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Meta-Analysis
. 2014 Nov 4;9(11):e112054.
doi: 10.1371/journal.pone.0112054. eCollection 2014.

Age-related cataract, cataract surgery and subsequent mortality: a systematic review and meta-analysis

E Song  1 , Hongpeng Sun  2 , Yong Xu  2 , Yana Ma  2 , Hong Zhu  2 , Chen-Wei Pan  2
Affiliations
Meta-Analysis

Age-related cataract, cataract surgery and subsequent mortality: a systematic review and meta-analysis

E Song et al. PLoS One. .

Abstract

Purpose: Changes 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.

Methods: We 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.

Results: Totally, 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; I(2) = 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; I(2) = 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, I(2) = 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; I(2) = 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; I(2)= 76.6%).

Conclusions: All 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.

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Conflict of interest statement

Competing Interests: Chen-Wei Pan is a PLOS ONE Editorial Board member. This does not alter the authors' adherence to PLOS ONE Editorial policies and criteria.

Figures

Figure 1
Figure 1. Flow diagram showing the selection process for inclusion of studies.
Figure 2
Figure 2. Random effects meta-analysis investigating the association between nuclear cataract and all-cause mortality.
HR = hazards ratio; CI = confidence interval.
Figure 3
Figure 3. Random effects meta-analysis investigating the association between cortical cataract and all-cause mortality.
HR = hazards ratio; CI = confidence interval.
Figure 4
Figure 4. Random effects meta-analysis investigating the association between posterior subcapsular cataract and all-cause mortality.
HR = hazards ratio; CI = confidence interval.
Figure 5
Figure 5. Random effects meta-analysis investigating the association between cataract surgery and all-cause mortality.
HR = hazards ratio; CI = confidence interval.
See this image and copyright information in PMC

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