Effect of Nd:YAG laser capsulotomy on the risk for retinal detachment after cataract surgery: systematic review and meta-analysis

Author: Liu H, Liu X, Chen Y, Wang D, Li Y, Chen H, Ma X.

Geographical coverage: Asia, America, Europe and others (unspecified)

Sector: Cataract surgery

Sub-sector: Risk of retinal detachment

Equity focus: Not reported

Study Population: Adults who have undergone cataract surgery.

Review type: Effectiveness review

Quantitative synthesis method: Meta-analysis

Qualitative synthesis method: Not applicable

Background:

Vision impairment and blindness affect over 339 million people globally, with 43.3 million classified as blind and 295.3 million experiencing moderate to severe visual impairment (MSVI). In the Americas, estimates of blindness vary from 1.93 cases per 1,000 people in southern Latin America to 7.40 cases per 1,000 in tropical Latin America. Global estimates frequently exclude data from Indigenous Peoples and other minority ethnic groups, leading to potential underestimation of the burden and insufficient public health strategies for these communities.

Objective:

To review the burden of vision impairment, blindness, and ocular disease in Indigenous Peoples of the Americas compared to non-Indigenous populations and to identify gaps in the literature.

Main Findings:

The review included 32 studies: 14 (43.75%) from tropical Latin America (13 in Brazil, 1 in Paraguay), 12 (37.5%) from high-income North America (8 USA, 4 Canada), 4 (12.5%) from central Latin America (2 Colombia, 1 Mexico, 1 Venezuela), 1 (3.12%) from Andean Latin America (Ecuador), and 1 (3.12%) from the Caribbean (Haiti). No studies were found from southern Latin America.

Eleven studies (34.37%) reported frequencies of vision impairment and blindness, mostly from high-income North America. No data were reported from Andean Latin America, the Caribbean, or southern Latin America. Vision acuity measurement methods and definitions of vision impairment and blindness varied widely.

Despite these differences, the frequency of vision impairment and blindness was clearly higher in tropical Latin America (28.5%) than in high-income North America (11.1%) for adults over 40 years, based on BCVA.

Ocular disease frequencies were reported in 26 studies (81.25%), mainly from tropical Latin America and high-income North America. Trachoma was discussed in 9 studies (34.61%), cataract in 7 (26.92%), diabetic retinopathy in 6 (23.07%), and pterygium in 5 (19.23%). Disease frequencies varied across regions and Indigenous groups.

Methodology:

The authors included studies published between January 2000 and November 2022 reporting on frequencies of vision impairment, blindness, or ocular diseases among Indigenous populations in the Americas. No language restrictions were applied. Screening and data extraction were based on eligibility criteria, and results were reported using descriptive synthesis aligned with the Global Burden of Disease (GBD) regional classifications.

Applicability/External Validity:

The review did not explicitly discuss generalisability. However, the limited representation of studies from southern and Andean Latin America raises concerns about the applicability of findings across the entire region.

Geographic Focus:

Studies were conducted in Brazil, Paraguay, USA, Canada, Colombia, Mexico, Venezuela, Ecuador, and Haiti.

Summary of Quality Assessment:

There is low confidence in the review’s conclusions due to key methodological limitations. The databases searched, the number of reviewers involved, and whether risk of bias was assessed were not reported.