Ocular ischemia with hypotony after injection of hyaluronic acid gel.

Young Jun Kim, Sung Soo Kim, Won Kyung Song, Sang Yeul Lee, Jin Sook Yoon

Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.

Ophthalmic plastic and reconstructive surgery 2011 Nov-Dec

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The authors experienced a case with ocular ischemia with hypotony following injection of a dermal filler for augmentation rhinoplasty. Immediately after injection, the patient demonstrated a permanent visual loss with typical fundus features of central retinal artery occlusion. Multiple crusted ulcerative patches around the nose and left periorbit developed, and the left eye became severely inflamed, ophthalmoplegic, and hypotonic. Signs of anterior and posterior segment ischemia were observed including severe cornea edema, iris atrophy, and chorioretinal swelling. The retrograde arterial embolization of hyaluronic acid gel from vascular branches of nasal tip to central retinal artery and long posterior ciliary artery was highly suspicious. After 6 months of follow up, skin lesions and eyeball movement became normalized, but progressive exudative and tractional retinal detachment was causing phthisis bulbi.

Citation

Young Jun Kim, Sung Soo Kim, Won Kyung Song, Sang Yeul Lee, Jin Sook Yoon. Ocular ischemia with hypotony after injection of hyaluronic acid gel. Ophthalmic plastic and reconstructive surgery. 2011 Nov-Dec;27(6):e152-5