Evidence map›Paper›PMID 41263987›Full record

SynthesisAesthetic plastic surgery2026

Visual Loss in Biostimulator Injectables: A Review of Incidence, Risk Factors, Etiology and Management Proposal.

Stephanie M Young, Alice S C Goh, Preethi Jeyabal, Adrian S H Ooi

Abstract readSystematic ReviewReview
PubMed Publisher
In one paragraph

Synthesis in Aesthetic plastic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Stephanie M YoungEagle Aesthetics and Surgery, Singapore, Singapore. stephanieyoung83@gmail.com.
Alice S C GohBE Specialist Clinic, Kuala Lumpur, Malaysia.
Preethi JeyabalEagle Aesthetics and Surgery, Singapore, Singapore.
Adrian S H OoiPolaris Plastic & Reconstructive Surgery, Singapore, Singapore.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAs the popularity of non-hyaluronic acid (HA) injectables such as biostimulators rise in medical aesthetics, so have the rates of complications related to these injectables, including that of iatrogenic visual loss from vascular occlusion.

methodsThe authors conducted a systematic review of the available literature on visual loss related to the most widely used biostimulator injectables including calcium hydroxylapatite (CaHA), polycaprolactone (PCL), poly-L-lactic acid (PLLA), and poly-D,L-lactic acid (PDLLA) to provide a report on the incidence of such events, as well as evidence-based management protocols.

resultsCaHA has at least 11 published cases of vascular occlusion causing visual impairment, most involving the nasal dorsum. PLLA has two confirmed reports of visual loss, one from injection to periorbital/nasal region, and another from injection to the temple. PDLLA- carboxy-methylcellulose (CMC) has two reported cases of visual loss, one from injection to the forehead, another from injection to glabella region. PDLLA-HA has one reported case of visual loss from posterior ischemic optic neuropathy (PION). PCL has no published cases of blindness but one case of facial artery embolism. An evidence-based management protocol includes a sound knowledge of anatomy and injectable characteristics, timely recognition of symptoms, immediate actions such as starting intraocular lowering agents and sending to the ophthalmologist, as well as supportive therapy such as hyperbaric oxygen, anti-inflammatory and anti-coagulation therapy.

conclusionsOur review and proposed management protocol is timely in guiding physicians of the recognition and management of vascular occlusion causing visual loss by biostimulator injectables, especially in a time of rising popularity of these injectables in medical aesthetics. LEVEL OF EVIDENCE V: 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 .

Indexed as

Biocompatible MaterialsBlindnessCosmetic TechniquesDermal FillersVision DisordersDurapatiteFemaleHumansIncidenceInjectionsMalePolyestersRisk AssessmentRisk FactorsBiocompatible MaterialsDermal FillersDurapatitePolyesterspoly(lactide)BiostimulatorsBlindnessComplicationInjectablesVascular occlusionVisual loss

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.