Ocular ischemia and ischemic oculomotor nerve palsy after vascular embolization of injectable calcium hydroxylapatite filler.
A healthy 25-year-old man who received a calcium hydroxylapatite filler injection for nose augmentation by a dermatologist suddenly developed blepharoptosis and orbital pain on the right side, associated with progressive visual disturbance of the right eye. Patchy necrosis at the nose and glabella, limitations of extraocular movements, and anterior segment ischemia, as evidenced by conjunctival injection, chemosis, corneal edema, dilated pupil, hyphema, and hypopyon, were noted. Orbital CT demonstrated linear deposits of a similar density to bone in the right medial orbit and eyelid, suggestive of multiple emboli along the conjunctival vessels. A provisional diagnosis of ocular ischemia and ischemic oculomotor nerve palsy secondary to vascular embolization was made. After 3 months, visual acuity, all intraocular inflammation, oculomotor nerve palsy, and skin necrosis resolved completely except for a dilated pupil.
Department of Ophthalmology, Samsung Medical Center, SungKyunKwan University School of Medicine, Seoul, Korea.
Mi Sun
MS
Sung
Hyeong Gyun
HG
Kim
Kyung In
KI
Woo
Yoon-Duck
YD
Kim
D000328:Adult; D000869:Anterior Eye Segment / Q000098:blood supply*; D001672:Biocompatible Materials / Q000009:adverse effects*; D001763:Blepharoptosis / Q000139:chemically induced / Q000000981:diagnostic imaging; D017886:Durapatite / Q000009:adverse effects*; D004617:Embolism / Q000139:chemically induced* / Q000000981:diagnostic imaging; D006801:Humans; D007267:Injections; D007511:Ischemia / Q000139:chemically induced* / Q000000981:diagnostic imaging; D008297:Male; D015840:Oculomotor Nerve Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging; D010146:Pain / Q000139:chemically induced; D012225:Rhinoplasty; D014057:Tomography, X-Ray Computed; D014786:Vision Disorders / Q000139:chemically induced
D001672:Biocompatible Materials; D017886:Durapatite