Objective To conduct a meta-analysis to investigate the association between cigarette smoking and risk of cataract surgery.
Methods Eligible studies were identified via both computer searches and reviewing the reference lists of the key articles searching through Medline, Cochrane Library, CNKI and Wanfang databases. Adjusred relative risk ratio (RR) or odds ratio(OR) and 95% confidence interval (CI) were calculated. Study-specific risk estimates were pooled using the fixed-effect and random-effect model. Meta-regression to assess for heterogeneity by several covariates were performed. Subgroup analysis stratified by different smoking status and region were also performed.
Result Eight prospective cohort and two case-control studies met our inclusion criteria. Ever smoking was marginally significant associated with increased risk of age-related cataract surgery [OR = 1.30, 95% CI（0.97-1.74）], when compared to never smoking. Current smokers [OR = 1.43, 95% CI（1.37-1.62）]were at higher risk of cataract surgary than past smokers [OR = 1.20, 95% CI（0.95-1.51）]. In subgroup analysis, studies conducted in the United States [OR = 1.74, 95% CI（1.56-1.94）] exhibited a strong positive relationship between ever smoking and cataract surgery than that conducted in Europe [OR = 1.19, 95% CI（1.0-1.43）]. The same tendency was found in current smoking [USA, OR = 1.74, 95% CI（1.56-1.94）; Europe, OR = 1.74, 95% CI（1.56-1.94）]. However, that association didn’t found in China and Australia.
Conclusion The overall current literature suggested that smoking was associated with increased risk of cataract surgery, especially current smoking and in the USA. Further efforts should be made to confirm these findings and clarify the underlying reason. |
