title: Severe visual loss and orbital infarction following periorbital aesthetic poly-(L)-lactic acid (PLLA) injection.
abstract: Visual loss following esthetic treatment of the face is a rare but devastating iatrogenic complication. The authors report a case of a 43-year-old man with blindness and ophthalmoplegia of the left eye following a treatment of the left periorbital region with the subcutaneous filler poly-(L)-lactic acid. The patient's symptoms began immediately following one of the tunneled injections. On presentation, the patient had clear signs of ocular and orbital ischemia. Angiography and further history suggested an embolic orbital infarction as the mechanism of injury. The increased usage of subcutaneous fillers for facial rejuvenation had introduced a small but proven risk of embolization of these viscous materials to the eye and orbit.
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, McGill University, Montreal, Quebec, Canada. steve.roberts@mail.mcgill.ca
authors.forename: Steve A I
authors.initials: SA
authors.lastname: Roberts
authors.forename: Bryan P
authors.initials: BP
authors.lastname: Arthurs
mesh_terms: D000328:Adult; D001766:Blindness / Q000139:chemically induced* / Q000175:diagnosis; D002482:Cellulose / Q000009:adverse effects*; D003357:Cosmetic Techniques; D005451:Fluorescein Angiography; D039682:HIV-Associated Lipodystrophy Syndrome / Q000628:therapy; D006801:Humans; D007049:Iatrogenic Disease; D007238:Infarction / Q000139:chemically induced* / Q000175:diagnosis; D007279:Injections, Subcutaneous; D007511:Ischemia / Q000139:chemically induced; D019344:Lactic Acid / Q000009:adverse effects*; D008297:Male; D008353:Mannitol / Q000009:adverse effects*; D009886:Ophthalmoplegia / Q000139:chemically induced* / Q000175:diagnosis; D009915:Orbit / Q000098:blood supply*; D011091:Polyesters; D011108:Polymers / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed
chemical_list: C482305:New-Fill; D011091:Polyesters; D011108:Polymers; D019344:Lactic Acid; D008353:Mannitol; C033616:poly(lactide); D002482:Cellulose