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: firstname.lastname@example.org
The authors have indicated no significant interest with commercial supporters.