Consensus Opinion on Safe Injection Technique and Management of PDLLA-HA200-Induced Visual Impairment

Abstract

Poly-D, L-lactic acid with hyaluronic acid (PDLLA-HA) represents a next-generation injectable combining the collagen-stimulating property of poly-D, L-lactic acid (PDLLA) microspheres with non-cross-linked hyaluronic acid (HA) as a carrier. One rare but devastating complication is visual field impairment and blindness due to inadvertent intravascular injection. Recognizing the need for a dedicated consensus on the management of PDLLA-HA-induced visual impairment, a panel of experts comprising oculoplastic surgeons, dermatologists, and aesthetic physicians was convened to give a consensus on safe practice with PDLLA-HA 200 (Juvelook Volume/Lenisna) and develop a management algorithm for the management of PDLLA-HA-induced blindness. © 2025 by Mutaz B. Habal, MD