Eye damage due to cosmetic ultrasound treatment: a case report

Yuanyuan Chen, Zhongyu Shi, Yin Shen, Yuanyuan Chen, Zhongyu Shi, Yin Shen

Abstract

Background: Rejuvenation of aging eyelids is one of cosmetic changes to the individual to create the appearance of youth. Tightening treatment of eyelid by ultrasonic heat could possibly develop acute eye injury, including acute increase of IOP, cataract and rarely myopia.

Case presentation: A case report of rejuvenation tightening treatment caused eye injury with 6 months' follow-up. All examinations were performed at a university teaching hospital. A healthy 32-year-old Asian woman had pain, photophobia and blurred vision in the right eye after rejuvenation tightening eye brow treatment. Intraocular pressure (IOP) was 31 mmHg in the right eye. Tyndall phenomena were observed. Visual acuity of the right eye dropped to 20/200 (from 20/20), with best-corrected visual acuities (BCVAs) 20/20. An iris pigment detachment was found. Neuro-ophthalmic examination was relative afferent pupillary defect (RAPD) positive with pericentral scotoma in the right eye, indicating optic nerve damage. In the optical quality analysis system (OQAS) exam, the objective scatter index (OSI) was 1.0 in the right eye and 0.7 in the left. Clearing additional plus lens power was difficult for this patient, indicating accommodation spasm in the right eye.

Conclusions: Rejuvenation with intense-focused ultrasound (IFUS) could cause heat injury, leads to acute increase of IOP. Heat damage in zonular fibers could cause accommodation spasm and myopia. Eye injuries caused by IFUS has been seldom reported. We recommend that cosmetic treatment in the eye area should be highly aware of side effect.

Keywords: Accommodation spasm; Acute increase of IOP; Myopia; Rejuvenation.

Conflict of interest statement

Ethics approval and consent to participate

Not applicable.

Consent for publication

Written informed consent was obtained from patient for publication of this case report and accompanying images.

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
IFUS induced iris pigment detachment. (a) anterior eye photo. White arrow: detached iris pigment floating in the anterior chamber. b One-week follow-up. Black circle: heat damaged iris; (c, d) Anterior segment optical coherence tomography (ASOCT) showed shallow anterior chambers at superior lateral in the right eye
Fig. 2
Fig. 2
Pericentral scotoma in the right eye indicating optic nerve damage caused by acute increase of IOP after the IFUS treatment
Fig. 3
Fig. 3
IFUS induced acquired myopia. The acoustic energy rays might cause dysfunction of the ciliary muscle, which affected the zonular tension, induced acquired myopia. The excessive curvature of refractive lens surface leads to curvature myopia and accommodation spasm. 1, ciliary muscle. 2, zonular fiber. 3, the lens

References

    1. Gliklich RE, White WM, Slayton MH, Barthe PG, Makin IR. Clinical pilot study of intense ultrasound therapy to deep dermal facial skin and subcutaneous tissues. Arch Facial Plast Surg. 2007;9(2):88–95. doi: 10.1001/archfaci.9.2.88.
    1. McMurray CJ, Burley CD, Elder MJ. Clear lens extraction for the treatment of persistent accommodative spasm after head trauma. J Cataract Refract Surg. 2004;30(12):2629–2631. doi: 10.1016/j.jcrs.2004.05.049.
    1. Pak CS, Lee YK, Jeong JH, Kim JH, Seo JD, Heo CY. Safety and efficacy of ulthera in the rejuvenation of aging lower eyelids: a pivotal clinical trial. Aesthet Plast Surg. 2014;38(5):861–868. doi: 10.1007/s00266-014-0383-6.
    1. Dubinsky TJ, Cuevas C, Dighe MK, Kolokythas O, Hwang JH. High-intensity focused ultrasound: current potential and oncologic applications. Am J Roentgenol. 2008;190(1):191–199. doi: 10.2214/AJR.07.2671.
    1. CHUA SH, Ang P, Khoo LS, GOH CL. Nonablative infrared skin tightening in type IV to V Asian skin: a prospective clinical study. Dermatol Surg. 2007;33(2):146–151.
    1. Suh D-H, Oh Y-J, Lee S-J, Rho J-H, Song K-Y, Kim N-I, Shin M-K. A intense-focused ultrasound tightening for the treatment of infraorbital laxity. J Cosmet Laser Ther. 2012;14(6):290–295. doi: 10.3109/14764172.2012.738912.
    1. Lee HS, Jang WS, Cha YJ, Choi YH, Tak Y, Hwang E, Kim BJ, Kim MN. Multiple pass ultrasound tightening of skin laxity of the lower face and neck. Dermatol Surg. 2012;38(1):20–27. doi: 10.1111/j.1524-4725.2011.02158.x.
    1. Administration FD. Guidance for industry and FDA staff - class II special controls guidance document: focused ultrasound stimulator system for aesthetic use. Health USDoHaHSFaDACfDaR. 2011. .
    1. Kyung Jung S, Yang SW, Soo Kim M, Kim C. Corneal stromal damage through the eyelid after tightening using intense focused ultrasound. Can J Ophthalmol. 2015;50(4):e54–e57. doi: 10.1016/j.jcjo.2015.04.010.

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