Journal List > J Korean Ophthalmol Soc > v.56(12) > 1010178

Jung, Kwon, and Jung: Treatment of Lower Eyelid Swelling after Retrobulbar Hyaluronic Acid Filler Injection in Phthisis Bulbi

Abstract

Purpose

To report treatment with hyaluronidase of lower lid swelling lasting for 1 year after retrobulbar hyaluronic acid filler in-jection 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 pa-tient 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 fol-lowing 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.

References

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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.
jkos-56-1961f1.tif
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.
jkos-56-1961f2.tif
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