Improper use of dermal fillers to treat frown and laugh lines can cause retinal artery occlusion and permanent blindness, according to a South Korean study published in the American Journal of Ophthalmology (2012). The findings may be eye-opening for the rising number of young, healthy women who undergo soft-tissue augmentation in the glabella or nasolabial folds, viewing this procedure as a safe method of achieving cosmetic goals.
In reviewing the medical records of 12 patients with sudden vision loss after filler injections, researchers found that ophthalmic retinal artery occlusion with choroidal ischemia was most prevalent and led to permanent blindness with no light perception. In 4 of the 7 patients with ophthalmic artery occlusion, blindness followed autologous fat injections in the glabellar region; 2 patients received autologous fat in the nasolabial fold, and 1 was injected with hyaluronic acid in both regions.
Use of autologous fat yielded significantly worse outcomes than hyaluronic acid and collagen injections, potentially because of the variable particle size, which can lead to blockage of different-sized arteries. Two patients who had received fat injections in the glabella sustained a cerebral fat embolism leading to brain infarction.
Therefore, patients should be aware of the possibility of development of retinal/ophthalmic artery occlusion and blindness, with poor prognosis.
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