Or Lior, Eviatar Joseph A, Massry Guy G, Bernardini Francesco P, Hartstein Morris E
*Assaf Harofeh Medical Center, Tzrifin, Israel; †Chelsea Eye and Cosmetic Surgery, New York, New York, ‡University of Southern California, Los Angeles, California, U.S.A.; and §Oculoplastica Bernardini, Milan, Italy.
Ophthalmic Plast Reconstr Surg. 2017 Jul/Aug;33(4):244-247. doi: 10.1097/IOP.0000000000000722.
The purpose of this study is to describe a new complication of a xanthelasma-like reaction which appeared after dermal filler injection in the lower eyelid region.
A retrospective case analysis was performed on 7 patients presenting with xanthelasma-like reaction after filler injection to the lower eyelids.
Seven female subjects with no history of xanthelasma presented with xanthelasma-like reaction in the lower eyelids post filler injection. Fillers included hyaluronic acid (2 patients), synthetic calcium hydroxyapatite (4 patients), and polycaprolactone microspheres (one patient). Average time interval between filler injection and development of xanthelasma-like reaction was 12 months (range: 6-18 months). Treatment included steroid injections, 5FU injections, ablative or fractionated CO2 laser, and direct excision. Pathology confirmed the lesion was a true xanthelasma in one patient. In treated patients, there was subtotal resolution after laser. Xanthelasma-like reaction resolved completely after direct excision. Three patients elected to have no treatment.
Previously there has been one reported case of xanthelasma after filler injection. This case series is the largest to date. Furthermore, this series is notable because xanthelasma-like reactions appeared after injection with 3 different types of fillers. None of the patients had evidence of xanthelasma prefiller injection. The precise mechanism by which filler injection can lead to the formation of xanthelasma-like reaction is unclear. A possible mechanism may be related to binding of low-density lipoprotein and internalization by macrophages. Further investigation is required. Nevertheless, physicians performing filler injections should be aware of this new complication and treatment options.
本研究旨在描述一种在下眼睑区域注射真皮填充剂后出现的睑黄瘤样反应的新并发症。
对7例在下眼睑注射填充剂后出现睑黄瘤样反应的患者进行回顾性病例分析。
7名无睑黄瘤病史的女性受试者在填充剂注射后在下眼睑出现睑黄瘤样反应。填充剂包括透明质酸（2例）、合成羟基磷灰石（4例）和聚己内酯微球（1例）。填充剂注射与睑黄瘤样反应发生之间的平均时间间隔为12个月（范围：6 - 18个月）。治疗方法包括类固醇注射、5-氟尿嘧啶注射、剥脱性或分次二氧化碳激光治疗以及直接切除。病理证实1例患者的病变为真性睑黄瘤。在接受治疗的患者中，激光治疗后部分消退。直接切除后睑黄瘤样反应完全消退。3例患者选择不进行治疗。
此前曾有1例注射填充剂后出现睑黄瘤的报道。该病例系列是迄今为止最大的。此外，该系列值得注意的是，在注射3种不同类型的填充剂后均出现了睑黄瘤样反应。所有患者在注射填充剂前均无睑黄瘤证据。填充剂注射导致睑黄瘤样反应形成的确切机制尚不清楚。一种可能的机制可能与低密度脂蛋白的结合以及巨噬细胞的内化有关。需要进一步研究。然而，进行填充剂注射的医生应意识到这种新的并发症及治疗选择。
