Department of Plastic and Reconstructive Surgery, Shaare-Zedek Medical Center, Jerusalem, Israel.
The Hebrew University Medical School, Jerusalem, Israel.
J Cosmet Dermatol. 2021 Aug;20(8):2409-2413. doi: 10.1111/jocd.14279. Epub 2021 Jun 17.
Over the years, botulinum toxin has found its place as a neuromuscular blocking agent in numerous medical fields. Since the approval of botulinum toxin by the FDA for cosmetic indications in 2002, it had become the most commonly performed esthetic procedure worldwide, with ever-growing demand. The characteristics of the toxin, along with the facial areas it is injected to, could possibly account for a wide array of complication.
The authors conducted a literature search for reported cases of ophthalmic adverse events following Botulinum toxin facial injections in the electronic databases of PubMed and Cochrane Library databases.
The authors found 25 publications, reporting 49 cases of ophthalmic adverse events following botulinum toxin injections. Injections for cosmetic indications accounted for 51% of all injections, treatment of blepharospasms for 22% of cases, protective ptosis for 11% of cases, and treatment of hemifacial spams for 8% of cases. The average quantity of botulinum toxin injected to a single patient ranged between 1.25 and 75 units, with a median of 13.75 units.Majority of injections for cosmetic indications were performed to the lateral canthal area (56%), followed by the glabella (28%) and the forehead (20%).Adverse events following injections included diplopia (64%), ptosis (14%), and decrease in visual acuity or vision loss (8%).
Botulinum toxin is gaining extreme popularity in the management of a wide area of diseases and for cosmetic indications. Proper knowledge of potential adverse events is crucial for the clinician in attempt to decrease complications.
多年来，肉毒毒素已在许多医学领域作为神经肌肉阻滞剂得到广泛应用。自 2002 年 FDA 批准肉毒毒素用于美容适应症以来，它已成为全球最常见的美容程序，需求不断增长。该毒素的特性以及注射到的面部区域可能导致多种并发症。
作者在 PubMed 和 Cochrane Library 数据库的电子数据库中对已发表的肉毒毒素面部注射后眼部不良事件的病例报告进行了文献检索。
作者发现了 25 篇出版物，报告了 49 例肉毒毒素注射后眼部不良事件。出于美容目的的注射占所有注射的 51%，治疗眼睑痉挛占 22%，预防上睑下垂占 11%，治疗面肌痉挛占 8%。单次注射的肉毒毒素平均剂量为 1.25 至 75 单位，中位数为 13.75 单位。出于美容目的的注射大多集中在眼外角区域（56%），其次是眉间（28%）和额头（20%）。注射后的不良事件包括复视（64%）、上睑下垂（14%）和视力减退或视力丧失（8%）。
肉毒毒素在治疗广泛疾病和美容适应症方面越来越受欢迎。临床医生必须充分了解潜在的不良反应，以尽量减少并发症。
