New Protocols for Filler-induced Blindness and Orbital Compromise Based on Systematic Analysis of Intra-arterial Thrombolytic Stroke Treatment With an International Task Force

Clicks: 1
ID: 339179
2026
Free PDF
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal

Ranked #127 of 128 articles by views in Aesthetic Surgery Journal Open Forum

Most read Least read

Bar heights use a square-root scale. Only the 120 most-read articles are drawn; the journal has 128 in total.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Sign in to mint
Abstract
Abstract Background Cosmetic fillers can embolize and occlude the ophthalmic artery and other internal or external carotid system end arteries, ultimately leading to irreversible orbital damage if not treated emergently. Objectives We sought to evaluate the efficacy of intra-arterial therapy (IAT) using hyaluronidase (HYAL) and/or thrombolytics for the emergent management of filler–related vision loss and other ischemic complications. Methods PubMed, Scopus, Embase, and Medline were used to identify literature on IAT for vision loss after filler injections. Additional case details of unpublished IAT for filler-induced blindness were also solicited among an international group. Demographic, procedural, and clinical data was abstracted from eligible studies. Repeated multi-disciplinary meetings and follow up surveys were conducted among an international vision task force including aesthetic injectors, dermatologists, ophthalmologists, neurologists, and neuro-interventionalists to develop suggested treatment protocols for neuro-interventional stroke teams, emergency departments, and injectors. Results 200 eligible cases of IAT for HA fillers were reviewed. Complete or partial successful artery recanalization was achieved in 89.5% of cases, of which 40.0 % had visual improvement. Cases with initial light perception (LP) had a higher rate of visual improvement following IAT than those with no LP post-filler injection (58.7%vs34.4%, respectively). Visual improvement was observed more frequently after IAT with HYAL and thrombolytics vs. HYAL alone (64.5%vs35.5%). Conclusions Overall, timely intra-arterial HYAL with thrombolytics can effectively recanalize filler-occluded arteries and has the potential to reverse vision loss or prevent further orbital compromise. Based on this systematic analysis and international multidisciplinary discussion process, simplified protocols are proposed.
Reference Key
openalex_W7225377040 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Sandy Zhang-Nunes, Shaili S. Davuluru, Manya Khrlobyan, Navdeep S Sangha, Kuo Chao, Hong Ha Nguyen, Corey Karp, Brandon J. Wong, Claire G. Olivas, Tanja Fischer, Heidi A. Waldorf, Tom S. Decates, Kim Newton, Kasra Khatibi, the ISAC Vision Task Force (International Society for Aesthetic Competence), Ramzi Alameddine, Hamad Alsalamah, Chytra V. Anand, Pierre AndreRaphaël AndréOfir Artzi, Patricia Barrera, Su Youn Becker‐Weimann, Beatriz Beltran, Hagai Betzer, Rodrigo Brant, Hugues Cartier, Daniel A. Cassuto, Olivier Claude, Jean D. A. Carruthers, Iñigo de Felipe, Stella Desyatnikova, Rebecca Fitzgerald, Jill Foster, Romeu Fadul Junior, Steven Fagien, Ronald Ian David Feiner, Alice Siew Ching Goh, Greg Goodman, Lisa D. Grunebaum, Christian Hausding, Catherine Hwang, Pimkwan Jaru-ampornpan, Jonathan A. Kadouch, Saami Khalifian, Femida Kherani, Marina Landau, Wendy Lee, Steven Liew, Leonardo Marini, John Martin, Beatriz Molina, Rachna Murthy, James Neffendorf, Hà Nguyễn Hồng, Alexandra L.J. Ogilvie, Farzad Pakdel, Tapan Patel, E Petzold, Thomas Rappl, Hervé Raspaldo, Fabián Pérez Rivera, Alexander Z. Rivkin, Kelsey A. Roelofs, Jonathan Roos, Christopher Rowland Payne, Leonie W. Schelke, Todd Schlesinger, Robyn D. Siperstein, Philippe Snozzi, Nenad Stankovic, Ziah Taufig, Jesper Thulesen, Ibrahima Traoré, Patrick J. Treacy, Jani van Loghem, Joan Vandeputte, Peter J. Velthuis, Ines Verner, André Vieira Braz, Simone Vogel, Rungsima Wanitphakdeedecha, Steven Weiner, Julie Woodward, Yana Alexandrovna Yutskovskaya, Thomas Zimmermann
Are you one of these authors? Claim your profile
Journal Aesthetic Surgery Journal Open Forum
Year 2026
DOI
10.1093/asjof/ojag222
URL
https://doi.org/10.1093/asjof/ojag222
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

Comments

No comments yet. Be the first to comment on this article.