透明质酸面部微整形致视功能障碍的临床观察  

Clinical observation of visual impairments caused by hyaluronic acid facial microplastic surgery

作　　者：王志立 陈晓 李磊[2] 李士清[1,2] 黄爱国 WANG Zhi-Li;CHEN Xiao;LI Lei;LI Shi-Qing;HUANG Ai-Guo(Henan Eye Hospital,the Henan Eye Institute,Zhengzhou 450003,Henan Province,China;The Henan Province People’s Hospital,Zhengzhou 450003,Henan Province,China)

机构地区：[1]河南省立眼科医院,河南省眼科研究所,河南省郑州市450003 [2]河南省人民医院,河南省郑州市450003

出　　处：《眼科新进展》2018年第11期1085-1088,共4页Recent Advances in Ophthalmology

摘　　要：目的观察使用透明质酸进行面部微整形所致视功能障碍患者的临床表现、治疗效果等。方法回顾性分析2013年1月至2017年12月我院眼科诊治的因面部微整形行透明质酸注射所致视功能障碍患者13例13眼的临床资料,包括一般情况、病史、临床检查结果、治疗效果及危险因素等。结果13例患者全是女性,年龄21～40岁,平均26.7岁。注射部位位于眉间者7例、鼻部者4例、额部者2例。13例全是单眼发病,突然发病者10眼;严重视功能障碍者9眼,包括无光感4眼,光感2眼,手动1眼,数指2眼;另外4眼视力0. 1。经眼底照相和荧光素眼底血管造影确诊为眼动脉阻塞者3眼、视网膜中央动脉阻塞者4眼、视网膜分支动脉阻塞者1眼、睫状后动脉阻塞者2眼、视网膜中央动脉阻塞合并睫状后动脉阻塞者1眼和眼底动脉血管痉挛者2眼。6例患者合并眼球运动障碍或面部外观异常。经治疗后,视力从0.1恢复到0.3、0.5、0.6者各1眼,光感恢复到手动者1眼,其他9眼视力未见改善。结论透明质酸面部微整形所致视功能障碍多发生于年轻女性,多数突然发病,视功能障碍严重,主要是眼底动脉阻塞。治疗后多数患者视功能恢复效果不明显。Objective To investigate the clinical manifestations and therapeutic effects of visual impairments caused by hyaluronic acid(HA)facial microplastic surgery.Methods It was a retrospective analysis in 13 patients(13 eyes)with visual impairments caused by microplastic surgery(facial fillers of HA injection)in eye hospital from January 2013 to December 2017.It included general data,medical history,clinical examination results including facial expression,visual acuity,intraocular pressure,fundus photography and fundus fluorenscense angiography(FFA),therapeutic effects and risk factors.Results All the patients were female,21 to 40 years old(average aged 26.7 years).The facial filler injected in all patients was HA.Injection sites included glabella in 7 patients,nasal dorsum in 4 patients and forehead in 2 patients.All the patients endured unilateral visual impairments.The visual impairments of 10 eyes was suddenly onset.Visual impairments of 9 eyes were serious,including 4 eyes with no light perception,2 eyes with only light perception,1 eye with only hand moving and 2 eyes with finger counting,while visual acuity of other 4 eyes was 0.1.There were ophthalmic artery occlusion(OAO)in 3 eyes,central retinal artery occlusion(CRAO)in 4 eyes,branch retinal artery occlusion(BRAO)in 1 eye,posterior ciliary artery occlusion(PAO)in 2 eyes,CRAO accompanying PAO in 1 eye and fundus arterial spasm in other 2 eyes by fundus photography and FFA.Abnormal facial appearance and ocular moving disorders could be found in 6 patients at the same time of examinations.After treatments,the visual acuity was restored from light perception to hand moving in 1 eye,from 0.1 to 0.3 in 1 eye,from 0.1 to 0.5 in 1 eye and from 0.1 to 0.6 in 1 eye,but other 9 eyes had no obvious changes in visual acuity.Conclusion All the patients are young women,who suffer visual impairments after HA facial microplastic surgeries,whose visual impairments of most patients are suddenly onset and serious,of which the main cause is related to fundus artery occlusion.And

关 键 词：面部微整形 眼底动脉阻塞 视功能障碍 透明质酸 

分 类 号：R779[医药卫生—眼科]