title: Verification of Embolic Channel Causing Blindness Following Filler Injection.
abstract: BACKGROUND
  Ocular complications following cosmetic filler injections are serious situations. This study provided scientific evidence that filler in the facial and the superficial temporal arteries could enter into the orbits and the globes on both sides. We demonstrated the existence of an embolic channel connecting the arterial system of the face to the ophthalmic artery.
  
  
  METHODS
  After the removal of the ocular contents from both eyes, liquid dye was injected into the cannulated channel of the superficial temporal artery in six soft embalmed cadavers and different color dye was injected into the facial artery on both sides successively. The interior sclera was monitored for dye oozing from retrograde ophthalmic perfusion.
  
  
  RESULTS
  Among all 12 globes, dye injections from the 12 superficial temporal arteries entered ipsilateral globes in three and the contralateral globe in two arteries. Dye from the facial artery was infused into five ipsilateral globes and in three contralateral globes. Dye injections of two facial arteries in the same cadaver resulted in bilateral globe staining but those of the superficial temporal arteries did not. Direct communications between the same and different arteries of the four cannulated arteries were evidenced by dye dripping from the cannulating needle hubs in 14 of 24 injected arteries. Compression of the orbital rim at the superior nasal corner retarded ocular infusion in 11 of 14 arterial injections.
  
  
  CONCLUSIONS
  Under some specific conditions favoring embolism, persistent interarterial anastomoses between the face and the eye allowed filler emboli to flow into the globe causing ocular complications.
authors.affiliation: The Chula Soft Cadaver Surgical Training Center and Department of Anatomy, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, 1873 Rama 4 Road, Pathumwan, Bangkok, 10330, Thailand, tansatitapinuntrum@gmail.com.
authors.forename: Tanvaa
authors.initials: T
authors.lastname: Tansatit
authors.forename: Hyoung Jin
authors.initials: HJ
authors.lastname: Moon
authors.forename: Prawit
authors.initials: P
authors.lastname: Apinuntrum
authors.forename: Thavorn
authors.initials: T
authors.lastname: Phetudom
mesh_terms: D001158:Arteries; D001766:Blindness / Q000209:etiology*; D002102:Cadaver; D000067548:Dermal Fillers / Q000008:administration & dosage / Q000009:adverse effects*; D005123:Eye / Q000098:blood supply*; D005145:Face / Q000098:blood supply*; D006801:Humans; D007267:Injections
chemical_list: D000067548:Dermal Fillers