【 文献重点摘要 】

Background

Soft tissue filler is commonly used for facial contouring. However, incorrect use can lead to severe ocular complications. Even though filler injections are quite different from fat grafts, they are considered similar procedures. However, to date, there are no proven preventive measures or treatments for blindness secondary to soft tissue filler injections.

Objectives

This literature review aimed to investigate visual compromise secondary to soft tissue filler injection and discuss the related vascular anatomy, pathophysiology, and prevention of ocular complications of soft tissue filler injections.

Methods

A literature search until July 2018 was performed for reports on visual compromise after filler injections. We evaluated the previous literature and eliminated cases using fat grafts and unknown fillers.

Results

A total of 50 reports of filler‐induced visual compromise were identified. Analysis of these cases showed that the procedure with greatest risk was nasal augmentation, followed by glabellar wrinkle treatment. Within the last 3 years searched, 35% of reported cases involved treatment of the nose. There were no reports of blindness from injections into the temple or chin and relatively few case reports in‐ volving forehead injections.

Conclusion

The most common injection site associated with blindness in a previous report was the glabella; however, the most common site currently associated with blindness due to filler injections was the nose. Extreme caution is necessary when performing nasal augmentation or glabellar wrinkle correction using soft tissue fillers to avoid the branches of the internal carotid artery.

KEYWORDS

blindness, filler, hyaluronic acid, ophthalmoplegia, visual impairment

背景

软组织填充剂常用于面部整形。然而，不正确的使用会导致严重的眼部并发症。尽管填充剂注射与脂肪移植有很大不同，但它们被认为是相似的程序。然而，到目前为止，对于继发于软组织填充剂注射的失明，还没有成熟的预防措施或治疗方法。

目的

本文旨在研究软组织填充剂注射后的视觉损害，并讨论软组织填充剂注射的相关血管解剖、病理生理学和眼部并发症的预防。

方法

对2018年7月之前的文献进行检索，寻找关于填充物注射后视觉损害的报告。我们评估了以前的文献，排除了使用脂肪移植物和未知填充物的病例。

结果

共发现50例填充物导致的视觉损害。对这些病例的分析表明，风险最大的手术是隆鼻，其次是眉间皱纹治疗。在最近3年的搜索中，35%的报告病例涉及鼻子的治疗。没有关于向太阳穴或下巴注射致盲的报告，涉及前额注射的病例报告相对较少。

结论

以往报道中最常见的致盲注射部位是眉间；然而，目前与填充物注射导致失明相关的最常见部位是鼻子。当使用软组织填充剂进行隆鼻或眉间除皱以避开颈内动脉分支时，必须格外小心。

关键词

失明、填充物、透明质酸、眼肌麻痹、视力受损