Risk of cataract in smokers: A meta-analysis of observational studies

Abstract

Abstract Objective The aim of the study was to compare the risk of cataract in smokers and ex-smokers. Methods A systematic search of observational studies was carried out in Medline, Embase, and Lilacs databases. Studies that have evaluated the association between cigarette smoking and any type of clinically diagnosed cataract were selected. The association estimators were extracted, adjusted at least by age, and were combined using random-effects models, by subtype of study (cohort, case control and cross sectional), subtype of cataract (nuclear, cortical, and posterior subcapsular), and exposure (current smoker or ex-smoker). Statistical heterogeneity, meta-regression analysis and publication bias were assessed. Results A total of 13 cohort studies, 12 case-control studies, and 18 cross-sectional studies were selected. A risk of cataract was found in current smokers: cohort (OR: 1.41; 95% CI: 1.24–1.60), cases and controls (OR: 1.45; 95% CI: 1.08–1.96), and cross-sectional studies (OR: 1.21; 95% CI: 1.09–1.34); risk of nuclear cataract: cohort (OR: 1.71; 95% CI: 1.47–1.98), case-control (OR: 1.79; 95% CI: 1.43–2.25), and cross sectional studies (OR: 1.45; 95% CI: 1.27–1.65). There was no risk of cortical or posterior subcapsular cataract in ex-smokers. Conclusions There is a risk of cataract in smokers, particularly nuclear type. With cross-sectional studies, similar results are obtained with cohorts and cases and controls.