Ophthalmoplegia as a complication of cosmetic facial filler injection

Kim, Ahro; Kim, Sunghee; Kim, Hyojung; Yang, Hee Kyung; Hwang, Jeong‐Min; Kim, Ji-Soo

doi:10.1111/aos.12893

Cited by 24 publications

(15 citation statements)

References 5 publications

(10 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Branch retinal artery occlusion may cause a partial visual loss. 11 , 12 Combinations of these patterns can occur. 13 , 14 Some visual loss patterns would be more amenable to reversal than others, and hyaluronic acid would be the only injectable agent potentially reversible at all via intervention.…”

mentioning

confidence: 99%

A Consensus on Minimizing the Risk of Hyaluronic Acid Embolic Visual Loss and Suggestions for Immediate Bedside Management

Goodman

Magnusson

Callan³

et al. 2019

Aesthetic Surgery Journal

View full text Add to dashboard Cite

Background Hyaluronic acid fillers have a satisfactory safety profile. However, adverse reactions do occur, and rarely intravascular injection may lead to blindness. Currently there is no internationally recognized consensus on the prevention or management of blindness from hyaluronic acid filler. Objectives The authors sought to give guidance on how to minimize the risk and optimize the management of this rare but catastrophic adverse reaction. Methods A multinational group of experts in cosmetic injectables from multiple disciplines convened to review current best practice and develop updated consensus recommendations for prevention and bedside intervention if visual loss occurs after cosmetic injection of hyaluronic acid filler. Results The consensus group provided specific recommendations focusing on the consenting process, prevention, and early management of visual impairment related to intravascular hyaluronic acid filler injection. Conclusions Although visual loss due to filler injections is rare, it is important that both patient and physician be aware of this risk. In this paper the authors describe methods and techniques available to reduce the risk and also document suggested initial management should a clinician find themselves in this situation. Level of Evidence: 5

show abstract

mentioning

confidence: 99%

A Consensus on Minimizing the Risk of Hyaluronic Acid Embolic Visual Loss and Suggestions for Immediate Bedside Management

Goodman

Magnusson

Callan³

et al. 2019

Aesthetic Surgery Journal

View full text Add to dashboard Cite

show abstract

“…To the best of our knowledge, there is no report considering outcomes of strabismus surgery after iatrogenic occlusion of the ophthalmic artery and its branches caused by cosmetic facial filler injections. Up to now, little is known of the clinical course and surgical outcomes of ophthalmoplegia and sensory strabismus related to iatrogenic artery occlusion after cosmetic facial filler injection [3, 4]. In this study, we found that strabismus surgery was successful only in patients without residual ophthalmoplegia.…”

Section: Discussionmentioning

confidence: 64%

“…Iatrogenic central retinal artery and/or ophthalmic artery occlusion could be caused by facial injection of filling materials [1, 2]. Visual loss is well known as a devastating complication of ophthalmic artery occlusion [1–3], whereas there is a lack of detailed description of the clinical course of strabismus and surgical outcomes related to this condition [4]. In a previous survey, ophthalmoplegia was initially present in 50% of patients with iatrogenic occlusion of the ophthalmic artery and its branches after cosmetic facial filler injections, and 33% had strabismus at the final examination [5].…”

Section: Introductionmentioning

confidence: 99%

Surgical outcomes of strabismus after iatrogenic ophthalmic artery occlusion caused by cosmetic filler injections

Yang¹,

Woo²,

Kim³

et al. 2019

BMC Ophthalmol

Self Cite

View full text Add to dashboard Cite

BackgroundTo investigate the surgical outcomes of strabismus related to iatrogenic occlusion of the ophthalmic artery and its branches from cosmetic facial filler injection.MethodsA retrospective study was performed on 6 patients who underwent strabismus surgery among 23 patients who had suffered occlusion of the ophthalmic artery and its branches after cosmetic facial filler injection. Initial, preoperative and final ocular motility examinations, the type of surgery and surgical outcomes were evaluated.ResultsAt initial presentation, visual acuity was no light perception in 5 patients and hand motion in one patient. Five out of 6 patients showed initial ophthalmoplegia. Among these 5 patients, eye motility fully recovered in 3 patients although sensory strabismus developed during follow-up, while the remaining 2 patients had persistent ocular motility limitations. Strabismus surgery was performed at 2.2 ± 1.5 years after iatrogenic ophthalmic artery occlusion. Preoperatively, 5 of the 6 patients showed exotropia, and one patient had esotropia. Vertical deviation was found in 3 out of 6 patients in addition to the horizontal deviation. Successful outcome was achieved only in the 4 patients without persistent ophthalmoplegia after 1.4 ± 1.0 years from surgery. The other two patients with persistent ocular motility limitations failed to achieve successful alignment after surgery, and one patient eventually underwent evisceration due to phthisis bulbi.ConclusionsIn our study, surgical outcomes of strabismus caused by cosmetic facial filler injection were successful only in patients without persistent ophthalmoplegia at the time of surgery.

show abstract

“…The amount of soft-tissue filler injected varies according to the type of filler used, for example, autologous fat is typically injected in larger volumes compared with HA fillers. 56…”

Section: Discussionmentioning

confidence: 99%

Soft-tissue Filler–associated Blindness: A Systematic Review of Case Reports and Case Series

Chatrath

Banerjee²,

Goodman

et al. 2019

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

Background: With the increase in the use of soft-tissue fillers worldwide, there has been a rise in the serious adverse events such as vascular compromise and blindness. This article aims to review the role of fillers in causing blindness and the association between hyaluronic acid (HA) filler and blindness. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were used to report this review. Results: A total of 190 cases of blindness due to soft-tissue fillers were identified, of which 90 (47%) cases were attributed to autologous fat alone, and 53 (28%) cases were caused by HA. The rest of the cases were attributed to collagen, calcium hydroxylapatite, and other fillers. Conclusions: Autologous fat was the most common filler associated with blindness despite HA fillers being the most commonly used across the globe. However, the blindness caused by other soft-tissue fillers like collagen and calcium hydroxylapatite was represented. It was also evident through the review that the treatment of HA-related blindness was likely to have better outcomes compared with other fillers due to hyaluronidase use.

show abstract

Ophthalmoplegia as a complication of cosmetic facial filler injection

Cited by 24 publications

References 5 publications

A Consensus on Minimizing the Risk of Hyaluronic Acid Embolic Visual Loss and Suggestions for Immediate Bedside Management

A Consensus on Minimizing the Risk of Hyaluronic Acid Embolic Visual Loss and Suggestions for Immediate Bedside Management

Surgical outcomes of strabismus after iatrogenic ophthalmic artery occlusion caused by cosmetic filler injections

Soft-tissue Filler–associated Blindness: A Systematic Review of Case Reports and Case Series

Contact Info

Product

Resources

About