Systematic Review of Soft-tissue Filler–associated Blindness: A Methodologic Concern Beyond Duplicated Cases

摘要

We recently found published an article by Chatrath et al, entitled “Soft-tissue Filler–associated Blindness: A Systematic Review of Case Reports and Case Series,” in the last issue of the Journal. We read this valuable article with a great interest. The article emphasized an important and critical complication associated to filler and fat injection, blindness-associated filler injection, and aimed to review the cases of fillers in causing blindness and the association between hyaluronic acid filler and fat injection with blindness. The usage of soft-tissue fillers is growing, and these compounds are associated with certain adverse effects from minor local adverse effects to catastrophic vascular occlusive adverse effects such as blindness. Hence, it is necessary to address these adverse effects and the authors chose systematic review as a gold standard for this purpose. Systematic reviews and meta-analyses are crucial to summarize pervious published evidence relating to efficacy and safety of health care interventions accurately and reliably. It is necessary to follow certain guidelines for conducting a systematic review. Currently, Preferred Reporting Items for Systematic Reviews and Meta-Analyses is a well-known statement in this regard. According to this statement, the authors should screen the results of their search to avoid any duplicated results. Also, the authors should exclude the previous review articles from their search result. The duplicated results can falsify the final conclusion. Chatrath et al included a review article in their results which was published previously by Lazzeri et al. This article summarized 32 cases of blindness following cosmetic injections of the face. However, Chatrath et al included again these 32 cases. This duplication falsified the results, and with respect to the valuable study of Chatrath et al, the results should be interpreted again. In addition to utilizing some software (eg, EndNote) to remove duplicated results, it is recommended to screen each result including cases one by one to avoid such fundamental mistakes.