Monash University and Chief of Surgery at the Skin and Cancer Foundation, Victoria, Australia.
Griffiths University, Southport, Queensland, Australia.
Aesthet Surg J. 2020 Aug 14;40(9):1009-1021. doi: 10.1093/asj/sjz312.
Hyaluronic acid fillers have a satisfactory safety profile. However, adverse reactions do occur, and rarely intravascular injection may lead to blindness. Currently there is no internationally recognized consensus on the prevention or management of blindness from hyaluronic acid filler.
The authors sought to give guidance on how to minimize the risk and optimize the management of this rare but catastrophic adverse reaction.
A multinational group of experts in cosmetic injectables from multiple disciplines convened to review current best practice and develop updated consensus recommendations for prevention and bedside intervention if visual loss occurs after cosmetic injection of hyaluronic acid filler.
The consensus group provided specific recommendations focusing on the consenting process, prevention, and early management of visual impairment related to intravascular hyaluronic acid filler injection.
Although visual loss due to filler injections is rare, it is important that both patient and physician be aware of this risk. In this paper the authors describe methods and techniques available to reduce the risk and also document suggested initial management should a clinician find themselves in this situation.
透明质酸填充物具有令人满意的安全性。然而，不良反应确实会发生，而且很少发生的血管内注射可能导致失明。目前，对于如何预防或治疗透明质酸填充物导致的失明，尚无国际公认的共识。
作者旨在就如何最大限度地降低这种罕见但灾难性不良反应的风险和优化管理提供指导。
一个由来自多个学科的美容注射专家组成的多国专家组聚集在一起，审查了目前的最佳实践，并为在美容注射透明质酸填充物后发生视力丧失的情况下的预防和床边干预制定了更新的共识建议。
共识小组提供了具体建议，重点关注与血管内透明质酸填充物注射相关的知情同意过程、预防和早期视力障碍管理。
尽管由于填充物注射导致的视力丧失很少见，但患者和医生都应该意识到这种风险很重要。本文作者描述了可用于降低风险的方法和技术，还记录了在临床医生遇到这种情况时建议的初始管理方法。
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