Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok, 10400, Thailand.
Department of Interventional Neuroradiology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Aesthetic Plast Surg. 2022 Feb;46(1):450-455. doi: 10.1007/s00266-021-02414-0. Epub 2021 Jul 6.
Facial rejuvenation and reconstruction with autologous fat injection are a common and effective procedure used worldwide. Most surgeons and patients are satisfied with the favorable outcomes. However, catastrophic complications from arterial and venous occlusion resulting in visual loss and stroke may occur.
We herein report a case of isolated venous occlusion from fat embolism. The patient developed acute painful proptosis and blurred vision of her right eye while undergoing an esthetic autologous fat injection into her forehead. Based on her clinical manifestations and radiologic findings, the patient was diagnosed with superior ophthalmic vein occlusion. Symptomatic and supportive treatments were given. Spontaneous clinical improvement occurred without secondary complications. Therefore, the initially planned endovascular therapy with transfemoral transvenous embolectomy of the right superior ophthalmic vein was canceled.
Facial augmentation with autologous fat injection can cause superior ophthalmic vein embolism. Surgeons should therefore perform this procedure very cautiously. Prompt ophthalmological evaluation and proper management are important for improving clinical outcomes.
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自体脂肪注射进行面部年轻化和重建是一种在全球范围内普遍且有效的方法。大多数外科医生和患者对其良好的效果均表示满意。然而,动脉和静脉阻塞可导致视力丧失和中风等灾难性并发症。
我们在此报告一例因脂肪栓塞引起的单纯静脉阻塞。患者在接受额部自体脂肪注射进行美容时,出现右眼急性疼痛性眼球突出和视力模糊。根据她的临床表现和影像学发现,患者被诊断为眼上静脉阻塞。给予对症和支持治疗。自发性临床改善发生,无继发性并发症。因此,最初计划对右眼的 superior ophthalmic vein 进行经股静脉经腔顺行取栓的血管内治疗被取消。
自体脂肪注射进行面部填充可能会导致眼上静脉栓塞。因此,外科医生在进行此操作时应非常谨慎。及时的眼科评估和适当的治疗对于改善临床结果很重要。
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