Corneoplastic Unit, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, Sussex, United Kingdom.
Ophthalmic Plast Reconstr Surg. 2009 Sep-Oct;25(5):394-7. doi: 10.1097/IOP.0b013e3181b3ac71.
To review our experience with the long-term orbitofacial complications of polyalkylimide 4% (Bio-Alcamid), including migration, infection, and recurrent swelling.
A retrospective case series of 4 patients who received preperiosteal polyalkylimide 4% filler treatment: 3 patients received treatment to cheeks and/or nasolabial folds and 1 received treatment to the tear-trough region. All 4 patients were referred with delayed complications.
Four patients presented with the unusual delayed complications of infection including abscess formation, migration of filler, recurrent swelling, and inflammatory nodules.
Because of the hydrophilic and endoprosthetic nature of polyalkylimide 4%, migration of the product is unexpected. We hypothesise that in our patients, filler migration occurred after bimanual expression and/or manipulation of the product with disruption of the surrounding collagen capsule. Because removal of polyalkylimide 4% is only achieved via aspiration and bimanual expression, which itself may precipitate long-term migration of the product, it is vital that clinicians are mindful of these complications and the pitfalls of overfill and misplacement of the product, for informed patient consent.
回顾我们在聚亚烷基酰胺 4%（Bio-Alcamid）长期眶面并发症方面的经验，包括移位、感染和复发性肿胀。
对 4 名接受聚亚烷基酰胺 4%填充剂治疗的患者进行回顾性病例系列研究：3 名患者接受颊部和/或鼻唇沟治疗，1 名患者接受泪槽区治疗。所有 4 名患者均因延迟性并发症就诊。
4 名患者出现了不常见的迟发性并发症，包括脓肿形成、填充物移位、复发性肿胀和炎症性结节。
由于聚亚烷基酰胺 4%的亲水性和内假体性质，产品的移位是出乎意料的。我们假设在我们的患者中，填充物的移位发生在双手挤压和/或操作产品后，破坏了周围的胶原胶囊。由于只能通过抽吸和双手挤压来去除聚亚烷基酰胺 4%，这本身可能导致产品的长期移位，因此临床医生必须注意这些并发症，以及过度填充和产品错位的陷阱，以便为患者提供知情同意。
