Can Restylane cause blindness if injected around the eyes?

Question

I am having a disagreement with my doctor over the use of Restylane around the eyes. My doctors insists that it is safe. However, I have heard that there are two other patients that went blind when using Restylane around the eyes. 1.Were the two patients injected with Restylane with a blunt or sharp needle? 2. Did the two patients suffer only partial blindness to one eye or unilateral blindness? 3. Also, where can the cases of these two patients be found in the medical literature?

Sam Naficy, MD, FACS · Answer

There are safer places to inject any dermal filler than others and meeting with a well-trained and experienced injector will provide the proper education, risks, benefits, and expectations for under eye rejuvenation, in general.

Kenneth D. Steinsapir, MD · Answer

The risk of visual loss is very small but it is certainly not zero. Using a blunt tipped cannula to place filler does not eliminate this risk. In fact, because the incidence of visual loss is so low, it is essentially impossible to prove that using a cannula makes any difference on this rate. The most important issue is a detailed knowledge of eyelid anatomy. The deepfill method that I developed and published provides a safe approach for placing fillers. If you are not comfortable taking this very small risk, it is not worth arguing with your doctor about this. Simply decline treatment.

Kimberly Lee, MD · Answer

Restylane is commonly used around the eyes and is my product of choice in that area. The most important thing when getting dermal fillers is the skill of the injector. If the filler is injected into a vessel, the filler can travel through the blood vessel and cause problems. A skilled injector will know how to avoid this. Please seek a board certified specialist who routinely does fillers around the eyes to better assist you.

Steven F. Weiner, MD · Answer

Restylane is my choice of dermal filler for injecting around the eye. I can not confirm or deny the 2 cases you state of blindness from injecting Restylane around the eye, I just don't know. This horrible complication has occurred with other dermal fillers and has been discussed at several meetings I've been too. It has nothing to do with the brand of filler injected and can occur with any of them. It has to do with an intravascular injection that travels retrograde from a vessel around the eye back to the retinal area. It would occur rather quickly (ie, in the office). HOWEVER, this complication is near impossible or impossible if blunt tipped cannulas are used. There is practically no way to enter a vessel with a blunt tipped cannula so injecting filler inside a vessel is extremely difficult. I also am constantly moving the cannula so as not to put too much product in one place or more than a minute amount if I'm near a vessel.

Can Restylane cause blindness if injected around the eyes?

Answers (4)

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