Abstract
PurposeChanges in lens may reflect the status of systemic health of human beings but the supporting evidences are not well summarized yet. We aimed to determine the relationship of age-related cataract, cataract surgery and long-term mortality by pooling the results of published population-based studies.MethodsWe searched PubMed and Embase from their inception till March, 2014 for population-based studies reporting the associations of any subtypes of age-related cataract, cataract surgery with all-cause mortality. We pooled the effect estimates (hazards ratios [HRs]) under a random effects model.ResultsTotally, we identified 10 unique population-based studies including 39,659 individuals at baseline reporting the associations of any subtypes of cataract with all-cause mortality from 6 countries. The presence of any cataract including cataract surgery was significantly associated with a higher risk of death (pooled HR: 1.43, 95% CI, 1.21, 2.02; P<0.001; I2 = 64.2%). In the meta-analysis of 9 study findings, adults with nuclear cataract were at higher risks of mortality (pooled HR: 1.55, 95% CI, 1.17, 2.05; P = 0.002; I2 = 89.2%). In the meta-analysis of 8 study findings, cortical cataract was associated with higher risks of mortality (pooled HR: 1.26, 95% CI, 1.12, 1.42; P<0.001, I2 = 29.7%). In the meta-analysis of 6 study findings, PSC cataract was associated with higher risks of mortality (pooled HR: 1.37, 95% CI, 1.04, 1.80; P = 0.03; I2 = 67.3%). The association between cataract surgery and mortality was marginally non-significant by pooling 8 study findings (pooled HR: 1.27, 95% CI, 0.97, 1.66; P = 0.08; I2 = 76.6%).ConclusionsAll subtypes of age-related cataract were associated with an increased mortality with nuclear cataract having the strongest association among the 3 cataract subtypes. However, cataract surgery was not significantly related to mortality. These findings indicated that changes in lens may serve as markers for ageing and systemic health in general population.
Highlights
Visual impairment (VI) is a global health burden, associated with increased mortality in different ethnic groups [1,2,3,4,5]
In the meta-analysis of 9 study findings, adults with nuclear cataract were at higher risks of mortality (Figure 2)
In the meta-analysis of 8 study findings, cortical cataract was associated with higher risks of mortality (Figure 3)
Summary
Visual impairment (VI) is a global health burden, associated with increased mortality in different ethnic groups [1,2,3,4,5]. Age-related cataract seems to increase the risk of death, the relationship of different cataract subtypes and mortality remains unclear. It is important for clinicians and ophthalmologists to understand the associations between different cataract subtypes and mortality as the pathophysiology, treatment and impact on visual functioning of the 3 subtypes are different [14]. The question of whether age-related cataracts are associated with an increased risk of death or whether the association between increased mortality and the occurrence of the cataract is caused by the relationship with higher age is unclear
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