一病例報告：玻尿酸注射鼻整型術後單眼失明及兩側大腦梗塞

Unilateral Blindness and Bilateral Cerebral Infarctions Following Hyaluronic Acid Injection Rhinoplasty: A Case Report

張馨丰(Hsin-Feng Chang) ； 陳建志(Jiann-Jy Chen) ； 蔡立泰(Li-Tai Tsai) ； 陳登郎(Dem-Lion Chen)

《台灣家庭醫學雜誌》 24卷1期 (2014/03) Pp. 35-40

https://doi.org/10.3966/168232812014032401004

摘要

一25歲女性於接受玻尿酸注射鼻整型術時，右眼突然失明；眼底檢查顯示右眼視網膜呈現嚴重的白色水腫，並且出現櫻桃紅斑。9小時後，患者開始感到左側上肢無力；腦部磁振造影顯示兩側大腦有散在性的梗塞，血管磁振造影無異常發現，遂住院接受點滴輸液及每日口服100 mg抗血小板劑aspirin。5日後，左上肢肌力恢復，但右眼依舊失明。爾後追蹤3個月，右眼視力依然沒有恢復。目前玻尿酸注射已廣為運用於微整形，但並非完全沒有併發症，應用於注射鼻部或眉間整型術時應當注意，須避免填充物逆流至中心視網膜動脈或顱內動脈造成相關之嚴重併發症。

並列摘要

A 25-year-old woman suddenly lost vision in her right eye during hyaluronic acid injection augmentation rhinoplasty. The fundus examination showed a cherry-red spot and severe edematous opacity in the right retina. Nine hours later, her left upper limb became weak. Brain magnetic resonance imaging demonstrated multiple acute infarctions in the cerebral hemispheres despite an unremarkable magnetic resonance angiogram. She took oral aspirin (100 mg daily) and received intravenous fluid supportive treatment during the ensuing hospitalization. Five days later, strength in the left upper limb power returned, but vision was not restored in the right eye. Three months later, the visual ability in the right eye had not improved. Hyaluronic acid injection has been widely utilized during micro-cosmetic surgery, but there are possible complications. Performing injection augmentation procedures should be careful when applied over the nose or glabella to prevent filler regurgitation into the central retinal artery or intracranial arteries.

並列關鍵字

hyaluronic acid ； injection augmentation rhinoplasty ； retinal ischemia ； cerebral infarction ； micro-cosmetic surgery

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