In the last article, we reviewed a study titled Iatrogenic Occlusion of the Ophthalmic Artery After Cosmetic Facial Filler Injections which was at the center of the controversy over glabella and periorbital injections of dermal filler. This study, published in the Korean Retina Society Journal, dealt with vision loss and other ophthalmologic complications of dermal filler injections and autologous fat transfer. In this article, we will take a closer look at the Korean Retina Society’s data on vision loss, a very serious complication of dermal filler treatments.

 

Causes

 

The injection sites associated with vision loss differ slightly depending on the study. According to the, Korean Retina Society’s data collected from 44 Korean patients, glabella was the most common site associated with vision loss with 26 patients (59%), followed by the nasolabial lines in 11 patients (25%) and the nose in 10 (23%).

 

This is similar to Ozturk et al.’s data in 12 cases of vision loss, among which 6 were associated with the site in the glabella, 4 with the nose, 1 with the forehead, and 1 with the periorbital area (Image 1).

Image 1. The number of cases with vision loss among 44 patients receiving dermal filler injections; Korean Retina Society’s data

 

One has to be aware that vision loss could arise from not just dermal filler but any foreign substance including autologous fat that is subcutaneously injected and blocks blood vessels.  

 

According to the Korean Retina Society’s report, among all cases of vision loss, 22 (50%) had received autologous fat transfer, 13 (30%) had received hyaluronic acid (HA) injection, 4 (9%) had received collagen injection, and 5 (11%) had received other. Autologous fat and HA have the highest rates of vision loss probably because they are the most frequently used materials in clinical practice.

 

[Advertisement] A-One LITE(Facial Diagnosys System) – Manufacturer: BOMTECH(www.bomtech.net)

 

Other injectables used in the face include polymethylmethacrylate (PMMA), poly-L-lactide acid (PLLA), calcium hydroxyapatite (CaHa), injectable dermal matrix, corticosteroid, paraffin and silicone oil, etc. (Table 1). As HA is associated with a high rate of vision loss, one should practice great caution when performing HA injections.

 

-To be continued