Incidence of nonarteritic ischemic optic neuropathy following topical clear corneal cataract surgery: survey and meta-analysis

Ing, Edsel; Kam, Joseph Wai Keung; Cheng, Jasmine; Wong, Samuel W. K.; Strungaru, Hermina; Slomovic, Allan R.; Weisbrod, Lawrence; Torun, Nurhan

doi:10.1016/j.jcjo.2019.06.006

Cited by 5 publications

(6 citation statements)

References 24 publications

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“…A total of 320 psNAION cases (125 occurring within 2 months and a further 125 within 1 year of surgery), 1,307 sNAION cases, 1,587,691 cataract surgeries, and 1,538,897 noncataract surgery controls were reported. Denominators for noncataract surgery controls were not included in four studies (10,(16)(17)(18). Detailed characteristics of cases and controls are summarized in Table 2.…”

Section: Included Study and Participant Characteristicsmentioning

confidence: 99%

“…A PRISMA flow diagram for selection study is shown in Figure 1. All studies were retrospective cohorts with two population-based studies (11,15), one survey (16), and the rest were cohort studies of those undergoing cataract surgery. Detailed characteristics of these studies are summarized in Table 1.…”

Section: Included Study and Participant Characteristicsmentioning

confidence: 99%

“…Four articles included patients from the same center and risking inclusion of the same cases (17,18,38,39). The single survey study was subject to significant recall, selection, nonresponse, and response inconsistency bias (16). Further methodological issues and NOS assessment scores are detailed in Table 1.…”

Section: Risk Of Bias and Study Qualitymentioning

confidence: 99%

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Nonarteritic Anterior Ischemic Optic Neuropathy After Cataract Surgery: A Systematic Review and Meta-Analysis

Shew¹,

Wang²,

Danesh‐Meyer³

2022

Journal of Neuro-Ophthalmology

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Background: Nonarteritic anterior ischemic optic neuropathy (NAION) has been reported to occur after cataract surgery. It is not clearly established whether cataract surgery increases the risk of NAION over baseline. Evidence Acquisition: Medline, PubMed, Embase, and Cochrane Central registers were systematically searched for eligible studies reporting on postcataract surgery NAION (psNAION) within 1 year. All peer-reviewed publications with events n $ 10 were included. Pooled incidence and odds/hazard ratios and 95% confidence intervals (CIs) were extracted and calculated using random effect models for early and delayed psNAION. Time to event data were pooled for temporal analysis of psNAION events within the first year. This systematic review was registered (PROS-PERO CRD42021274383). Results: Nine articles met the selection criteria with five studies suitable for meta-analysis. A total of 320 psNAION cases, 1,307 spontaneous NAION (sNAION) cases, 1,587,691 cataract surgeries, and 1,538,897 noncataract surgery controls were included. Pooling of 63,823 cataract surgeries and 161,643 controls showed a hazard ratio of 4.6 (95% CI 2.7-7.8) of psNAION within 1 year of surgery. Pooled unadjusted incidence of psNAION within 2 months was ) per 100,000/year, psNAION within 1 year was 32.36 (95% CI 9.38-55.34) per 100,000/year, and sNAION was 8.87 (95% CI 2.12-15.62) per 100,000/ year. psNAION cases were older by a mean of 7.6 years; otherwise, pooled odds ratios for baseline risk factors in psNAION vs. sNAION cases were not statistically significant. psNAION within the first year peaked within 72 hrs and at 6 weeks after the surgery with 73% of cases occurring within 6 months. Conclusion:The risk of NAION after cataract surgery is four times greater within the first year and usually occurs within 6 months. However, the absolute risk remains low at 1 in 1,000-3,100 surgeries and is unlikely to warrant extra mention for consenting.

