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Literature review finds risk for blindness from dermal fillers is rare

The risk for blindness from soft-tissue fillers was rare, however, injecting physicians need firm knowledge of vascular anatomy to understand prevention strategies, according to a recently published literature review.

Katie Beleznay, MD, FRCPC, and colleagues conducted a world literature search of National Library of Medicine, Ovid Medline and Cochrane Library to identify ocular complications after soft-filler injections from reports published through January 2015.

There were 98 cases of vision changes identified. Glabella (38.8%), nasal region (25.5%) nasolabial fold (13.3%) and forehead (12.2%) were the sites at highest risk for complications. The most common filler type causing this complication was autologous fat (47.9%), followed by hyaluronic acid (23.5%) and collagen (8.2%).

Vision loss and pain were the most common symptoms, with most cases of vision loss not recovering. In 23.5% of the cases, central nervous system complications were encountered. There were no consistently successful treatments of blindness.

“With the increased use of soft tissue augmentation for revolumization, it is imperative to be aware of potential devastating ocular complications,” the researchers concluded. “Although the risk is very low, the authors believe that prevention begins with education and the ability to recognize potentially grave adverse events. Injectors should have a firm understanding of the vascular anatomy of high-risk sites and understand the depth and plane of injection.

“Further discussion among experts, relating their experiences with ocular complications from filler, is essential to build consensus that will improve patient safety and optimize outcomes.” – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.