Eye Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, 102218 Beijing, China.
Department of Burns and Plastic Surgery, Fourth Medical Center of Chinese PLA General Hospital, 100048 Beijing, China.
Front Biosci (Landmark Ed). 2022 Feb 12;27(2):59. doi: 10.31083/j.fbl2702059.
Cosmetic filler injection can cause a variety of eye complications; however, there is currently no good way to evaluate injury severity and prognosis. By analyzing the injury manifestations of severe ocular complications following cosmetic filler injection and their prognosis, we propose a new injury severity scale.
Twenty-two eyes of 22 patients experiencing ocular complications following cosmetic filler injection were followed for 6 months to observe injury characteristics, manifestations and prognosis. Best corrected visual acuity (BCVA), intraocular pressure (IOP), split lamp microscopy, fundus photography, optical coherence tomography (OCT), and fundus fluorescein angiography were examined at the onset and follow-up visits.
According to the immediate BCVA at the time of injury (with the presence or absence of brain infarction), a new injury severity scale was proposed, namely, Grades 1-4. Grade 1 (4 patients) and Grade 2 (2 patients) tended to have no atrophy of the globe. Grade 3 (12 patients) and Grade 4 (4 patients) were more likely to develop atrophy of the globe (4/12 patients and 2/4 patients, respectively) at the last follow-up. Grade 3 and Grade 4 were more likely to be complicated with ophthalmoplegia and ptosis (7/16 patients).
The new injury severity scale we proposed can determine the prognosis of different ocular complications following cosmetic filler injection. Accordingly, we can inform injured patients regarding the possibility of phthisis bulbi and the extent of improvement of visual impairment, ophthalmoplegia, ptosis and stroke.
美容填充物注射可引起多种眼部并发症；然而，目前尚无评估损伤严重程度和预后的良好方法。通过分析美容填充物注射后严重眼部并发症的损伤表现及其预后，我们提出了一种新的损伤严重程度分级。
对 22 例因美容填充物注射而发生眼部并发症的患者的 22 只眼进行了 6 个月的随访，以观察损伤特征、表现和预后。在发病时和随访时检查最佳矫正视力（BCVA）、眼压（IOP）、裂隙灯显微镜、眼底照相、光学相干断层扫描（OCT）和眼底荧光血管造影。
根据损伤时即刻的 BCVA（是否伴有脑梗死），提出了一种新的损伤严重程度分级，即 1-4 级。1 级（4 例）和 2 级（2 例）患者眼球萎缩倾向不明显。3 级（12 例）和 4 级（4 例）患者在最后一次随访时更有可能发生眼球萎缩（4/12 例和 2/4 例）。3 级和 4 级更有可能并发眼肌麻痹和上睑下垂（16 例中有 7 例）。
我们提出的新损伤严重程度分级可预测美容填充物注射后不同眼部并发症的预后。因此，我们可以告知受伤患者眼球痨和视力损害、眼肌麻痹、上睑下垂和中风改善程度的可能性。
