[Histopathological study of experimental intrapalpebral injection of hyaluronic acid gel]

[Modern opportunities of lagophthalmos correction]

The main goal in the treatment of lagophthalmos is prevention of serious corneal complications. Based on the results of 2453 surgeries performed in patients with lagophthalmos, a detailed analysis of modern surgical techniques was carried out highlighting their advantages and disadvantages. The article describes in detail the most effective methods of static correction of lagophthalmos, their features and indications, and presents the results of using an original palpebral weight implant.

[Ophthalmological complications after contour plastic]

Ophthalmological complications after filler injections for aesthetic improvement in various regions of human face are extremely rare. Among them, blindness is considered the most dangerous and almost irreversible. Over 100 cases of vision loss, described by specialists from different countries of Asia, Europe and North America, give evidence that real statistics may be significantly higher. While autologous fat is the most frequent cause of blindness, partial vision recovery was described after hyaluronic acid filler and calcium hydroxyapatite injections. This article attempts to summarize the data from available publications and inform the specialists about the potential risk areas, clinical manifestations, as well as preventive and treatment methods in case such complications do develop.

[Experimental study of hyaluronic acid gel fillers biodegradation in orbit]

INTRODUCTION

Recently, hyaluronic acid gel (HAG) fillers were proposed as an effective alternative treatment option for surgical orbital volume augmentation. Several authors reported about long-standing effect of the filler.

PURPOSE

To assess the features of HAG biodegradation after intraorbital injection in experimental environment.

MATERIAL AND METHODS

In the course of the experiment, 7 chinchilla rabbits (14 eyes) received a single 1ml intraorbital HAG injection (Restylane SubQ, Galderma, Sweden) using a cannula. The animals' orbits were examined by ultrasound scan after the injection and at 1, 3, 6, 9, 12 and 18 months. The animals were subsequently sacrificed for morphological study of orbital tissue containing the HAG filler.

RESULTS

The HAG filler persisted in the orbit of experimental animals during the whole follow-up period. The volume of HAG depot and its density diminished gradually till the 18th month, after which the particles of HAG could still be detected with the morphological study and ultrasound.

CONCLUSION

The HAG filler persisted in the orbit of experimental animals up to 18 months. Incomplete biodegradation explains the longstanding duration of the injection effect.

[Hyaluronic acid gel implants for correction of pathological conditions of the orbit and eyelids]

PURPOSE

To evaluate the effectiveness of injectable implants made of hyaluronic acid gel (HAG) in ophthalmoplastics.

MATERIAL AND METHODS

The study included 57 patients (37 patients with lagophthalmos related to acute or chronic facial nerve palsy, endocrine ophthalmopathy; 20 patients with enophthalmos, anophthalmic syndrome). Depending on filler particle size, the patients received either intrapalpebral or intraorbital HAG injection. The biometric measures of palpebral fissure, the position of the eye/implant, and the condition of the cornea were evaluated during the follow-up period (12 months for eyelid and 18 for orbital injection).

RESULTS

In the course of the follow-up, all patients showed reliable reduction of lagophthalmos; additionally, improvement of the condition of the cornea was observed in patients after intrapalpebral injection; patients after intraorbital injection exhibited reduction in enophthalmos, upper orbital palpebral fold retraction and upper eyelid excursion. No serious complications have occurred after the injection.

CONCLUSION

As minimally invasive method of treating various pathologies of the orbit and eyelids, HAG fillers showed good clinical effectiveness and safety.