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Vol. 94. Issue 2.
Pages 60-74 (February 2019)
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Vol. 94. Issue 2.
Pages 60-74 (February 2019)
Original article
DOI: 10.1016/j.oftale.2018.10.011
Risk of cataract in smokers: A meta-analysis of observational studies
Riesgo de catarata en fumadores: metaanálisis de estudios observacionales
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E. Beltrán-Zambrano, D. García-Lozada
Corresponding author
, E. Ibáñez-Pinilla
Facultad de Medicina, Universidad El Bosque, Bogotá, Colombia
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Table 1. Characteristics of cohort studies included in the meta-analysis.
Table 2. Characteristics of case and control studies included in the meta-analysis.
Table 3. Characteristics of cross-sectional studies included in the meta-analysis.
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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.

Keywords:
Smoking
Cataract
Risk factors
Meta-analysis
Resumen
Objetivo

El propósito del estudio fue comparar el riesgo de catarata en fumadores y exfumadores.

Métodos

La búsqueda sistemática de estudios observacionales se realizó en las bases de datos Medline, Embase y Lilacs. Se seleccionaron estudios que hubieran evaluado la asociación entre fumar cigarrillos y cualquier tipo de catarata diagnosticada clínicamente. Se extrajeron los estimadores de asociación ajustados al menos por edad y se combinaron mediante modelos de efectos aleatorios, por tipo de estudio observacional (cohorte, casos y controles y transversal), por tipo de catarata (nuclear, cortical o subcapsular posterior) y de exposición (fumador actual o exfumador). Se evaluaron heterogeneidad estadística, análisis de meta-regresión y sesgo de publicación.

Resultados

Fueron seleccionados 13 estudios de cohortes, 12 de casos y controles y 18 de corte transversal. Se encontró riesgo de catarata en fumadores actuales: cohortes (OR: 1,41; IC95%: 1,24–1,60), casos y controles (OR: 1,45; IC95%: 1,08–1,96) y transversales (OR: 1,21; IC95%: 1,09-1,34) y riesgo de catarata nuclear: cohortes (OR: 1,71; IC95%: 1,47-1,98), casos y controles (OR: 1,79; IC95%: 1,43-2,25) y corte transversal (OR: 1,45; IC95%: 1,27-1,65). No se observó riesgo de catarata cortical ni subcapsular posterior en exfumadores.

Conclusiones

En fumadores existe riesgo de catarata, especialmente de tipo nuclear. Con estudios transversales se obtienen resultados similares a los obtenidos con cohortes y casos y controles.

Palabras clave:
Hábito de fumar
Catarata
Factores de riesgo
Metaanálisis

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