Age-Related Cataract, Cataract Surgery and Subsequent Mortality: A Systematic Review and Meta-Analysis

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.

Expressions of Senescence-Associated β-Galactosidase and Senescence Marker Protein-30 are Associated with Lens Epithelial Cell Apoptosis

“…Compared with the other 2 cataract types, cortical cataract is more likely to be associated with secondary angle-closure glaucoma that is caused by lens expansion and could cause critical damage to the entire eye; however, nuclear cataract generally develops slowly and usually induces a myopic shift [ 48 ]. Song et al reported a weaker association between cortical cataract and lower survival rate compared with nuclear cataract, which is partly in agreement with our results [ 49 ]. The TUNEL and immunohistochemical staining revealed that the LECs apoptosis in the central part of the anterior lens capsules was more severe than in the surrounding part.…”

Influence of Uncomplicated Phacoemulsification on Central Macular Thickness in Diabetic Patients: A Meta-Analysis

“…Cataracts are the most common cause of blindness in the world, and they usually require surgical removal [ 1 ]. The worldwide prevalence of diabetes is on the rise, and patients with diabetes have higher risk of developing cataract compared with patients without diabetes [ 2 ].…”

Population-based assessment of visual impairment among ethnic Dai adults in a rural community in China

“…Visual impairment (VI) is a devastating disability throughout the world 1 2 3 4 5 6 7 and is associated with functional limitations 8 , falls 9 , difficulties in managing stairs 10 , depressive symptoms 11 , cognitive dysfunction 12 , and increased risk of mortality 13 14 . The quality-adjusted life-year (QALY) loss associated with VI has been estimated to be more than other common chronic disorders such as hypertension, diabetes, obesity, and hyperlipidemia 15 .…”