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The M.A.STE.R.S algorithm for acute visual loss management after facial filler injection
Author(s) -
Graue Gerardo,
Ochoa Araujo Dora Aline,
Plata Palazuelos Cristina,
Núñez Medrano Juan Ángel,
López San Juan Fernando José,
Sánchez Pereda Daniela,
Capiz Correa Daniel Raúl,
Velasco Leopoldo
Publication year - 2020
Publication title -
journal of cosmetic dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.626
H-Index - 44
eISSN - 1473-2165
pISSN - 1473-2130
DOI - 10.1111/jocd.13393
Subject(s) - medicine , retinal artery occlusion , central retinal artery occlusion , guideline , filler (materials) , glaucoma , algorithm , surgery , ophthalmology , retinal , visual acuity , pathology , computer science , materials science , composite material
Objective To propose an algorithm of treatment for sudden visual loss following filler injections and perform an English‐written literature search for assignment of evidence level and grade recommendation. Methods Algorithm of treatment includes ocular physical Maneuvers , hyAluronidase administration , intravenous STE roids, intraocular pressure Reduction, and Supplemental Oxygen ( M.A.STE .R.S ) based on previous acute management reports. Special consideration for algorithm buildup was made for ophthalmic diseases that share physiopathological features such as central retinal artery occlusion, systemic vasculitis affecting vision, and acute glaucoma. Finally, a systematic cross‐review of the reported cases with visual loss was done to identify the level of evidence and grant a recommendation grade. Results A search through PubMed and Medscape databases for English‐written scientific papers using the terms facial filler, retinal artery occlusion, management, treatment, complications, and adverse events quoted a total of 46 papers (190 cases) which were then analyzed. A high variability on management for treatment of sudden visual loss after facial filler injections was observed. This was attributed partially to the great diversity of medical specialists performing cosmetic facial procedures such as dermatologists, plastic surgeons, esthetic doctors and ophthalmologists, and the lack of high evidence level studies. Conclusions The proposed algorithm provides an initial guideline based on prior literature reports and physiopathology involving facial filler injection complications. Analysis identified 22 successfully treated cases with vision recovery (11.57%). Ocular physical maneuvers had the best evidence‐based level and grade recommendation (A) for the management of acute vision loss secondary to facial filler injections.