Evidence map›Paper›PMID 41627566›Full record

SynthesisInternational ophthalmology2026

Tobacco smoking is not associated with primary open-angle glaucoma: a systematic review and meta-analysis.

Saajan Ramji, Sohail Daniel, Abdus Samad Ansari, Timothy L Jackson, Abdulmalik Alsaif, Obeda Kailani

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in International ophthalmology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Saajan Ramji *North West London NHS Foundation Trust, London, UK.
Sohail Daniel *Royal Bolton Hospital, Bolton NHS Foundation Trust, Bolton, UK.
Abdus Samad AnsariKing's Ophthalmology Research Unit (KORU), Department of Ophthalmology, King's College Hospital, London, UK.
Timothy L JacksonKing's Ophthalmology Research Unit (KORU), Department of Ophthalmology, King's College Hospital, London, UK.
Abdulmalik AlsaifSchool of Life Course Sciences, Faculty of Life Science and Medicine, King's College London, London, UK.
Obeda KailaniKing's Ophthalmology Research Unit (KORU), Department of Ophthalmology, King's College Hospital, London, UK. ok@okvisionclinic.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis systematic review explores the relationship between tobacco smoking and the development of primary open-angle glaucoma (POAG). Glaucoma is the leading cause of irreversible blindness worldwide. Prior literature investigating the link between tobacco smoking and glaucoma has reported contradictory findings on the association between tobacco smoking and POAG.

methodsSystematically EMBASE, MEDLINE, and Web of Science were searched, encompassing articles published up until April 2025. The inclusion criteria comprised observational and randomised controlled studies that provided a statistical analysis exploring the association between tobacco smoking and POAG in adult populations. The ROBINS-E tool was utilised to assess the risk of bias of studies and meta-analyses were completed using RevMan software. The main outcomes were effect estimates that measured the association between tobacco smoking and POAG.

resultsAcross 26 eligible studies and 289,930 participants, there was a prevalence of 6,454 cases of POAG. The meta-analyses revealed that current smokers (OR = 1.00, 95%CI 0.76-1.33, p = 0.97, n = 11), past smokers (OR = 0.92, 95%CI 0.75-1.11, p = 0.38, n = 6) as well as both current and past tobacco smoking combined (OR = 1.00, 95%CI 0.84-1.19, p = 1.00, n = 17) exhibited no statistically significant association with POAG when compared to individuals who had never smoked. Heterogeneity ranged from low to substantial across comparisons, and risk of bias was frequently rated as high among included observational studies. The lack of an associative effect was sustained, on exclusion of studies with a high risk of bias.

conclusionAlthough the results suggest no significant statistical association between tobacco smoking and POAG, given the substantial morbidity and mortality associated with tobacco smoking and the detrimental impact on systemic and ocular health, tobacco smoking cessation should remain at the forefront of health promotion. PROSPERO registration ID: CRD42023409440.

Indexed as

Glaucoma, Open-AngleIntraocular PressureTobacco SmokingHumansPrevalenceRisk FactorsGlaucomaMeta-analysisNicotineSmokingSystematic review

Identifiers

PMID41627566
PMCPMC12864230

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.