Fundus artery occlusion caused by cosmetic facial injections
Fundus artery occlusion caused by cosmetic facial injections
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DOI：
10.3760/cma.j.issn.0366-6999.20133254
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发表时间：
2014-04-20
影响因子：
6.1
通讯作者：
Lu Ning
中科院分区：
文献类型：
--
作者：
Chen Yanyun;Wang Wenying;Lu Ning
背景近年来，随着面部填充物美容注射的日益普及，相关并发症也越来越多。然而，迄今为止，对引起这种并发症的手术方法和预防措施还没有很好的研究。本研究旨在探讨面部填充物注射所致眼底动脉阻塞的临床特点和视力预后。主要结果的措施是填充材料，注射部位，最佳矫正视力（BCVA），荧光素眼底血管造影，以及相关的眼部和全身的mappings.Results 11例患者眼动脉阻塞（OAO）和1例患者各有视网膜中央动脉阻塞（CRAO）和前部缺血性视神经病变（AION）。注射材料包括自体脂肪（7例）、透明质酸（5例）和骨胶原（1例）。注射部位为额区（5例）、眼周区（2例）、颞区（2例）、鼻区和鼻区（4例）。注射自体脂肪与比透明质酸更差的最终BCVA相关。7例额颞部注射自体脂肪患者的最佳矫正视力均为无光感。大部分OAO患者有眼痛、头痛、上睑下垂、眼肌麻痹等症状，最终最佳矫正视力无改善。自体脂肪注射往往与疼痛性失明、上睑下垂、眼肌麻痹和视力不良有关。自体脂肪注射的预后比透明质酸注射差得多。
Background With the increasing popularity of cosmetic facial filler injections in recent years, more and more associated complications have been reported. However, the causative surgical procedures and preventative measures have not been studied well up to now. The aim of this stady was to investigate the clinical characteristics and visual prognosis of fundus artery occlusion resulting from cosmetic facial filler injections.Methods Thirteen consecutive patients with fundus artery occlusion caused by facial filler injections were included. Main outcome measures were filler materials, injection sites, best-corrected visual acuity (BCVA), fundus fluorescein angiography, and associated ocular and systemic manifestations.Results Eleven patients had ophthalmic artery occlusion (OAO) and one patient each had central retinal artery occlusion (CRAO) and anterior ischemic optic neuropathy (AION). Injected materials included autologous fat (seven cases), hyaluronic acid (five cases), and bone collagen (one case). Injection sites were the frontal area (five cases), periocular area (two cases), temple area (two cases), and nose area and nasal area (4 cases). Injected autologous fat was associated with worse final BCVA than hyaluronic acid. The BCVA of seven patients with autologous fat injection in frontal area and temple area was no light perception. Most of the patients with OAO had ocular pain, headache, ptosis, ophthalmoplegia, and no improvement in final BCVA.Conclusions Cosmetic facial injections can cause fundus artery occlusion. Autologous fat injection tends to be associated with painful blindness, ptosis, ophthalmoplegia, and poor visual outcomes. The prognosis is much worse with autologous fat injection than hyaluronic acid injection.