*Oculoplastica Bernardini, Genova, Italy; †Ophthalmology Department, Dunyagoz Ankara Hastanesi, Ankara, Turkey; and ‡Consultores Oftalmológicos, Buenos Aires, Argentina.
Ophthalmic Plast Reconstr Surg. 2014 Jan-Feb;30(1):34-9. doi: 10.1097/IOP.0000000000000001.
To describe the authors experience with calcium hydroxyl-apatite (CaHa) injections for the aesthetic correction of tear trough, infraorbital hollows, deep upper sulcus, dark circles and lower eyelid bags.
The records of 63 patients (127 eyelids) injected with CaHa for aesthetic rejuvenation of the periocular region between March 2012 and March 2013 were retrospectively evaluated. All injections were carried out using a 25-gauge cannula after adding 0.5 ml of 2% lidocaine to 1.5 ml vials of the original product. Postoperative visits were scheduled at 1 week and 1 month. Any previous treatment was recorded, and necessity of retreatments and side effects was evaluated. Patient satisfaction was recorded at 1 month with self-evaluation of the treatment result as "worsened," "unchanged," or "improved." Standard pre- and postinjection photographs were taken and compared to analyze the success of the procedure. Pictures were retrospectively graded by the authors on a similar improvement scale of 1 (worse), 2 (no change), and 3 (improvement).
Fifty-eight/sixty-three patients were women (92%), with an average age of 42 years (range; 18-57 years). Chief complaints were "hollows" in 94% of patients, "dark circles" in 33%, lower eyelid "bags" in 17%, and deep upper sulcus in 4.7%. Twenty-three patients (36.5%) required an additional correction 1 month after the primary treatment. Satisfaction was as high as 98% among patients treated primarily for hollowness, and the overall satisfaction rate was 92%. Associated dark circles were satisfactorily treated in 68% of the patients. Temporary side effects involved mild erythema and swelling for 2 to 3 days and pseudoxanthalesma effect in 22 eyelids (17.4%) lasting <6 weeks. In 2 patients, erythema lasted longer than 4 weeks. The 2 worse complications in this series were migration of the product above the medial canthal tendon in 1 patient and overcorrection in another patient. These complications were all managed conservatively and resolved spontaneously within 6 to 8 weeks. No case of irregular contour, palpable lumpiness, or unevenness were encountered. In the end, only 1 patient thought she was worsened after the treatment.
Treatment of the periocular region with CaHa injections is a safe and effective treatment with high patient satisfaction and low complication rate. Advanced technical skills may have to be acquired for the specific treatment of this area using this particulate material.
描述作者使用羟基磷灰石（CaHa）注射治疗泪槽、眶下凹陷、深上睑沟、黑眼圈和下眼睑袋的经验。
回顾性分析 2012 年 3 月至 2013 年 3 月期间 63 例（127 只眼）接受 CaHa 注射进行眶周美学年轻化治疗的患者记录。所有注射均在添加 0.5 毫升 2%利多卡因至 1.5 毫升原始产品小瓶后使用 25 号套管进行。术后 1 周和 1 个月安排随访。记录任何先前的治疗情况，并评估是否需要再次治疗以及是否有副作用。1 个月时通过患者自我评价治疗结果为“恶化”、“不变”或“改善”来记录患者满意度。术前和术后均拍摄标准照片，并进行比较以分析手术的成功程度。作者对照片进行回顾性分级，采用相似的改善程度 1（更差）、2（无变化）和 3（改善）进行评分。
63 例患者中 58 例（92%）为女性，平均年龄为 42 岁（范围：18-57 岁）。主要主诉为 94%的患者存在“凹陷”，33%的患者存在“黑眼圈”，17%的患者存在“下眼睑袋”，4.7%的患者存在“深上睑沟”。23 例（36.5%）患者在初次治疗后 1 个月需要进一步矫正。初次治疗主要用于治疗凹陷的患者中，满意度高达 98%，总体满意度为 92%。68%的患者可满意治疗相关的黑眼圈。暂时性副作用包括 2-3 天的轻度红斑和肿胀，22 只眼（17.4%）出现假性黄瘤效应，持续时间<6 周。2 例患者的红斑持续时间超过 4 周。本系列中 2 例更严重的并发症为 1 例患者的产品迁移至内眦腱上方，另 1 例患者出现过度矫正。这些并发症均通过保守治疗解决，且在 6-8 周内自发缓解。未出现轮廓不规则、可触及的肿块或不平坦等情况。最后，只有 1 例患者认为治疗后情况恶化。
使用 CaHa 注射治疗眶周区域是一种安全有效的治疗方法，患者满意度高，并发症发生率低。使用这种颗粒状物质对该区域进行特定治疗可能需要掌握先进的技术技能。
