Objective:To evaluate the general anesthesia on efficiency and safety of the photodynamic therapy (PDT) on patients with port wine stain (PWS).Method:A retrospective analysis was conducted on the data of patients who underwent PDT and were divided into groups either with or without general anesthesia relatively. The lesion color was expressed in terms of the Commission Internationale de l’Eclairage (CIE) L *a *b * color system, where L value corresponds to the lightness, a value to the red-green coordinate and b value to the yellow-blue coordinate. Paired t-test was used to evaluate the difference of L value, a value and b value before and after treatment respectively. Student t-test was carried out between the two groups on ΔL, Δa and Δb to illustrate the efficiency of general anesthesia in PDT. Pain scores were used to evaluate the pain degree after PDT treatment, and Mann-Whitney U test was carried out to compare the pain scores between the patients with and without general anesthesia. The adverse effects (including blister, scab and scar) were evaluated as well. The adverse effects rate was compared using Chi-square test. Results:A total of 62 cases (134 treatments) were reviewed, including 6 cases with general anesthesia in every treatment (general anesthesia group), 9 cases with general anesthesia or not (patial anesthesia group), and 47 cases with no anesthesia in their PDT treatments (non-anesthesia group). For patients with general anesthesia, a value decreased by 5.63±2.51, having statistical difference ( P=0.007), and for those without general anesthesia, L value increased by 3.39±5.16 ( P=0.035), a value decreased by 2.12±3.28 ( P=0.039), and b value increased by 3.05±3.92 ( P =0.016). Comparing between the two groups, |Δa| was much higher (5.63±2.51 vs. 2.12±3.28, P=0.047) in patients with general anesthesia, which indicated a better regression in red. Pain score evaluation showed no difference [7(6, 7) vs. 7(6, 8), P=0.653] between the two groups in the pain degree after treatment. Percentage of scab in the general anesthesia cases was 66.7%(18/27), while 51.4%(55/107) in the non-anesthesia cases, with no significant difference ( P=0.064). No blister case was reported in the general anesthesia cases, while only 5 cases were observed in 107 non-anesthesia cases (4.7%). The difference wasn’t significant ( P=0.252). No scar was reported in all the enrolled patients. Conclusions:General anesthesia can improve the red regression of PWS lesions in photodynamic therapy, but post-treatment pain and the rate of adverse effect can not be improved by general anesthesia.

Hyaluronic acid (HA) injections have already been one of most popular cosmetic procedures for around 18 years. However, blindness is one of the most serious complications caused by HA injections. There is still no consensus on the treatment for vision recovery. The efficacy and safety of different delivery administration of hyaluronidase such as retrobulbar injection and endovascular intervention are still controversial so far. Based on current status, prevention is prior to treatment, which is widely recognized in the world. The pathogenic mechanism of blindness induced by filler injection is still not clear, and there exist several theories including the artery embolism, ischaemia, artery spasm and venous involvement, which are all related to the ophthalmic artery and its branches. Therefore, acquiring anatomic knowledge and the relevant parameters will help us prevent to damage the ophthalmic artery and its branches during HA injections. The mechanism, treatment progress and prognosis of blindness caused by HA injections in recent years were analyzed and summarized in this article. We hope it will help the clinician to improve the relevant knowledge about vision loss caused by HA injection, as well as to promote the safety of filler injection.

Objective:To evaluate the general anesthesia on efficiency and safety of the photodynamic therapy (PDT) on patients with port wine stain (PWS).Method:A retrospective analysis was conducted on the data of patients who underwent PDT and were divided into groups either with or without general anesthesia relatively. The lesion color was expressed in terms of the Commission Internationale de l’Eclairage (CIE) L *a *b * color system, where L value corresponds to the lightness, a value to the red-green coordinate and b value to the yellow-blue coordinate. Paired t-test was used to evaluate the difference of L value, a value and b value before and after treatment respectively. Student t-test was carried out between the two groups on ΔL, Δa and Δb to illustrate the efficiency of general anesthesia in PDT. Pain scores were used to evaluate the pain degree after PDT treatment, and Mann-Whitney U test was carried out to compare the pain scores between the patients with and without general anesthesia. The adverse effects (including blister, scab and scar) were evaluated as well. The adverse effects rate was compared using Chi-square test. Results:A total of 62 cases (134 treatments) were reviewed, including 6 cases with general anesthesia in every treatment (general anesthesia group), 9 cases with general anesthesia or not (patial anesthesia group), and 47 cases with no anesthesia in their PDT treatments (non-anesthesia group). For patients with general anesthesia, a value decreased by 5.63±2.51, having statistical difference ( P=0.007), and for those without general anesthesia, L value increased by 3.39±5.16 ( P=0.035), a value decreased by 2.12±3.28 ( P=0.039), and b value increased by 3.05±3.92 ( P =0.016). Comparing between the two groups, |Δa| was much higher (5.63±2.51 vs. 2.12±3.28, P=0.047) in patients with general anesthesia, which indicated a better regression in red. Pain score evaluation showed no difference [7(6, 7) vs. 7(6, 8), P=0.653] between the two groups in the pain degree after treatment. Percentage of scab in the general anesthesia cases was 66.7%(18/27), while 51.4%(55/107) in the non-anesthesia cases, with no significant difference ( P=0.064). No blister case was reported in the general anesthesia cases, while only 5 cases were observed in 107 non-anesthesia cases (4.7%). The difference wasn’t significant ( P=0.252). No scar was reported in all the enrolled patients. Conclusions:General anesthesia can improve the red regression of PWS lesions in photodynamic therapy, but post-treatment pain and the rate of adverse effect can not be improved by general anesthesia.

Hyaluronic acid (HA) injections have already been one of most popular cosmetic procedures for around 18 years. However, blindness is one of the most serious complications caused by HA injections. There is still no consensus on the treatment for vision recovery. The efficacy and safety of different delivery administration of hyaluronidase such as retrobulbar injection and endovascular intervention are still controversial so far. Based on current status, prevention is prior to treatment, which is widely recognized in the world. The pathogenic mechanism of blindness induced by filler injection is still not clear, and there exist several theories including the artery embolism, ischaemia, artery spasm and venous involvement, which are all related to the ophthalmic artery and its branches. Therefore, acquiring anatomic knowledge and the relevant parameters will help us prevent to damage the ophthalmic artery and its branches during HA injections. The mechanism, treatment progress and prognosis of blindness caused by HA injections in recent years were analyzed and summarized in this article. We hope it will help the clinician to improve the relevant knowledge about vision loss caused by HA injection, as well as to promote the safety of filler injection.