面部美容注射导致视力丧失的临床分析  

Clinical analysis of visual loss caused by facial cosmetic fillers injection

作　　者：胡秀卓 陈思琪[1] 张倩[1] 吴鹏森[1] 卢苇[1] 

机构地区：[1]大连医科大学附属第二医院眼科,116023

出　　处：《中华眼科杂志》2017年第8期594-598,共5页Chinese Journal of Ophthalmology

摘　　要：目的探讨面部美容注射导致视力丧失的危险因素、临床表现及治疗。方法回顾性系列病例研究。收集大连医科大学附属第二医院眼科2014年12月至2016年6月收治的18例（18只眼）因面部美容注射导致视力丧失患者的临床资料。总结其一般情况、病史、入院时的面部外观情况以及临床检查和治疗结果。根据患者提供的病史及产品包装确认注射物的种类。所有患者确诊后予以一般治疗、降眼压治疗以及其他处理措施。结果所有患者均为女性，年龄24.0-45.0岁，平均年龄33.4岁。注射物主要为玻尿酸、自体脂肪等；注射部位位于额部6例，位于鼻部8例，额部及鼻背部均有4例；患者视力丧失后就诊时间平均为31.7 h。就诊时所有患眼视力均已无光感，注射部位局部皮肤颜色改变，出现不同程度的上睑下垂，眼底检查可见相应动脉阻塞改变。其中视网膜中央动脉阻塞患者17例，睫状动脉阻塞患者1例，经积极治疗后2例患者视力提高至光感，1例患者视力提高至眼前手动，余患者视力未见提高。结论面部美容注射后出现视力丧失的患者多为中青年女性，注射部位主要为鼻部和额部，阻塞的血管以视网膜中央动脉为主。患者未到正规机构注射，使用不规范的药品，操作者对解剖层次辨识不够及注射方法不当为导致血管阻塞的主要危险因素，治疗效果不佳。ObjectiveTo investigate the risk factors, clinical manifestations, and treatment of visual loss caused by cosmetic fillers injection.MethodsIt was a retrospetive case series study. Collect the clinical data of 18 cases （18 eyes） which were diagnosed as visual loss caused by facial cosmetic fillers injection in the Second Hospital of Dalian Medical University during December, 2014 to June, 2016. Summarize the general condition, medical history, clinical examination results （including visual acuity, intraocular pressure, fundus condition, etc.） and the patient＇s facial appearance at the time of admission. Take the examinations such as VEP, FFA, OCT, etc. Confirm the composition of the fillers according to the medical history and the product packaging. After the diagnosis, all patients were treated generally combined with intraocular pressure reduction treatment and other treatment measures.ResultsAll the patients were female, 24—45 years old, with average age of 33.4. The fillers were mainly consisted of hyaluronic acid or autologous fat. For 6 patients the fillers were injected in the forehead, 8 patients were in the nose, the other 4 patients were in both sites. The mean time was 31.7 hours since the onset to the acceptance of medical treatment. All the patients manifested as no light perception, injection site ischemia, different degree of ptosis and fundus examination showed artery occlusion signs. Seventeen patients were central retinal artery occlusion, one was posterior ciliary artery occlusion. After active treatment, 2 patients＇ visual acuity improved to light perception, one improved to hand movements, while the others had no significant improvement.ConclusionsMost patients who suffered visual loss after cosmetic injections are young or middle-aged women, with most common injection sites at nose or forehead. The visual loss is mainly caused by central retinal artery occlusion which leads to an ineffective clinical treatment. The main factors that may induce artery occlusion are： injection

关 键 词：视觉障碍 美容 透明质酸 注射 视网膜动脉闭塞 

分 类 号：R62[医药卫生—整形外科] R771.3[医药卫生—外科学]