Intravenous Hyaluronidase for Visual Loss Secondary to Filler Injection: A Novel Therapeutic Approach.

Despite the establishment of international expert consensus groups, peer-reviewed guidelines, and evidence-based protocols for both reducing the risk of arterial embolization of hyaluronic acid filler from aesthetic injection and promptly treating complications, perhaps the most devastating complication of visual loss remains largely irreversible. This article examines the novel therapeutic approach of using high-dose intravenous hyaluronidase when other attempts to restore vision have failed. Evidence for the safety of the proposed dosing in an emergency setting has been demonstrated in previous papers investigating the use of hyaluronidase for myocardial infarction in the 1970s. This approach has the advantage of reducing the time delay and risks associated with retrobulbar injection. Though rare, the risk of anaphylaxis must be able to be managed.