Mortada Hatan, Seraj Hadeel, Alhamoud Mustafa A, Alghoribi Reema Saleh, Alsuhaibani Omar Saleh, Khoshhal Mohammed Saad, Neel Omar Fouda
Division of Plastic Surgery, Department of Surgery, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
Department of Plastic Surgery & Burn Unit, King Saud Medical City, Riyadh, Saudi Arabia.
Aesthetic Plast Surg. 2022 Dec;46(6):3013-3035. doi: 10.1007/s00266-022-02924-5. Epub 2022 Jun 1.
With the recent increase in interest in using autologous fat (AF) filler injections to enhance aesthetic facial appearance, there is a noticeable increase in the complications such as vascular compromise and blindness. This systematic review and meta-analysis aimed to understand the symptomatology of ophthalmic complications related to AF facial injections for cosmetic purposes, their underlying causes, management options, and the final clinical outcomes.
This review was conducted according to the International Prospective Register of Systematic Reviews (PROSPERO) guidelines. In November 2021, we performed a systematic review of available literature using the following electronic databases: Cochrane, MEDLINE, and EMBASE. Our search was limited to the published studies between 2000 and 2021.
A total of 1052 publications and 34 articles published were included. Twenty case reports, two case series, one prospective cohort study, and eleven retrospective studies were evaluated. The forehead was the most common single injection site (n = 196, 55.36%). The most common initial symptom was periorbital swelling (92.7%). The pooled prevalence of ophthalmic artery occlusion was 50.4% out of all AF injection-related complications. Regarding the management, most patients were managed conservatively (n = 278, 51.38%). Complete improvement was observed among 423 patients (80.57%).
Autologous facial fat injection is a minimally invasive procedure with a favorable safety profile in cosmetic applications. However, the common use of these injections in aesthetic surgery has resulted in a concomitant increase in devastating consequences, such as blindness. Therefore, a firm understanding of the potential complications of such interventions is essential.
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
随着近期人们对使用自体脂肪（AF）填充注射来改善面部美观的兴趣增加，诸如血管损伤和失明等并发症显著增多。本系统评价和荟萃分析旨在了解与用于美容目的的AF面部注射相关的眼部并发症的症状、潜在原因、处理方法以及最终临床结果。
本评价按照国际系统评价前瞻性注册库（PROSPERO）指南进行。2021年11月，我们使用以下电子数据库对现有文献进行了系统评价：Cochrane、MEDLINE和EMBASE。我们的检索限于2000年至2021年发表的研究。
共纳入1052篇出版物和34篇发表的文章。评估了20篇病例报告、2篇病例系列、1篇前瞻性队列研究和11篇回顾性研究。额头是最常见的单一注射部位（n = 196，55.36%）。最常见的初始症状是眶周肿胀（92.7%）。在所有与AF注射相关的并发症中，眼动脉阻塞的合并患病率为50.4%。关于处理，大多数患者采用保守治疗（n = 278，51.38%）。423例患者（80.57%）观察到完全改善。
自体面部脂肪注射是一种微创操作，在美容应用中具有良好的安全性。然而，这些注射在美容手术中的普遍使用导致了诸如失明等灾难性后果的相应增加。因此，充分了解此类干预的潜在并发症至关重要。
证据级别III：本刊要求作者为每篇文章指定证据级别。有关这些循证医学评级的完整描述，请参阅目录或作者在线指南www.springer.com/00266 。
