Effectiveness And Safety Of Orbital Fat Repositioning Versus Autologous Fat Grafting In Correcting Tear Trough Deformity:A Systematic Review

[Objective]To systematically review the effectiveness and safety of orbital fat repositioning and autologous fat grafting in correcting tear trough deformity.[Methods]Such databases as MEDLINE,EMbase,The Cochrane Library,CNKI,and WanFang Data from January,2010 to January,2020 were searched to comprehensively collect the clinical trials that compared orbital fat repositioning and autologous fat grafting in treating tear trough deformity.Two reviewers independently screened studies according to exclusion and inclusion criteria,extracted data,and assessed the methodological quality.Then,meta-analysis was performed using Stata 15.1 software.[Results]Nine clinical trials were eventually included.The results of meta-analysis showed that the pooled prevalence of successful surgery and complications of orbital fat repositioning was respectively 96.7%(95%CI:95.1%-98.4%)and 18.4%.(95%CI:5.0%-31.8%);Autologous fat grafting presented with the successful surgery prevalence of 93.0%(95%CI:87.3%-98.7%)and the complication incidence of 24.4%(95%CI:15.7%-33.0%).For tear troughs of different Barton grades,orbital fat repositioning held different successful surgery prevalence of 90.2%(95%CI:83.9%-94.7%)for Grade I,99.5%(95%CI:97.0%-100.0%)for Grade Ⅱ,97.4%(95%CI:91.0%-99.7%)for Grade Ⅲ.[Conclusion]For patients with tear trough deformity and without obvious skin or orbicularis oculi muscle laxity,both fat repositioning and autologous fat grafting can produce good results.Yet in patients of higher-grade deformities with apparent infraorbital depression and orbital fat herniation,fat repositioning produced better results than autologous fat grafting.