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Section: Included Study and Participant Characteristicsmentioning

confidence: 99%

Section: Included Study and Participant Characteristicsmentioning

confidence: 99%

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Nonarteritic Anterior Ischemic Optic Neuropathy After Cataract Surgery: A Systematic Review and Meta-Analysis

Shew¹,

Wang²,

Danesh‐Meyer³

2022

Journal of Neuro-Ophthalmology

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“…One year after the publication by Yang et al [30 ▪▪ ], Ing et al [31] reported the results of a survey regarding the prevalence of PCSON that they had sent to all ophthalmologists in five regions of Canada. The investigators received responses from 182 surgeons (an estimated response rate of 18−32%).…”

Section: Contemporary Studiesmentioning

confidence: 99%

Post-cataract surgery optic neuropathy: a chronological narrative review of the literature and speculation on pathogenesis

Bhatti

Miller

2022

Current Opinion in Ophthalmology

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Purpose of reviewTo appraise the literature on the incidence of an acute anterior optic neuropathy resembling spontaneous nonarteritic anterior ischemic optic neuropathy (NAION) following uncomplicated cataract surgery and to explore the proposed pathogenesis of both immediate and delayed onset post-cataract surgery optic neuropathy (PCSON).Recent findingsA number of case reports, case series, and retrospective case-controlled, big data, and population-based studies have identified an apparent association between cataract surgery and the occurrence of an acute anterior optic neuropathy that can either be immediate or delayed in onset. However, a recent study found no link between modern day cataract surgery and an increased risk of an acute anterior optic neuropathy.SummaryImmediate PCSON appears to be related to negative perfusion pressure at the level of the optic disc due to increased intraocular pressure. The pathogenesis of delayed PCSON is unknown but probably multifactorial. Patients who have experienced spontaneous NAION or PCSON in one eye may be at risk of PCSON in the fellow eye.

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“…The most common risk factors for NAION development are high blood pressure, diabetes (4,5). Additional potential risk factors include hyperlipidemia, increased homocysteine, sleep apnoea, anti-cardiolipin antibody syndrome, ischemic heart disease, thyroid disease, peptic ulcer disease, nocturnal low blood pressure, blood loss, and cataract surgery (6)(7)(8)(9)(10)(11). This extensive list remains the subject of scrutiny amongst in prior NAION literature (12).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of hemodynamic changes in nonarteritic anterior ischemic optic neuropathy using multimodality imaging

Sun

Wang

et al. 2021

Quant Imaging Med Surg

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Background: Nonarteritic anterior ischemic optic neuropathy (NAION) patients experience hypoperfusion in the short posterior ciliary arteries (SPCAs), however, the cause of hypo-perfusion is unclear.Real-time dynamic hemodynamic observations may provide clues into specific NAION pathogenic mechanisms. We aim to analyze hemodynamic changes occurring in NAION using multimodality imaging.Our specific focus is identifying pathogenic mechanisms underlying SPCA insufficiency in NAION.Methods: Three-dimensional arterial spin labeling (3D ASL) magnetic resonance imaging (MRI) and three-dimensional time-of-flight (3D-TOF) magnetic resonance angiography (MRA) were performed on 25 NAION patients (50 eyes) and 22 (44 eyes) normal cases were recruited. The diameter of the initial part of the ophthalmic artery and internal carotid artery siphon were measured using MRA. Blood vessel identification and blood flow (BF) were detected using 3D ASL MRI. We measured BF values of the optic nerve head (ONH) region of the retina/choroid complex, optic nerve (ON), temporal lobe, and occipital lobe.Results: We studied 32 NAION affected eyes, 18 NAION uninvolved eyes, and 44 normal eyes. Diameter of the initial part of ophthalmic artery in the NAION affected eyes was significantly larger than the uninvolved eyes (P=0.026). Diameter of the NAION eyes was 1.33±0.19 mm [mean ± standard deviation (SD)], uninvolved eyes were 1.15±0.21 mm. At a photolabeling delay times (PLD) of 1,500 and 2,500 ms, BF of the ONH and ON in NAION affected eyes was significantly less than uninvolved and normal eyes (pONH <0.001 both at 1,500 and 2,500 ms, pON <0.001 and pON =0.001 at 1,500 and 2,500 ms, respectively).ONH of uninvolved eyes was also significantly less than normal eyes. Additionally, BF of the ONH region

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Incidence of nonarteritic ischemic optic neuropathy following topical clear corneal cataract surgery: survey and meta-analysis

Cited by 5 publications

References 24 publications

Nonarteritic Anterior Ischemic Optic Neuropathy After Cataract Surgery: A Systematic Review and Meta-Analysis

Nonarteritic Anterior Ischemic Optic Neuropathy After Cataract Surgery: A Systematic Review and Meta-Analysis

Post-cataract surgery optic neuropathy: a chronological narrative review of the literature and speculation on pathogenesis

Evaluation of hemodynamic changes in nonarteritic anterior ischemic optic neuropathy using multimodality imaging

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