Impact of cataract surgery on depression and cognitive function: Systematic review and meta-analysis

Importance In elderly people, visual impairment is associated with depressive symptoms and cognitive decline. However, the impact of cataract surgery on depression and cognitive impairment is still controversial. Background To evaluate the effect of cataract surgery on depression and cognitive status in the elderly. Design This study was a meta-analysis. Participants Patients with age-related cataract who underwent cataract surgery were recruited for this study. Methods A literature search was performed on PubMed, Scopus and Web of Science. Data were extracted from selected studies by two independent reviewers. The pooled standardized mean difference (SDM) was estimated using a random-effects model. Heterogeneity was evaluated using the Q and I-2 tests. Multiple sensitivity analyses and assessment of publication bias were performed. Main Outcome Measures The main outcome was a report of a measure of depression or cognitive impairment before and after surgery. Results Sixteen studies were included: 14 of them reported data on depression and 9 of them on cognitive function. Depression significantly decreased after surgery (SDM = 0.460; 95% CI: 0.223-0.697; P < .001). In six controlled studies, the reduction of depression was higher in the surgery group than in the control group (SDM = 0.161; 95% CI: 0.027-0.295; P = .019). Cognitive function significantly improved after surgery (SDM = 0.254; 95% CI: 0.120-0.388; P < .001). In four controlled studies, the improvement of cognitive function was higher in the surgery group than in the control group (SDM = 0.188; 95% CI: 0.002-0.374; P = .048). Results were stable after sensitivity analyses. Conclusions and Relevance This meta-analysis provides evidence that cataract surgery has a positive effect on depression and cognitive function in the elderly.