Carruthers Jean D A, Fagien Steve, Rohrich Rod J, Weinkle Susan, Carruthers Alastair
Vancouver, British Columbia, Canada From the University of British Columbia.
Plast Reconstr Surg. 2014 Dec;134(6):1197-1201. doi: 10.1097/PRS.0000000000000754.
Vascular occlusion causing blindness is a rare yet greatly feared complication of the use of facial aesthetic fillers. The authors performed a review of the aesthetic literature to ascertain the reported cases of blindness and the literature reporting variations in the vascular anatomy of the human face. The authors suggest a small but potentially helpful addition to the accepted management of the acute case. Cases of blindness, mostly irreversible, from aesthetic filler injections have been reported from Asia, Europe, and North America. Autologous fat appears to be the most frequent filler causing blindness. Some cases of partial visual recovery have been reported with hyaluronic acid and calcium hydroxylapatite fillers. The sudden profusion of new medical and nonmedical aesthetic filler injectors raises a new cause for alarm about patient safety. The published reports in the medical literature are made by experienced aesthetic surgeons and thus the actual incidence may be even higher. Also, newer injectors may not be aware of the variations in the pattern of facial vascular arborization. The authors present a summary of the relevant literature to date and a suggested helpful addition to the protocols for urgent management.
血管阻塞导致失明是面部美容填充剂使用中一种罕见但令人极为恐惧的并发症。作者对美容文献进行了回顾，以确定已报道的失明病例以及报道人类面部血管解剖变异的文献。作者建议在急性病例的公认处理方法中增加一项虽小但可能有用的措施。亚洲、欧洲和北美均有报道称，美容填充剂注射导致失明的病例，多数为不可逆性失明。自体脂肪似乎是导致失明最常见的填充剂。有报道称，使用透明质酸和羟基磷灰石钙填充剂后出现了部分视力恢复的情况。新涌现的医学和非医学美容填充剂注射者数量突然增多，这引发了对患者安全的新担忧。医学文献中的已发表报告由经验丰富的美容外科医生撰写，因此实际发生率可能更高。此外，新的注射者可能并不了解面部血管分支模式的变异情况。作者总结了迄今为止的相关文献，并对紧急处理方案提出了一项建议性的有用补充措施。
