Table 8Cataract - Systematic Reviews

Study, Year, TitleAimsLiterature searchesPatients/trialsInterventionsResultsConclusionQuality score
Powe et al, 1994 91
Synthesis of the literature on visual acuity and complications following cataract extraction with intraocular lens implantation
To define the effectiveness and risks of cataract surgeryMEDLINE 1975-April 1991; reference lists83 single-arm observational studies and 7 cohort studies
Median n=231 (17 to 22,791)
22 studies: phacoemulsification; 58 studies: extracapsular extraction; 1 study: intracapsular extraction; 18 studies: mixed phacoemulsification and extracapsular extractionPooled % of eyes with 20/40 acuity or better: 95.5% (CI 95.1% to 95.9%) in pts with no ocular comorbidities and 87% (CI 89.3% to 90.2%) for all eyes
Harms - pooled rates - % (CI):
Endophtalmitis 0.13 (0.09 to 0.17)
Bullous keratopathy 0.3 (0.2 to 0.4)
Malposition/dislocation of IOL 1.1 (0.9 to 1.2)
Clinical cystoid macular edema 1.4 (1.2 to 1.6)
Angiographic cystoid macula edema 3.5 (2.9 to 4.0)
Retinal detachment 0.7 (0.6 to 0.8)
Posterior capsular opacification 19.7 (19.1 to 20.3)
Cataract surgery yields excellent visual acuity and is relatively safe regardless of method of surgical extractionGood
Schaumberg et al, 1998 163
A systematic overview of the incidence of posterior capsule opacification
To obtain an estimate of the incidence of posterior capsule opacification (PCO) and to explore factors that may influence its developmentMEDLINE 1979-1996; reference lists49 studies (design NR); total n=NR27 studies: extracapsular extraction; 9 studies: phacoemulsification; 13 studies: mixed extracapsular extraction and phacoemulsificationPooled rate, incidence of posterior capsule opacification:
1 year: 11.8% (9.3%–14.3%)
3 years: 20.7% (16.6%–24.9%)
5 years: 28.4% (18.4%–38.4%)
Visually significant PCO develops in more than 25% of patients undergoing extracapsular extraction or phacoemulsification with IOL within 5 years of surgeryFair
Taban et al, 2005 164
Acute endophthalmitis following cataract surgery
To determine the reported incidence of acute endophthalmitis following cataract extraction and to explore possible contributing factorsCochrane (database not specified); MEDLINE 1963-March 2003; reference lists; textbook hand search; conference proceedings and abstracts215 studies (design NR); total n=NRNRPooled rate, incidence of endophthalmitis: 0.128%
Rate 1963-1999: 0.109%
Rate 2000-2003: 0.265%
(RR 2.44. CI 2.27 to 2.61)
Incidence of endophthalmitis associated with cataract extraction has increased over the last decade and may be linked to the increasing use of sutureless clear corneal incisions.Fair

Abbreviations: CI = confidence interval, IOL = intraocular lenses, NR = not relevant, PCO = posterior capsule opacification, RR = relative risk.

From: 3, Results

Cover of Screening for Visual Impairment in Older Adults
Screening for Visual Impairment in Older Adults: Systematic Review to Update the 1996 U.S. Preventive Services Task Force Recommendation [Internet].
Evidence Syntheses, No. 71.
Chou R, Dana T, Bougatsos C.

PubMed Health. A service of the National Library of Medicine, National Institutes of Health.