Arvind Kumar Morya, Academic Editor, Doctor, Professor, Researcher, Science Editor, Senior Lecturer, Senior Researcher, Surgeon, Department of Ophthalmology, All India Institute of Medical Sciences, Bibi Nagar, Hyderabad 508126, Telangana, India. bulbul.morya@gmail.com
Research Domain of This Article
Ophthalmology
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Dec 6, 2024; 12(34): 6736-6739 Published online Dec 6, 2024. doi: 10.12998/wjcc.v12.i34.6736
Ophthalmic complications of injectable facial fillers
Prateek Nishant, Arvind Kumar Morya, Sony Sinha, Ranjeet Kumar Sinha
Prateek Nishant, Department of Ophthalmology, ESIC Medical College, Patna 801103, Bihar, India
Arvind Kumar Morya, Department of Ophthalmology, All India Institute of Medical Sciences, Hyderabad 508126, Telangana, India
Sony Sinha, Department of Ophthalmology-Vitreo-Retina, Neuro-Ophthalmology and Oculoplasty, All India Institute of Medical Sciences, Patna 801507, Bihar, India
Ranjeet Kumar Sinha, Department of Community Medicine, Patna Medical College, Patna 800004, Bihar, India
Author contributions: Morya AK designed the research; Nishant P and Sinha RK performed the research; Sinha S and Sinha RK analyzed data and wrote the letter; and Nishant P revised the letter.
Conflict-of-interest statement: The authors declare that there are no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Arvind Kumar Morya, Academic Editor, Doctor, Professor, Researcher, Science Editor, Senior Lecturer, Senior Researcher, Surgeon, Department of Ophthalmology, All India Institute of Medical Sciences, Bibi Nagar, Hyderabad 508126, Telangana, India. bulbul.morya@gmail.com
Received: June 4, 2024 Revised: September 18, 2024 Accepted: September 25, 2024 Published online: December 6, 2024 Processing time: 129 Days and 21.7 Hours
Abstract
The recently published mini-review article by Miotti et al is an effort to clarify various aspects regarding the choice between fat grafts and fillers in facial aesthetic surgery. One of the complications associated with the administration of fillers is the possibility of vascular injury and spread of the dermal filler into the orbit, causing unexpected effects at a site distant from that of the initial injection, including ophthalmoplegia, ptosis and even visual compromise. Acute vision loss following filler injection is a devastating complication, occurring in up to 0.0008% of cases. The greatest risk of this complication occurs with nasal augmentation, followed by glabellar wrinkle treatment. While injected autologous fat predominantly occludes the proximal portion of the ophthalmic artery, hyaluronic acid fillers obstruct the ophthalmic artery comparatively distally. Treatment interventions include thrombolysis, hyperbaric oxygen therapy, oral aspirin, cobamamide and acetazolamide and administration of corticosteroids. However, most studies show a poor prognosis in the form of partial or no recovery of vision. Hence, prevention is of paramount importance. A high index of suspicion is also warranted on the part of both those administering as well as receiving injections of facial fillers to prevent potentially vision-threatening complications of this seemingly innocuous procedure.
Core Tip: The recently published mini-review article by Miotti et al is an effort to clarify various aspects regarding the choice between fat grafts and fillers in facial aesthetic surgery. One of the complications associated with the administration of fillers is the possibility of vascular injury and spread of the dermal filler into the orbit, causing unexpected effects at a site distant from that of the initial injection, including ophthalmoplegia, ptosis and even visual compromise. Acute vision loss following filler injection is a devastating complication, occurring in up to 0.0008% of cases.
