Epidemiological association between cigarette smoking and primary open-angle glaucoma: a meta-analysis

Objective. The rote of cigarette smoking as a risk factor for primary open-angle glaucoma (POAG) remains controversial. The aim of this study was to examine this association by conducting a detailed meta-analysis of studies published in peer-reviewed literature on the subject. Methods. A comprehensive search for articles published up 31 December 2002 was performed, reviews of each study were conducted, and data were abstracted. Prior to meta-analysis, the studies were evaluated for publication bias and heterogeneity. Results. Our analysis was based on seven reports. We found no evidence of publication bias or heterogeneity among the studies. The summary odds ratios from a fixed-effects model were 1.37 (95% CI: 1.00-1.87) for current smokers and 1.03 (95% CI: 0.77-1.38) for past smokers. Conclusions. Our meta-analysis results suggest that current smokers are at significantly increased risk of developing POAG. Efforts should be directed towards augmenting the campaign against smoking by adding the increased risk of POAG to the better-known arguments against smoking. (C) 2003 The Royal Institute of Public Health. Published by Elsevier Ltd. All rights reserved.