Department of Ophthalmology and Otolaryngology/Head and Neck Surgery, Saint Louis University, St Louis, Missouri, USA.
Ophthalmic Plast Reconstr Surg. 2012 Sep-Oct;28(5):335-7. doi: 10.1097/IOP.0b013e31825ca73e.
To describe the complication of anterior filler displacement following injection of calcium hydroxylapatite gel (Radiesse) for anophthalmic enophthalmos correction.
Retrospective case series of patients who experienced anterior filler displacement following orbital injection of calcium hydroxylapatite. Data includes patient demographics, indication for injection, route and volume of injection, description of postinjection complications, and final outcome.
Four cases of anterior filler displacement and expansion following injection of calcium hydroxylapatite were identified. The patients' ages ranged from 33 to 64 years old. All 4 patients underwent multiple prior orbital surgeries and suffered from anophthalmic enophthalmos. Injectable calcium hydroxylapatite was delivered transcutaneously, to the deep extraconal orbital space, via 27-gauge, 1.25-inch retrobulbar needles. Each patient received an initial 1.3 ml of filler, with 1 patient receiving an additional 0.8 ml. Within 1 week, all patients experienced prominent, edematous lower eyelids. A CT scan of 1 patient radiographically documented anterior migration of the filler material. Two patients required transconjunctival excision of the filler and infiltrated orbital fat. Histopathologic examination of 1 specimen revealed chronic foreign body granulomatous inflammation. Two patients were treated medically, with resolution of clinical findings over 6 to 9 months.
Anterior filler displacement is a potential complication of orbital volume augmentation with injectable calcium hydroxylapatite. Patients should be counseled regarding this possibility when considering options for the treatment of anophthalmic enophthalmos. A history of multiple prior orbital surgeries, with associated tissue disruption and scarring, may be a risk factor for filler displacement.
描述注射钙羟磷灰石凝胶（Radiesse）矫正无眼窝凹陷时前填充物移位的并发症。
回顾性病例系列，研究对象为接受眶内注射钙羟磷灰石后发生前填充物移位的患者。数据包括患者人口统计学资料、注射适应证、注射途径和注射量、注射后并发症描述以及最终结果。
共发现 4 例注射钙羟磷灰石后发生前填充物移位和扩张的病例。患者年龄为 33 岁至 64 岁。所有 4 例患者均接受过多次眼眶手术，患有无眼窝凹陷。可注射性钙羟磷灰石通过 27 号、1.25 英寸的球后针经皮注射到深部眶外间隙。每位患者初始接受 1.3 毫升填充物，1 例患者额外接受 0.8 毫升。1 周内，所有患者均出现明显的眼睑水肿。1 例患者的 CT 扫描显示填充物材料的前向迁移。2 例患者需要经结膜切除填充物和浸润性眶内脂肪。1 例标本的组织病理学检查显示慢性异物肉芽肿性炎症。2 例患者接受了药物治疗，6 至 9 个月后临床症状缓解。
前填充物移位是注射用钙羟磷灰石眶容积增大的潜在并发症。在考虑治疗无眼窝凹陷的方案时，应向患者说明这种可能性。多次眼眶手术史，伴组织破坏和瘢痕形成，可能是填充物移位的危险因素。
