The Classification and Prognosis of Periocular Complications Related to Blindness following Cosmetic Filler Injection

Abstract

Therapeutic, V.

The treatment of hyaluronic acid aesthetic interventional induced visual loss (AIIVL): A consensus on practical guidance

“…In reviewing the evidence base, blindness following injection was initially described in 1963 and more recent reports show that the pattern of involvement of the surrounding periocular tissues is variable . The ophthalmological literature describes a clinical condition of Central Retinal Artery Occlusion (CRAO) .…”

“…In reviewing the evidence base, blindness following injection was initially described in 1963 8 and more recent reports show that the pattern of involvement of the surrounding periocular tissues is variable. 9 The ophthalmological literature describes a clinical condition of Central Retinal Artery Occlusion (CRAO). 10,11 Patients who smoke, are hypertensive, have a high body mass index, high serum lipid levels, diabetes, and cardiac disease, have important modifiable risk factors associated with retinal emboli; it can be hypothesized that these patients may bear the higher risk for AIIVL.…”

Vascular Complication in Aesthetic Medicine Treated with Hyperbaric Oxygenation

“…The symptoms included paling and pain at the injection site. In such an event it is required to interrupt the procedure and immediately administer hyaluronidase for the purpose of dissolving the hyaluronic acid [1,2,3,4,5]. If ulceration occurs, it is necessary to apply hyperbaric oxygenation [6].…”

“…Intravascular injections are much more serious as the administration of as little as 0.05 ml of hyaluronic acid may result in blindness [1,2,3,4,5]. Anatomic changes in the facial vessels make the procedure unpredictable.…”

Another face of dermal fillers

“…The cases of blindness after the cosmetic injection following autologous fat transfer are more likely to be attributable to intravascular embolism rather than external pressure on the vessel [18]. Myung et al classified periocular complications related to blindness following HA fillers into type I (blindness without ptosis or ophthalmoplegia), type II (blindness and ptosis without ophthalmoplegia), type III (blindness and ophthalmoplegia without ptosis), and type IV (blindness with ptosis and ophthalmoplegia) [26]. Improved visual acuity in patients with vascular occlusion after a filler injection is extremely rare.…”