{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T02:30:19Z","timestamp":1792636219989,"version":"4.5.0"},"reference-count":53,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:p>\n                    There is conflicting evidence for the association between smoking and dry eye disease (DED). We conducted a meta-analysis to determine the true relationship between smoking and DED. A systematic literature search was performed using electronic databases, including PubMed, Embase and Cochrane Library, till August 2021 to identify observational studies with data on smoking as risk factor of DED. Quality assessment of the included studies was conducted using Joanna Briggs Institute (JBI) critical appraisal checklists. The random-effects model was used to calculate the pooled odds ratio (OR). Heterogeneity was evaluated by Cochrane Q and I\n                    <jats:sup>2<\/jats:sup>\n                    index; in addition, subgroup, sensitivity, and meta-regression analyses were performed. Publication bias was assessed using funnel plot and Egger\u2019s regression test. A total of 22 studies (4 cohort and 18 cross-sectional studies) with 160,217 subjects met the inclusion criteria and were included in this meta-analysis. There is no statistically significant relationship between current smokers (OR\n                    <jats:sub>adjusted<\/jats:sub>\n                    = 1.14; 95% CI: 0.95\u20131.36;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.15; I\n                    <jats:sup>2<\/jats:sup>\n                    = 84%) and former smokers (OR\n                    <jats:sub>adjusted<\/jats:sub>\n                    = 1.06; 95% CI: 0.93\u20131.20;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.38; I\n                    <jats:sup>2<\/jats:sup>\n                    = 26.7%) for the risk of DED. The results remained consistent across various subgroups. No risk of publication bias was detected by funnel plot and Eggers\u2019s test (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &gt; 0.05). No source of heterogeneity was observed in the meta-regression analysis. Our meta-analysis suggest current or former smoking may not be involved in the risk of dry eye disease. Further studies to understand the mechanism of interaction between current smokers and formers smokers with DED are recommended.\n                  <\/jats:p>","DOI":"10.4103\/ijo.ijo_2193_21","type":"journal-article","created":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T07:18:21Z","timestamp":1654067901000},"page":"1892-1904","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":33,"title":["Association of dry eye disease with smoking: A systematic review and meta-analysis"],"prefix":"10.4103","volume":"70","author":[{"given":"Muhammad Ali","family":"Tariq","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Dow University Hospital, Dow International Medical College, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamza","family":"Amin","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Dr. Ruth K. M. Pfau Civil Hospital, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bilal","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Dow University Hospital, Dow International Medical College, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uzair","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Dow University Hospital, Dow International Medical College, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashar","family":"Mohiuddin","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Dow University Hospital, Dow International Medical College, Karachi, 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