Permanent Vision Loss Due to Vascular Variation After Ear Hyaluronic Acid Injection: Two Case Reports and Literature...

Area of Science:

• Aesthetic Medicine
• Ophthalmology
• Vascular Surgery

Background:

• Prominent auricles are aesthetically desirable, leading to increased use of injectable fillers like hyaluronic acid (HA) as a non-surgical alternative.
• This trend has unfortunately resulted in a rise of reported complications, including vision loss.

Purpose of the Study:

• To investigate the mechanisms behind vision loss after ear HA injections.
• To propose preventive strategies and treatment countermeasures for such complications.

Main Methods:

• Two rare cases of blindness following ear HA injections were analyzed.
• Ophthalmological evaluations identified central retinal artery occlusion.
• Treatment involved hyaluronidase, arterial thrombolysis, and supportive eye care.

Main Results:

• Digital subtraction angiography revealed anatomical variations in ophthalmic arteries, potentially predisposing patients to blindness.
• One patient experienced bilateral vision loss with partial recovery in one eye; the other had unilateral blindness with significant recovery.
• Anatomical variations included ophthalmic arteries originating from the external carotid artery.

Conclusions:

• Ear filler injections pose a high risk due to the dense vascular and neural network and anatomical variations.
• Large HA volumes can compress structures, leading to visual impairment.
• HA ear fillers are not recommended as a routine substitute for surgical correction of prominent ears.