SynthesisFrontiers in medicine2026
Air pollution exposure and cataract outcomes: a systematic review and pollutant-specific meta-analysis.
Synthesis in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
3 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Background: Air pollution is increasingly recognized as a potentially modifiable environmental determinant of age-related ocular disease, but its association with cataract remains incompletely characterized. Epidemiological evidence remains heterogeneous across pollutants and study methods, although emerging experimental findings support biological plausibility for pollution-related lens injury. Objectives: To systematically evaluate the epidemiologic evidence linking air-pollution exposure with cataract-related outcomes and to quantitatively synthesize pollutant-specific associations where sufficiently comparable data were available. Methods: PubMed, Embase, Scopus, Web of Science, and Google Scholar were searched through August 10, 2026 for observational studies reporting cataract-specific associations with specific air pollutants. Risk of bias was assessed using ROBINS-E for longitudinal follow-up studies and the WHO air-quality epidemiology instrument for cross-sectional and aggregate studies. Comparable hazard ratios (HRs) were synthesized using restricted maximum-likelihood random-effects models in Stata 18, with Knapp-Hartung sensitivity analyses. Results: Fifteen studies were included in the systematic review, of which seven contributed to at least one meta-analysis. The pooled HR was 1.036 (95% CI, 0.988-1.086) per 1 µg/m Conclusion: NO₂ showed the most consistent association with cataract outcomes, whereas evidence for PM₂.₅ remained heterogeneous and that for black carbon was limited. Although these findings support further investigation of traffic-related and other ambient pollution mixtures in cataract epidemiology, the sensitivity of NO₂ estimates to small-study inference precludes firm causal conclusions. Independent prospective studies with improved exposure assessment and standardized cataract phenotyping are needed. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/recorddashboard#, identifier CRD420261509514.
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