Asking friend to inject rhinoplasty filler to welcome Lunar New Year, 20-year-old girl admitted on emergency to hospital due to blindness

04/02/2021 15:24

On the morning of January 25th, 2021, Viet Duc University Hospital received a female patient – N.T.H (20 years old, from Bac Ninh) for emergency because of blindness after a filler injection at a spa. According to patient and accompanying person, patient was injected by a close friend, a spa staff, for nose job on the evening of January 24th, 2021. During the injection, patient feels dizzy, headache, blurred vision in left eye, the whole body is hot, then turns cold. H’s friend contacted a friend who is also staff at another spa for instructions on how to buy an antidote for injections at spa. After finding that ineffective, H was directed to a hospital, which could not handle it, and then transferred to National Hospital of Ophthalmology. Immediately upon arriving at National Hospital of Ophthalmology, patient was quickly instructed by a doctor to move to emergency department at Aesthetic, Maxillofacial and Plastic Surgery Center, Viet Duc University Hospital.

 

Ass. Prof. Nguyen Hong Ha – Head of Aesthetic, Maxillofacial and Plastic Surgery Department said: Patient came to Viet Duc University Hospital with pain, panic, cold, pale skin on left eyelid with purple spots on it. Left eye was not able to see anything, only to distinguish between light and dark, total left eyelash drooping, all the eye muscles completely paralyzed. Doctor deployed multi-specialized emergency; resuscitation actively, reduced intracranial pressure, high dose oxygen, vasodilators, testing whole body. Plastic surgeon injects local antidote along the path of eyes artery branches; ophthalmologist examines the condition of eyes, injects an ophthalmic solution; doctor of diagnostic imaging performed a assessment, which showed obstruction of most branches of the artery that feeds the eye and even the central branch of retina.

 

Dr. Le Thanh Dung, PhD – Head of  Diagnostic Imaging Department, Viet Duc University Hospital said: With experience in handling complications after injecting similar fillers, immediately after receiving notification about the case , the emergency system has been activated, the synchronous coordination between plastic surgeons, electrochemical intervention and endothelial resuscitation to provide treatment for patient, photoelectric group intervenes conducted cerebral vessels digital subtraction angiography – DSA, locating ocular occlusion artery, directly infuse filler lysates into artery, then continue to treat patient with fibrinolytics for treatment and prevention of thromboembolism, the intervention duration lasted 6 hours. Immediately after treatment, patient’s vision was improved, and after 24 hours, the retinal central artery was reconnected, which is a very significant visual sign in treatment and prognosis of recovery eyesight for patient.

 

After more than 6 hours of emergency, patient is gradually stabilized. Vasodilators have returned and begun eyeing the eye tissues. The signs of muscle and skin necrosis were reduced, paralysis signs were also partially improved, vision improved but not much, from only light and dark discernible to blurred palms. Patient needed to be monitored closely in the following days.

 

 

Complications of ocular occlusion is a serious and devastating complication of filler injection, in addition to causing blindness, loss of vision also threatens to obstruct cerebral artery, which is life-threatening or clogged skin arteries, muscle orbital canal leading to total necrosis of right orbital removal of the eyeball.