Incidence of cataract operations in Finnish male smokers unaffected by alpha tocopherol or beta carotene supplements

Teikari, J. M.; Rautalahti, Matti; Haukka, Jari; Järvinen, Pentti A.; Hartman, Anne M.; Virtamo, Jarmo; Albanês, Demetrius; Heinonen, Olli P.

doi:10.1136/jech.52.7.468

Cited by 68 publications

(35 citation statements)

References 24 publications

(17 reference statements)

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“…[9][10][11] There has been considerable interest in the possible protective role of dietary antioxidants and supplements in age-related cataract, but evidence of effectiveness to date is equivocal. 3 In 2 clinical trials, high-dose antioxidant supplementation did not delay cataract formation, 12,13 but in a third study, supplementation did delay progression. 14 Tobacco smoking is a major modifiable risk factor for many chronic diseases.…”

Section: J Cataract Refract Surg 2005; 31:2395-2404 Q 2005 Ascrs and mentioning

confidence: 99%

Smoking and cataract: Review of causal association

Kelly

Thornton²,

Edwards³

et al. 2005

Journal of Cataract and Refractive Surgery

112

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Several risk factors for the development of cataract have been identified. This review evaluates epidemiologic literature that has examined tobacco smoking as a risk factor for cataract formation using established causality criteria. Twenty-seven studies were included in this review. Evidence suggests that smoking has a 3-fold increase on the risk for incident nuclear cataract development. There was also evidence of dose response, temporal relationship, and reversibility of effect. There was limited evidence of an association between smoking and posterior subcapsular cataract, but little or no association with cortical cataract. Thus, the literature review indicated a strong association between smoking and the development of cataract, particularly nuclear cataract. The association fulfills the established criteria for causality. The association between smoking and other types of cataract is less distinct and requires further evaluation.

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Section: J Cataract Refract Surg 2005; 31:2395-2404 Q 2005 Ascrs and mentioning

confidence: 99%

Smoking and cataract: Review of causal association

Kelly

Thornton²,

Edwards³

et al. 2005

Journal of Cataract and Refractive Surgery

112

View full text Add to dashboard Cite

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“…Seven trials testing high-dose vitamin E supplements, either alone or in combination with other vitamin supplements, in generally well-nourished populations have found little benefit on cataract for treatment durations as long as 8 years in men and 10 years in women. 22–28 For selenium, randomized trial data are limited. Selenium was included in a multivitamin/mineral combination found to be associated with a lower risk of cataract in a nutritionally-deficient population in China, 23 and in well-nourished populations in Italy 29 and the United States.…”

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confidence: 99%

Age-Related Cataract in Men in the Selenium and Vitamin E Cancer Prevention Trial Eye Endpoints Study

et al. 2015

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IMPORTANCE Observational studies suggest a role for dietary nutrients such as vitamin E and selenium in cataract prevention. However, the results of randomized clinical trials of vitamin E supplements and cataract have been disappointing and are not yet available for selenium.OBJECTIVE To test whether long-term supplementation with selenium and vitamin E affects the incidence of cataract in a large cohort of men. DESIGN, SETTING, AND PARTICIPANTSThe Selenium and Vitamin E Cancer Prevention Trial (SELECT) Eye Endpoints Study was an ancillary study of the Southwest Oncology Group-coordinated SELECT, a randomized placebo-controlled 4-arm trial of selenium and vitamin E conducted among 35 533 men, 50 years and older for African American participants and 55 years and older for all other men, at 427 participating sites in the United States, Canada, and Puerto Rico. A total of 11 267 SELECT participants from 128 SELECT sites participated in the SELECT Eye Endpoints ancillary study.INTERVENTIONS Individual supplements of selenium (200 μg per day from L-selenomethionine) and vitamin E (400 IU per day of all rac-α-tocopheryl acetate). MAIN OUTCOMES AND MEASURESIncident cataract was defined as a lens opacity, age related in origin, and responsible for a reduction in best-corrected visual acuity to 20/30 or worse based on self-reports confirmed by medical record review. Cataract extraction was defined as the surgical removal of an incident cataract.RESULTS During a mean (SD) of 5.6 (1.2) years of treatment and follow-up, 389 cases of cataract were documented. There were 185 cataracts in the selenium group and 204 in the no selenium group (hazard ratio, 0.91; 95 % CI, 0.75-1.11; P = .37). For vitamin E, there were 197 cases in the treated group and 192 in the placebo group (hazard ratio, 1.02; 95 % CI, 0.84-1.25; P = .81). Similar results were observed for cataract extraction.CONCLUSIONS AND RELEVANCE These data from a large cohort of apparently healthy men indicate that long-term daily supplementation with selenium and/or vitamin E is unlikely to have a large beneficial effect on age-related cataract.TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT00784225

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“…7 10-45 Although the majority of epidemiological studies have shown a positive correlation between higher dietary antioxidant intake and decreased cataract formation, 7 11-27 conflicting conclusions exist. [36][37][38][39][40][41][42][43] Also, as studies on b carotene and lung cancer have shown, epidemiological evidence does not guarantee positive findings in interventional studies. [46][47][48][49] This is a report of the results of the Antioxidants in Prevention of Cataract (APC) Study, an interventional trial conducted in south India.…”

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The Antioxidants in Prevention of Cataracts Study: effects of antioxidant supplements on cataract progression in South India

Gritz

Srinivasan

Smith

et al. 2006

British Journal of Ophthalmology

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Aim: To determine if antioxidant supplements (b carotene and vitamins C and E) can decrease the progression of cataract in rural South India. Methods: The Antioxidants in Prevention of Cataracts (APC) Study was a 5 year, randomised, triple masked, placebo controlled, field based clinical trial to assess the ability of interventional antioxidant supplements to slow cataract progression. The primary outcome variable was change in nuclear opalescence over time. Secondary outcome variables were cortical and posterior subcapsular opacities and nuclear colour changes; best corrected visual acuity change; myopic shift; and failure of treatment. Annual examinations were performed for each subject by three examiners, in a masked fashion. Multivariate modelling using a general estimating equation was used for analysis of results, correcting for multiple measurements over time. Results: Initial enrolment was 798 subjects. Treatment groups were comparable at baseline. There was high compliance with follow up and study medications. There was progression in cataracts. There was no significant difference between placebo and active treatment groups for either the primary or secondary outcome variables. Conclusion: Antioxidant supplementation with b carotene, vitamins C and E did not affect cataract progression in a population with a high prevalence of cataract whose diet is generally deficient in antioxidants.

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Incidence of cataract operations in Finnish male smokers unaffected by alpha tocopherol or beta carotene supplements

Cited by 68 publications

References 24 publications

Smoking and cataract: Review of causal association

Smoking and cataract: Review of causal association

Age-Related Cataract in Men in the Selenium and Vitamin E Cancer Prevention Trial Eye Endpoints Study

The Antioxidants in Prevention of Cataracts Study: effects of antioxidant supplements on cataract progression in South India

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