J Korean Ophthalmol Soc.  2015 Dec;56(12):1961-1964. 10.3341/jkos.2015.56.12.1961.

Treatment of Lower Eyelid Swelling after Retrobulbar Hyaluronic Acid Filler Injection in Phthisis Bulbi

• Jung SI
• Kwon JW
• Jung JH

• KMID: 2148761
• DOI: http://doi.org/10.3341/jkos.2015.56.12.1961

Abstract

PURPOSE
To report treatment with hyaluronidase of lower lid swelling lasting for 1 year after retrobulbar hyaluronic acid filler injection due to phthisis bulbi.
CASE SUMMARY
A 54-year-old female presented with right lower eyelid swelling lasting 1 year. There was no tenderness in the right lower eyelid but Tyndall effect was observed. Ultrasonographic findings showed soft tissue swelling in the right lower eyelid. The patient had 3 mm enophthalmos in the right eye on exophthalmometry due to phthisis bulbi resulting from trauma 10 years prior to presentation. Retrobulbar hyaluronic acid filler (Juvederm voluma; Allergan, Irvine, CA, USA) injections were performed to increase orbital volume; 2 mL of filler was injected in the retrobulbar space twice at 1-month interval. After injections, the patient experienced right lower lid swelling lasting 1 year. The patient was diagnosed with lower eyelid swelling due to anterior filler displacement. Hyaluronidase (H-lase inj 1,500 IU/A; Gunil, Seoul, Korea) was reconstituted in 10 mL of normal saline and 0.1 mL (15 IU) of reconstituted hyaluronidase was injected into the right lower eyelid subcutaneously at 5 different areas. At 5 weeks following injections, the lower eyelid swelling was rarely observed and she was satisfied with the result.
CONCLUSIONS
Long-lasting lower lid swelling after retrobulbar hyaluronic acid filler injection can be quickly and effectively treated with hyaluronidase injections.

Keyword

Filler; Hyaluronic acid; Hyaluronidase

MeSH Terms

Enophthalmos
Eyelids*
Female
Humans
Hyaluronic Acid*
Hyaluronoglucosaminidase
Middle Aged
Orbit
Seoul
Hyaluronic Acid
Hyaluronoglucosaminidase

Figure

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  Figure 1. Clinical photographs of the patient's eyelid at first visit. (A) Right lower eyelid swelling and exotropia. (B) Tyndall effect.

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  Figure 2. Clinical photographs of the patient's eyelids. (A) 1 week after hyaluronidase injection. (B) 5 weeks after hyalur-onidase injection. These pictures show decreased eyelid swel-ling and resolution of exotropia.

Reference

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