A 46-year-old woman experienced an immediate decline in vision in her right eye after a periocular high-intensity focused ultrasound (HIFU) cosmetic procedure directed to the upper and lower eyelids. She presented 10 days later with a corrected distance visual acuity (CDVA) of 20/40 in the affected eye. Slitlamp examination revealed 2 parallel dense lens opacities and feather-like posterior capsular haze (Figure 1, A and B). One month later, opacities persisted while capsular changes partially resolved, but vision remained unchanged. Anterior-segment optical coherence tomography confirmed 2 parallel longitudinal lens injuries (Figure 1, C and D). The patient underwent cataract extraction with intraocular lens implantation, resulting in complete visual recovery (CDVA 20/20). HIFU is a widely used cosmetic technique that tightens and lifts the skin through thermally induced collagen remodelling.1 However, misapplication near the ocular region can lead to irreversible ocular damage, highlighting the need for proper probe positioning and adequate ocular shielding during periocular HIFU procedures.2
Figure 1.
A: Slitlamp photograph showed 2 parallel dense lens opacities. B: Slitlamp retroillumination photograph showed feather-like posterior capsular haze. C: Slitlamp retroillumination photograph obtained 1 month later. D: AS-OCT showed 2 parallel longitudinal lens opacities.
Footnotes
Disclosures: Neither author has any financial or proprietary interest in any material or method mentioned.
First author:
Yingyan Qin, MD, PhD
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
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] [PubMed] [Google Scholar]
- 2.Marafon SB, Marinho DR, Kwitko S. Cornea opacity, uveitis with iris atrophy and lens damage following cosmetic high-intensity ultrasound of the eyelid: a case report. BMC Ophthalmol. 2023;23(1):230. [DOI] [PMC free article] [PubMed] [Google Scholar]