OCULAR COMPLICATION AFTER NASAL CALCIUM HYDROXYLAPATITE INJECTION -- A CASE REPORT

鼻部微晶瓷注射後之眼部併發症－病例報告

洪冠智(Kuan-Chih Hong) ； 楊博閔(Po-Min Yang)

《中華民國眼科醫學會雜誌》 55卷 (2016/12) Pp. 67-72

https://doi.org/10.30048/ACTASOS.201612_55.0011

摘要

Purpose: To present a case of ocular complication after nasal calcium hydroxylapatite injection. Methods: Case report. Results: A 24-year-old female presented with sudden onset of blurred vision in her left eye a few minutes after an injection of calcium hydroxylapatite in the nasal area. A physical examination showed limited extra-ocular movement of her left eye and left sided ptosis. Visual acuity in her left eye decreased to counting fingers at 20 cm, and a dilated pupil was also noted. She then underwent brain and orbital computed tomography and magnetic resonance imaging and the findings were normal. Acute embolic posterior ischemic optic neuropathy with ophthalmoplegia and ptosis were impressed. The patient refused further examinations and she discharged herself against our advice. Conclusion: We report a case of acute embolic posterior ischemic optic neuropathy with ophthalmoplegia and ptosis after a nasal injection of calcium hydroxylapatite. This case highlights that clinicians should be aware of the potentially disastrous ocular complications when performing nasal injections of calcium hydroxylapatite.

關鍵字

calcium hydroxylapatite ； ophthalmoplegia ； optic neuropathy

並列摘要

目的：報告一個鼻部微晶瓷注射後之眼部併發症。方法：病例報告。結果；二十四歲女性在鼻部注射微晶瓷幾分鐘後視力模糊。身體檢查發現左眼鼻側方向的眼球運動受限，同時左眼也有眼瞼下垂。檢查發現左眼視力下降至只能在20公分遠處數出手指並且瞳孔放大。腦部電腦斷層與核磁共振檢查皆正常。診斷為疑似急性栓塞性後部缺血性視神經病變合併眼肌麻痺，患者拒絕進一步的治療與檢查並自行離院。結論：鼻部微晶瓷注射後可能併發急性栓塞性後部缺血性視神經病變及眼肌麻痺。在執行鼻部微晶瓷注射時需小心這個嚴重的併發症。