Risk of Cataracts Studied in Interventional Cardiologists and Catheterization Lab Staff
July 31, 2017—In Catheterization and Cardiovascular Interventions, Ahmed Elmaraezy, MD, et al published a systematic review and meta-analysis that assessed the risk of developing a radiation-induced cataract among interventional cardiologists and catheterization lab staff (2017;90:1–9).
The background of the study is that the eye lens is one of the most radiosensitive organs in the body and interventional cardiologists are exposed to radiation during cardiac catheterization procedures, so they are highly susceptible to develop a radiation-induced cataract.
The investigators reported that they performed a systematic literature search of nine electronic databases to retrieve studies that reported cataract among interventional cardiologists. Records were screened for eligibility and data were extracted and analyzed using Review Manager software (RevMan) for Windows.
As summarized in Catheterization and Cardiovascular Interventions, eight studies involving 2,559 patients (exposed interventional cardiologists = 1,224) were included. Posterior lens opacity was significantly higher in interventional cardiologists relative to the control group (relative risk [RR], 3.21; 95% confidence interval [CI], 2.14–4.83; P < .00001). In contrast, there was no significant difference between both groups in cortical lens opacity (RR, 0.69; 95% CI, 0.46–1.06; P = .09) and nuclear opacity (RR, 0.85; 95% CI, 0.71–1.02; P = .08).
The investigators concluded that interventional cardiologists are at a high risk of developing a radiation-induced cataract; therefore, protective measures with high safety rates should be taken.
In an accompanying editorial in Catheterization and Cardiovascular Interventions, Timothy D. Henry, MD, and Christopher R. Henry, MD, noted that both interventional cardiologists and cardiac catheterization lab staff had a significantly higher relative risk (3.21 and 2.76, respectively) of posterior lens opacity than the control group in the meta-analysis (2017;90:10–11). They advised that it is essential to provide “best practice” in radiation dose management and lead shielding in the catheterization lab with the standard “As Low As Reasonably Achievable." There is a clear need for better data to quantitate the radiation risk and to design innovative strategies to decrease that risk, advised Drs. Henry and Henry in Catheterization and Cardiovascular Interventions.