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Review
. 2024 Oct 25;16(10):e72370.
doi: 10.7759/cureus.72370. eCollection 2024 Oct.

Cataract in HIV Patients: A Systematic Review and Meta-Analysis

Dillan Cunha Amaral  1 , Lidia Cheidde  2 , Bruno Fortaleza de Aquino Ferreira  3 , Laura Cheidde  4 , Pedro Paulo Ladeira Júnior  4 , Isabelle Menezes  5 , Vinícius Gomes  1 , Bruno L B Esporcatte  1 , Milton Ruiz Alves  3 , Mário Luiz Ribeiro Monteiro  3 , Joyce Hisae Yamamoto  3 , Ricardo Noguera Louzada  3   1
Affiliations
Review

Cataract in HIV Patients: A Systematic Review and Meta-Analysis

Dillan Cunha Amaral et al. Cureus. .

Abstract

HIV-induced AIDS attacks the immune system, leading to opportunistic infections. This syndrome has been linked to an increased risk of developing uveitis and subsequent cataracts. Consequently, cataract surgery may be associated with intra- and postoperative complications in HIV/AIDS patients. We conducted a systematic review and meta-analysis to investigate the impact of cataract surgery on individuals with HIV. The primary outcome of interest was the incidence of postoperative complications, including uveitis, as well as an analysis of potential risk factors. We systematically searched the PubMed, Embase, Web of Science, and Cochrane databases, identifying a total of 828 studies. Ultimately, four studies met our inclusion criteria. Of these, three studies exhibited a moderate risk of bias, while one study demonstrated a tendency toward a higher risk. Our analysis revealed that corrected distance visual acuity (CDVA) improved after cataract surgery, with a mean difference (MD) of -0.55 (-0.97; -0.12). This was derived from a sample characterized by heterogeneity (I² = 88%, τ² = 0.1429), with a p-value <0.01. Patients with a history of HIV-related uveitis showed less improvement in CDVA, with an MD of -0.30 (-1.03; 0.43). Regardless of the presence of prior uveitis, complications such as cystoid macular edema (CME), posterior capsular opacification, and postoperative uveitis were reported following cataract surgery. The overall prevalence of postoperative uveitis was estimated at 7% (95% CI: 1-13%) based on a random effects model, with heterogeneity measured at I² = 34%. Cataract surgery in HIV-positive patients results in significant improvements in visual acuity, although the presence of preoperative HIV-related uveitis may affect these outcomes. Postoperative complications, such as CME and uveitis, are more prevalent in this population and require careful management.

Keywords: cataract; hiv; hiv aids; systematic review and meta-analysis; uveitis.

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Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. PRISMA flowchart of study selection
PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses
Figure 2
Figure 2. Quality assessment
Figure 3
Figure 3. (A) Correct distance visual acuity forest plot. (B) Intraoperative posterior capsular rent forest plot
Figure 4
Figure 4. (A) Intraoperative CME forest plot. (B) CME in HIV + and in HIV – individuals forest plot
CME, cystoid macular edema
Figure 5
Figure 5. (A) Postoperative PCO forest plot. (B) Postoperative uveitis forest plot
PCO, posterior capsular opacification
See this image and copyright information in PMC

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