New Research Highlights the Risk of Vision Loss with Forehead Injectable Fillers

by | Last updated Jul 4, 2023 | Published on May 27, 2014 | Healthcare News

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Cosmetic filler injections are the most preferred non-surgical options to restore a smoother, more youthful appearance to the skin. But the shocking news is that you may literally go blind with these fillers. According to a recent study published online in JAMA Ophthalmology, Off-label injection of wrinkle fillers into the forehead can lead to many types of ophthalmic artery occlusion.

44 patients, who suffered occlusion of the ophthalmic artery after filler injections were examined and the occlusion was characterized as either diffuse or localized. Diffuse occlusions included decreases in retinal or choroidal perfusion and affected the entire retina or choroid, and they had poor visual outcomes. Localized occlusions affected only focal vascular regions in the retina or choroid.

According to the report, the consequences can be severe, depending on the location and size of the occlusion and the filler used. Patients who received autologous-fat injections were the most likely to have diffuse occlusions and brain lesions.

It was found that 86% of patients who received autologous fat suffered diffuse occlusions, compared to 39% of those who received hyaluronic acid. Brain scans also revealed lesions in 46% of autologous-fat recipients compared to 8% of hyaluronic-acid recipients.

Arterial occlusions are represented by diagnostic codes that are to be reported on the medical claim by physicians providing treatment for the same. This is important from the point of view of Physician billing and coding for reimbursement.

ICD-9-CM Codes

362.31 – Central Retinal Artery Occlusion
362.32 – Retinal arterial branch occlusion
362.33 – Partial retinal arterial occlusion
362.34 – Transient retinal arterial occlusion

ICD-10-CM codes

H34.13 – Central retinal artery occlusion, bilateral
H34.239 – Retinal artery branch occlusion, unspecified eye
H34.219 – Partial retinal artery occlusion, unspecified eye
H34.00 – Transient retinal artery occlusion, unspecified eye

It is suspected that the reason behind the complication may be injections that can plunge the filler material into a crease or fold with such force that the filler ends up where it doesn’t belong. It enters the bloodstream and gets into an artery that feeds the eye. Tiny bits of filler then block the retinal artery and/or become embedded in the retina, leading to potentially severe and seemingly irreversible vision loss. Plastic surgeons should make sure that while providing injectable fillers, patients are aware of such potential complications concerned with the ophthalmological procedure. Thorough explanation and great caution are needed before and during the procedures.

Indirect ophthalmoscopy is considered an effective treatment that allows for the best possible visual outcome after this complication.

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