discerned (TABLE 1) [2,13-15]. Short-term complications like pain, swelling, fever, immediate hypersensitivity reactions, occur immediately or within several days past treatment and disappear after several weeks. A more severe short-term complication is necrosis [5,16]. Necrosis occurs immediately or within a few days if blood vessels are obstructed by the filler material or if they are injured during the treatment [17]. Mid-term complications such as delayed inflammatory reactions, ulceration and granuloma reaction may occur after 2-12 months. I...

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“…Polymethyl methacrylate (PMMA) is used by cosmetic surgeons in some countries, and can occasionally lead to serious ocular complications including orbital myositis (Figure 16; Kubota & Hirose, 2005;Sato et al, 2007;Silva & Curi, 2004) …”

Section: Orbital Foreign Bodymentioning

confidence: 99%

Orbital Myositis

Kubota

2011

Idiopathic Inflammatory Myopathies - Recent Developments

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Blindness and total ophthalmoplegia after aesthetic polymethylmethacrylate injection: case report

Cited by 78 publications

References 3 publications

Purtscher-Like Retinopathy and Diffuse Alveolar Hemorrhage Caused by Soft Tissue Injection for Gluteal Augmentation

Purtscher-Like Retinopathy and Diffuse Alveolar Hemorrhage Caused by Soft Tissue Injection for Gluteal Augmentation

Clinical data on injectable tissue fillers: a review

Orbital Myositis

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