Verification of Embolic Channel Causing Blindness Following Filler Injection
Verification of Embolic Channel Causing Blindness Following Filler Injection
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DOI：
10.1007/s00266-014-0426-z
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发表时间：
2015-02
影响因子：
2.4
通讯作者：
T. Tansatit;Hyoung-Jin Moon;Prawit Apinuntrum;Thavorn Phetudom
中科院分区：
文献类型：
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作者：
T. Tansatit;Hyoung-Jin Moon;Prawit Apinuntrum;Thavorn Phetudom
背景：美容填充剂注射后的眼部并发症是很严重的情况。本研究为面部及颞浅动脉内的填充物进入眶内及双侧球内提供了科学依据。我们证明了一个连接面部动脉系统和眼动脉的栓塞通道的存在。方法对6具软质防腐尸体取下双眼眼球内容物后，分别在颞骨浅动脉空腔通道内注射液体染料，并在两侧面动脉内先后注射不同颜色的染料。监测巩膜内是否有眼内灌注染色渗出。结果12个球体中，12条颞浅动脉的染料注射进入3个同侧球体，2个对侧球体。将面部动脉的染料注入5个同侧球和3个对侧球。同一具尸体的两条面部动脉的染料注射导致双侧球体染色，而颞浅动脉的染色则没有。在24条注射动脉中，有14条插管针中心滴下染料，证实了4条插管动脉的相同动脉和不同动脉之间的直接联系。在14例动脉注射中，有11例因眶缘上鼻角受压而延缓眼部注射。结论在某些有利于栓塞的特定条件下，面部与眼间持续的动脉间吻合术可使填充物栓塞流入眼球，引起眼部并发症。未指定水平本刊要求作者为每份提交的证据指定一个证据水平，以适用循证医学排名。这不包括评论文章、书评和涉及基础科学、动物研究、尸体研究和实验研究的手稿。有关这些循证医学评级的完整描述，请参阅目录或在线作者说明http://www.springer.com/00266。
BackgroundOcular complications following cosmetic filler injections are serious situations. This study provided scientific evidence that filler in the facial and the superficial temporal arteries could enter into the orbits and the globes on both sides. We demonstrated the existence of an embolic channel connecting the arterial system of the face to the ophthalmic artery.MethodsAfter the removal of the ocular contents from both eyes, liquid dye was injected into the cannulated channel of the superficial temporal artery in six soft embalmed cadavers and different color dye was injected into the facial artery on both sides successively. The interior sclera was monitored for dye oozing from retrograde ophthalmic perfusion.ResultsAmong all 12 globes, dye injections from the 12 superficial temporal arteries entered ipsilateral globes in three and the contralateral globe in two arteries. Dye from the facial artery was infused into five ipsilateral globes and in three contralateral globes. Dye injections of two facial arteries in the same cadaver resulted in bilateral globe staining but those of the superficial temporal arteries did not. Direct communications between the same and different arteries of the four cannulated arteries were evidenced by dye dripping from the cannulating needle hubs in 14 of 24 injected arteries. Compression of the orbital rim at the superior nasal corner retarded ocular infusion in 11 of 14 arterial injections.ConclusionUnder some specific conditions favoring embolism, persistent interarterial anastomoses between the face and the eye allowed filler emboli to flow into the globe causing ocular complications.No Level AssignedThis journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .