Update in Soft-Tissue Filler-Associated Blindness

Area of Science:

• Ophthalmology
• Dermatology
• Cosmetic Surgery

Background:

• Minimally invasive cosmetic procedures using soft-tissue fillers are increasingly popular.
• Adverse events, including blindness, have been increasingly reported following filler administration.

Purpose of the Study:

• To review and report cases of blindness linked to soft-tissue fillers published from 2015 to 2018.

Main Methods:

• A systematic search of the Ovid MEDLINE database was conducted.
• The search covered publications from January 1, 2015, to August 1, 2018, using a specific Boolean search string.

Main Results:

• Sixty new cases of filler-induced blindness were identified.
• Hyaluronic acid (HA) was the most common filler implicated (70.0%), followed by autologous fat and calcium hydroxyapatite (CaHA) (11.7% each).
• The nose, glabella, and forehead were the most frequent injection sites. Vision restoration occurred in 16.7% of cases, with hyaluronidase showing promise.

Conclusions:

• A significant number of soft-tissue filler blindness cases have been reported since 2015, with a notable increase involving HA fillers.
• Prompt administration of hyaluronidase may be effective in restoring vision for HA-related blindness.
• Healthcare providers must be knowledgeable about managing this severe complication.