Review finds reported facial filler complications often involved lasting vision loss
The analysis also found brain infarction in some reported patients, but it cannot estimate the risk for all people receiving fillers.
Moderate evidenceReviewInterpret with caution
Medical disclaimer: This article summarizes research findings and is for informational purposes only. It is not medical advice.
Editorial illustration — not from the study.
Researchers reviewed studies describing eye or neurologic problems after facial dermal filler injections. Eye blood-vessel blockages, including blockage of the ophthalmic or central retinal artery, were the most commonly reported complications, and the glabellar and nose regions were frequently identified as higher-risk injection sites in the included reports.
The pooled proportion of permanent vision loss was 57%, with a 95% confidence interval of 45% to 68%. Brain infarction occurred in 27%, with a 95% confidence interval of 19% to 38%. These percentages describe the selected patients reported in the review, not the risk for everyone who receives facial fillers.
What the review examined
The researchers conducted a systematic review and proportion meta-analysis of studies found in PubMed/MEDLINE, Scopus, and Web of Science, along with manual searching. They included studies reporting ocular or neuro-ophthalmic complications after facial dermal filler injections. Information on filler type, injection site, complications, treatment, and visual outcomes was extracted. Sixteen studies involving 81 patients were included, and study quality was assessed with Joanna Briggs Institute tools. The abstract does not provide enough information to determine the exact designs of all included studies.
What the review concluded
Ophthalmic artery occlusion and central retinal artery occlusion were the most frequently reported complications. The pooled proportion of permanent vision loss was 0.57, or 57% (95% CI, 45%–68%), and the pooled proportion with brain infarction was 0.27, or 27% (95% CI, 19%–38%). A subgroup analysis found no statistically significant difference in permanent vision loss among reports involving autologous fat, mixed fillers, or hyaluronic acid fillers (p=0.9738). The abstract states that visual recovery was limited despite varied treatments, but it does not establish that any particular treatment caused or prevented recovery.
Who this may apply to
These findings are most directly relevant to people and clinicians seeking information about documented ocular or neurologic complications after facial dermal filler injections. They do not provide a risk estimate for the general population of people receiving fillers, and they do not show that one filler type is safer than another. The results also should not be interpreted as evidence that any specific treatment will improve outcomes.
What this could mean
The findings highlight that severe eye and neurologic complications have been reported after facial dermal filler injections and may include lasting vision loss or brain injury. However, because the review focused on reported complication cases rather than all filler procedures, its percentages cannot be used to measure the overall likelihood of these events. The analysis also cannot establish which filler type or injection site causes greater risk.
Limitations & evidence assessment
The review included only 81 patients from 16 studies, so the sample was small for estimating proportions. Studies of severe complications may be more likely to be published or identified than studies with less serious outcomes, creating possible selection or publication bias. The included reports may also have differed in how complications and recovery were defined and followed over time. The abstract reports quality assessment but does not provide the individual quality results or enough detail about the designs of the included studies. Because there was no comparison group of people who received fillers without reported complications, the study cannot estimate incidence or prove causation.
Why this evidence level: This was a systematic review with a meta-analysis, which can combine findings across studies. However, the analysis included only 81 patients from 16 studies, and the abstract provides limited detail about study designs and possible reporting bias, so the results require careful interpretation.
Evidence levels are editorial estimates derived from study metadata — they are not clinical appraisals.
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