新型面部美容填充剂（聚-DL-乳酸）注射后发生多发性分支视网膜动脉阻塞：1 例报告。
Multiple branch retinal artery occlusions following the new facial cosmetic filler (Poly-D, L-lactic Acid) injection a case report.
机构信息
Department of Ophthalmology, Eye Center, China Medical University Hospital, China Medical University, Taichung, Taiwan.
School of Chinese Medicine, China Medical University, Taichung, Taiwan.
出版信息
BMC Ophthalmol. 2023 Mar 6;23(1):86. doi: 10.1186/s12886-023-02821-8.
BACKGROUND
Poly-D, L-lactic acid is (PDLLA) a new cosmetic filler. We reported the first case of PDLLA-related devastating complication of multiple branch retinal artery occlusion (BRAO).
CASE PRESENTATION
A 23-year-old female had sudden blindness after injection of PDLLA at the glabella. After emergency intraocular pressure-lowering medicine, ocular massage, steroid pulse therapy, heparin and alprostadil infusion, and subsequent treatments including acupuncture and 40 sessions of hyperbaric oxygen therapy, her best-corrected visual acuity improved from hand motion at 30 cm to 0.3 within 2 months.
CONCLUSION
Although safety of PDLLA was evaluated in animal studies and in 16,000 human cases, it could still cause rare but devastating retinal artery occlusion as in the present case. Proper and immediate therapies could still improve patient's vision and scotoma. Surgeons should keep in mind the possibility of iatrogenic filler-related retinal artery occlusion.
背景
聚-DL-乳酸（PDLLA）是一种新型的美容填充剂。我们报告了首例 PDLLA 相关的多发性分支视网膜动脉阻塞（BRAO）灾难性并发症。
病例介绍
一名 23 岁女性在眉间注射 PDLLA 后突然失明。在紧急降眼压药物、眼球按摩、类固醇脉冲治疗、肝素和前列地尔输注以及随后的治疗包括针灸和 40 次高压氧治疗后，她的最佳矫正视力在 2 个月内从 30 厘米的手动提高到 0.3。
结论
尽管 PDLLA 的安全性已在动物研究和 16000 例人类病例中得到评估，但它仍可能导致本例中罕见但严重的视网膜动脉阻塞。适当和及时的治疗仍可改善患者的视力和视野缺损。外科医生应牢记医源性填充剂相关视网膜动脉阻塞的可能性。
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