Occlusion of the Central Retinal Artery by Fillers Used in Cosmetology Practice: Mechanism of Development, Diagnosis, Treatment and Prevention

Currently, aesthetic medicine has become widespread in everyday clinical practice. With the increase in the number of cosmetic procedures, the number of complications associated with them has increased significantly, which often go beyond the scope of aesthetic medicine. One of the common forms of cosmetology is injection therapy, which involves the use of various derma fillers, botulinum toxin, and vitamin therapy complexes. This article describes the mechanism of development of one of the most severe complications of injection cosmetology — central retinal artery occlusion, an algorithm for providing emergency care to a patient in the event of this complication and methods for its prevention. Conclusion. Central retinal artery occlusion is an extremely rare but formidable complication that can occur during cosmetic injections with fillers, almost always leading to irreversible vision loss and blindness. To improve the prognosis, immediate recognition of signs of filler embolism and immediate initiation of intensive therapy within the “therapeutic window” (~60 minutes) are crucial. Adherence to safe injection techniques (taking into account anatomy, aspiration test, small doses and low pressure on the syringe plunger), the use of hyaluronic acid-based fillers in the periorbital area and the doctor’s readiness to provide emergency care in a timely manner can minimize the risk of such a complication.

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