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New research · Ophthalmology
Aesthetic plastic surgery · 11h
ReviewAesthetic plastic surgery · 2026

Guide for Managing Vascular Occlusion Due to Fillers with Extended Neuro-Ophthalmic Involvement: A Review of Diagnosis, Classification and Treatment.

Javier Madero-Pérez, Marta Gil-Martinez, Lorena Arrien … Nabil Fakih-Gomez
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OphthalmologyReview

Neurological complications including stroke occur in up to 24% of filler-induced ophthalmic vascular occlusion cases.

Guide for Managing Vascular Occlusion Due to Fillers with Extended Neuro-Ophthalmic Involvement: A Review of Diagnosis, Classification and Treatment.

Javier Madero-Pérez … Nabil Fakih-Gomez
Aesthetic plastic surgery · 2026
Background

Filler-induced ophthalmic vascular occlusion (FIVO) is rare but devastating, while stroke remains even less frequent.

Methods

After screening 48 records, 35 articles met inclusion criteria.

n = 48 records
24%
Results
24%
checked for stroke and nerve damage - more than 1 in 5 had it
n = 48 records
More results

Three thematic domains emerged: etiology, classification, and management.

Embolic events occur immediately via direct intra-arterial injection or later through embolus fragmentation, migration, or arteriovenous shunting.

Temporal classification distinguishes fulminant, immediate, and delayed presentations with distinct prognostic implications.

More results

Imaging provides critical diagnostic and therapeutic guidance.

“
Conclusion · 1 of 3

FIVO is a time-critical emergency. Early intervention with hyaluronidase and supportive measures at the point of care, followed by rapid referral for advanced ophthalmic and neurological evaluation, is essential.

Conclusion · 2 of 3

Standardized guidelines are urgently needed to harmonize practice and improve patient outcomes.

Conclusion · 3 of 3

LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable.

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