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Avoiding and Treating Blindness From Fillers: A Review of the World Literature

Beleznay, Katie MD, FRCPC, FAAD*; Carruthers, Jean D. A. MD, FRCSC, FRC (OPHTH), FASOPRS; Humphrey, Shannon MD, FRCPC, FAAD*; Jones, Derek MD‡,§

doi: 10.1097/DSS.0000000000000486
Review Article

BACKGROUND: As the popularity of soft tissue fillers increases, so do the reports of adverse events. The most serious complications are vascular in nature and include blindness.

OBJECTIVE: To review the cases of blindness after filler injection, to highlight key aspects of the vascular anatomy, and to discuss prevention and management strategies.

METHODS: A literature review was performed to identify all the cases of vision changes from filler in the world literature.

RESULTS: Ninety-eight cases of vision changes from filler were identified. The sites that were high risk for complications were the glabella (38.8%), nasal region (25.5%), nasolabial fold (13.3%), and forehead (12.2%). Autologous fat (47.9%) was the most common filler type to cause this complication, followed by hyaluronic acid (23.5%). The most common symptoms were immediate vision loss and pain. Most cases of vision loss did not recover. Central nervous system complications were seen in 23.5% of the cases. No treatments were found to be consistently successful in treating blindness.

CONCLUSION: Although the risk of blindness from fillers is rare, it is critical for injecting physicians to have a firm knowledge of the vascular anatomy and to understand key prevention and management strategies.

Departments of *Dermatology and Skin Science, and

Ophthalmology and Visual Science, University of British Columbia, Vancouver, British Columbia, Canada;

Skin Care and Laser Physicians of Beverly Hills;

§Division of Dermatology, University of California at Los Angeles, Los Angeles, California

Address correspondence and reprint requests to: Katie Beleznay, MD, FRCPC, FAAD, Carruthers and Humphrey Cosmetic Medicine, Suite 820-943 West Broadway, Vancouver, BC V5Z 4E1, Canada, or e-mail: kbeleznay@gmail.com

The authors have indicated no significant interest with commercial supporters.

© 2015 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.
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