[Effectiveness and interest of retrobulbar hyaluronidase injections in the treatment of blindness complicating facial hyaluronic acid injections: A literature review]

INTRODUCTION

Hyaluronic acid injections are becoming increasingly common among both the general public and the medical community, but they are not without risks. The occurrence of blindness, although rare, is a tragic event for both the patient and the practitioner. One of the treatments proposed in the literature is to inject hyaluronidase as close as possible to the site of ischemia, retrobulbarly. The aim of our study is to evaluate the effectiveness and potential benefits of retrobulbar hyaluronidase injections.

MATERIALS AND METHODS

A literature review was conducted using the PubMed database. Only articles addressing retrobulbar hyaluronidase injections for the treatment of blindness following hyaluronic acid injections were included.

RESULTS

We identified 12 case reports or series, comprising a total of 16 patients. Among these 16 patients, 3 regained their vision. Hyaluronidase was injected between 20minutes and 7days after the onset of the complication, with injected doses ranging from 3×150IU to 3×1500IU.

DISCUSSION

Literature reveals only 3 cases of successful treatment out of the 16 reported injections. The time interval before retrobulbar injection, as well as the dose and the experience of the injecting practitioner, may influence the success rate of this treatment. Other treatments, such as intravascular hyaluronidase injections, remain to be explored.

Measurement of quality of life in orthognathic surgery using an original questionnaire: About a series of 123 cases

INTRODUCTION

The aim of this study was to measure changes in the quality of life of patients who had orthognathic surgery using an original questionnaire, designed for this purpose.

MATERIAL AND METHOD

This single-center retrospective study included all patients who had orthognathic surgery in our center between 2014 and 2019. An original questionnaire comprising 13 items in 4 domains was sent to patients postoperatively by email after telephone contact and obtaining their consent. Items were scored on a 5-point scale ranging from (-1), worse than before surgery, to (+3), better than before surgery.

RESULTS

All data were collected in a standardized way. In total, 123 patients responded. The mean score for all surgeries combined was +1.14, indicating an improvement in QOL considered to be "low to moderate". A total of 118 patients (95.9%) reported an improvement following surgery, including 18 patients (14.6%) who reported a marked improvement. The greatest improvement was observed for psychosocial aspects and morphology.

CONCLUSION

This study shows a positive effect of orthognathic surgery on patients' QOL, including self-perception, relationships with others, or functional aspects as mastication and breathing. We propose an original tool that is easy to use by patients to measure quality of life following orthognathic surgery.