ĐIỀU TRỊ THÀNH CÔNG BIẾN CHỨNG MÙ MẮT VÀ THIẾU MÁU HOẠI TỬ DA TỔ CHỨC QUANH NHÃN CẦU DO TẮC MẠCH SAU TIÊM CHẤT LÀM ĐẦY

Abstract

Introduction: The use of hyaluronic acid (HA) in cosmetic surgery is becoming increasingly popular worldwide, leading to an increase in complications such as swelling, pain, deformity, infection, lumps after injection, embolism, etc. Among them, complications of ophthalmic artery occlusion causing blindness, necrosis of the skin, muscles and tissues around the eyeball are the most serious complications. Up to now, there have been hundreds of cases of blindness after injecting fillers in the world, but the number of cases where vision has been saved can be counted on the fingers. Methods: Retrospective study on patients with vision loss and other complications due to filler injection such as skin ischemia, ptosis, ophthalmoplegia… at Viet Duc University hospital from Sep 2019 to June 2022. All patients were treated with hyaluronidase and fibrinolytics, combined with systemic therapies. Patients were discharged and re-examined after 1 month, 6 months and 12 months. Results: Nine out of 10 patients (90%) had improved vision, even after the treatment period exceeded the recommended time. Skin necrosis, ptosis, ophthalmoplegia of all patients recovered almost to normal. No complications of hyaluronidase and fibrinolytics were recorded. Conclusion: The multi-therapy method of intra-arterial injection of Hyaluronidase and Ateplase can help restore vision due to ophthalmic artery and central retinal artery occlusion as well as ischemic necrosis of the skin and periorbital tissues. This method is safe and effective. Further studies with larger sample sizes are needed to obtain a more complete protocol and conclusion.