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Anatomical Guideline for Retrobulbar Hyaluronidase Injection.
J Cosmet Dermatol
August 2025
Institute of Biomaterial Implant, Department of Oral Anatomy, College of Dentistry, Wonkwang University, Iksan 54538, Republic of Korea, Iksan, Republic of Korea.
Background: Vision loss following cosmetic filler injections is a rare but devastating complication resulting from inadvertent intravascular embolization, most often affecting the ophthalmic artery. Retrobulbar hyaluronidase injection has been proposed as an emergency intervention, yet anatomical guidelines for its administration remain poorly defined.
Objective: To propose an anatomically informed protocol for safe and effective retrobulbar hyaluronidase injection in cases of filler-induced central retinal artery occlusion.
Retrobulbar Hyaluronidase in Hyaluronic Acid-Induced Ocular Vascular Occlusion: Efficacy, Challenges, and Implications for Clinical Practice.
Aesthetic Plast Surg
March 2025
Intensive Therapy Unit, General Hospital of Castellon, Castellon, Spain.
Introduction: Ophthalmic vascular occlusion due to hyaluronic acid (OVOH) is a rare but devastating complication of cosmetic filler injections, often resulting in severe vision loss.
Materials: The methodology involved a systematic search across PubMed, NCBI, Google Scholar, and Cochrane to investigate factors influencing central retinal artery occlusion (CRAO) caused by fillers. Searches focused on "eye vascular anatomy," "ocular physiology in response to ischemia," "components AND hyaluronic acid AND inflammation," "recovery from blindness associated with fillers," "retrobulbar technique," and "hyaluronidase degradation AND fillers.
Retrobulbar Hyaluronidase Injection for Vascular Side Effects.
Aesthetic Plast Surg
June 2025
Division in Anatomy & Developmental Biology, Department of Oral Biology, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
Causes and management of sight threatening complications of dermal filler injections: A review.
Clin Exp Ophthalmol
April 2024
The Eye Institute Hawke's Bay, Hastings, New Zealand.
Injectable dermal fillers continue to increase in popularity in aesthetic medicine. Although rare, vision loss secondary to filler injections is a devastating complication associated with a poor visual prognosis. The mechanism for vision loss is thought to be related to retrograde embolization of the dermal filler from peripheral vessels in the face into the ophthalmic arterial system.
View Article and Find Full Text PDFHyaluronidase for Dermal Filler Complications: Review of Applications and Dosage Recommendations.
JMIR Dermatol
January 2024
Ailesbury Clinics Ltd, Dublin, Ireland.
Background: Hyaluronidase (Hyal) can reverse complications of hyaluronic acid (HA) fillers, which has contributed substantially to the popularity of such procedures. Still, there are differing opinions regarding Hyal treatment, including dosage recommendations in filler complication management.
Objective: We aimed to address unanswered questions regarding Hyal treatment for HA filler complications, including timing and dosage, skin pretesting, properties of various Hyals and interactions with HA gels, and pitfalls of the treatment.