A new injury severity scale for ocular complications following cosmetic filler injection

Abstract

Background: Cosmetic filler injection can cause a variety of eye complications; however, there is currently no good way to evaluate injury severity and prognosis. By analyzing the injury manifestations of severe ocular complications following cosmetic filler injection and their prognosis, we propose a new injury severity scale. Methods: Twenty-two eyes of 22 patients experiencing ocular complications following cosmetic filler injection were followed for 6 months to observe injury characteristics, manifestations and prognosis. Best corrected visual acuity (BCVA), intraocular pressure (IOP), split lamp microscopy, fundus photography, optical coherence tomography (OCT), and fundus fluorescein angiography were examined at the onset and follow-up visits. Results: According to the immediate BCVA at the time of injury (with the presence or absence of brain infarction), a new injury severity scale was proposed, namely, Grades 1-4. Grade 1 (4 patients) and Grade 2 (2 patients) tended to have no atrophy of the globe. Grade 3 (12 patients) and Grade 4 (4 patients) were more likely to develop atrophy of the globe (4/12 patients and 2/4 patients, respectively) at the last follow-up. Grade 3 and Grade 4 were more likely to be complicated with ophthalmoplegia and ptosis (7/16 patients). Conclusions: The new injury severity scale we proposed can determine the prognosis of different ocular complications following cosmetic filler injection. Accordingly, we can inform injured patients regarding the possibility of phthisis bulbi and the extent of improvement of visual impairment, ophthalmoplegia, ptosis and stroke.

Clinical Manifestations and Prognosis of Embolism Caused by Filler Injection in Different Facial Regions

“…( See table, Supplemental Digital Content 1, which displays information on 165 patients. 44–98 http://links.lww.com/PRSGO/C749).…”

A novel predictive model for phthisis bulbi following facial hyaluronic acid cosmetic injection

“…In our prior study 5 , a total of 22 cases (numbered 1-22 in chronological order of rst visit) suffering from ocular/orbital complications following cosmetic ller injection were included in the same period such as this one. Among them, two patients receiving facial cosmetic injection of autologous fat instead of HA were excluded.…”

“…To observe long-term prognosis of ASI following cosmetic ller injection, we followed up the previous 22 patients 5 with rst visit between June 2017 and February 2021 for up to 2 years. It was found that 10 out of the 22 patients underwent various degrees of long-term ciliary process dysfunction, excluding visual impairment, ophthalmoplegia and ASI occurring within 24 hours after facial cosmetic ller injection.…”

Retinal artery occlusion after facial filler injection in a patient with patent foramen ovale: a case report and literature review

“…Although facial filler injection is safer and more easily controlled than conventional surgery, the emergence of this new method has led to increasing reports of serious adverse events, such as arterial obstruction-related vision loss, skin changes, muscle paralysis, and periorbital vascular lesions. 1,[3][4][5][6][7][8][9][10][11] Thus far, no authoritative clinical guidelines have been established.…”