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Published on: October 13, 2017
Hyalurostructure treatment: superior clinical outcome through a new protocol-a 4-year comparative study of two
Philippe Berros1, Lilian Lax, Frédéric Bétis
1Monte Carlo, Monaco; and Heidelberg, Germany From the Department of Ophthalmology and Oculoplasty, Princess Grace Hospital, and Alcazar Eye Clinic.
Background:
The tear trough represents a main aesthetic characteristic of the aging process, which leads many patients to the wish for a safe and efficient rejuvenation method to fill their eye rings. The authors analyzed results and complication rates of two methods for hollow eye ring treatment.
Methods:
The authors used two methods on two patient collectives. Group A was treated using hyaluronic acid gel (Restylane; Q-Med, Uppsala, Sweden) and a reinforced 25-gauge Pix'l+ micro cannula. The authors developed a modified method for group B that included a combination of cooling of the periorbital area, no local anesthesia, preincision displacement of malar fat 10 mm below the orbital border, and postintervention corticoid therapy for 48 hours.
Results:
Protocol B was associated with significantly lower complication rates. The authors also analyzed in how smoking, age, and skin properties might affect the clinical outcome. They found that choice of treatment and a history of blepharoplasty were significant predictive factors that correlated with complications.
Conclusions:
Tear trough treatment by hyalurostructure shows satisfying and efficient results with few complications. The revised technique used in group B combines multiple peri-interventional procedures including preinjection cooling of the periorbital area, preincision with displacement of the malar fat 10 mm below the orbital border, applying gentle back-and-forth movements while injecting, and oral corticosteroid therapy 48 hours after intervention. This technique makes hyalurostructure a competent and promising treatment for tear trough management.
Clinical Question/Level Of Evidence:
Therapeutic, III.

