Akeyna reposted this
Associate Professor of Dermatology at Harvard Medical School; Director of Magic Wand Initiative; Physician Scientist at Wellman Center/MGH; Innovator; Biotech co-Founder; Co-Founder & President of Face of Angel nonprofit
There should be more research, education and conversation about this dreadful and serious side effect from cosmetic fillers. Many patients don’t even know they can get blindness from fillers.
Honorary Fellowship in Cosmetic Surgery @ Australian College of Cosmetic Surgery and Medicine | Botox, Dermatopathology
Significant Vision Recovery from Filler-Induced Complete Blindness with Combined Intra-Arterial Injection of Hyaluronidase and Thrombolytic Agents Ha H. Nguyen1 • Huyen T. T. Tran1 • Quan H. Duong1 • Minh D. Nguyen2 • Hai X. Dao3 • Dung T. Le3 Received: 5 May 2021 / Accepted: 23 October 2021 / Published online: 12 November 2021 Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2021 Abstract With the increase of cosmetic injectable hyaluronic acid (HA), there have been more cases with serious complications, including skin necrosis, blindness, and cerebral embolism. Patients who have recovered from HA filler-induced total vision loss are extremely rare. We report a case of a 27-year-old female who developed severe ocular pain on the right side and total vision loss following a 1.0 ml HA filler injection in the nasal dorsum. She arrived at our hospital 4 hours later. Her visual acuity was no light perception (NLP), and she exhibited eyelid ptosis, ophthalmoplegia, and frontal and nasal ecchymosis. She was promptly treated with subcutaneous and retrobulbar hyaluronidase injections, as well as intra-arterial 1500 IU hyaluronidase injections into the right ophthalmic artery with DSA assistance. Her vision improved from NLP to counting fingers at 1.0 meters. Unfortunately, 13 hours later, she felt an intense headache, and her vision again decreased to NLP. We immediately performed an injection of 1500 IU hyaluronidase combined with 8 mg alteplase for intra-arterial thrombolysis (IAT) into the right ophthalmic artery. Her vision improved immediately afterward. After 3 months, her visual acuity had significantly recovered from NLP (admission vision status) to 20/50 (Snellen chart with glasses). Similarly, skin, conjunctival, eye movement, and ptosis symptoms completely recovered. This case demonstrates that reversal of complete blindness due to embolism of the ophthalmic and central retinal arteries could be accomplished through multidisciplinary therapies, especially IAT using fibri- nolytic agents combined with hyaluronidase followed by an anticoagulant regimen. Level of evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www. springer.com/00266. Keywords Filler complications Hyaluronic acid Intra- arterial thrombolysis Ophthalmic artery Central retinal artery Vision loss