Clinical Health Updates

Statin use may reduce risk of cataracts

Clinical Question:
Do statins reduce the risk of cataracts?

Bottom Line:
Statin use is associated with a reduced incidence of nuclear cataracts, the most common type of age-related cataracts. However, this type of study design (prospective cohort study) does not prove a causal relationship between the use of statins and lower risk of developing cataracts. It is possible that other confounding variables (eg, genetics or patient compliance) are causally related.

Klein BE, Klein R, Lee KE, Grady LM. Statin use and incident nuclear cataract. JAMA 2006;295:2752-2758.

Study Design:
Cohort (prospective)

Statins are widely prescribed for their lipid-lowering effects but also have putative antioxidant properties. Oxidative stress is believed to play a role in the development of nuclear cataract, but little is known regarding the relationship of statin use and cataract incidence. The author evaluate the relationship of use of statins and incident cataract in adults in a midwestern community in the United States. The Beaver Dam Eye Study, an observational, longitudinal, population-based study of age-related eye disease in Beaver Dam, Wis. There were 1299 persons who were seen at the third examination in 1998-2000, had gradable photographs in both eyes, and were deemed to be at risk of developing nuclear cataract within 5 years. Five-year incidence of cataract with respect to statin use. Cataracts were graded from photographs taken through the participant’s dilated pupil. A total of 210 persons developed incident nuclear cataract in the interval from 1998-2000 to 2003-2005. Five-year incidence of nuclear cataract was 12.2% in statin users compared with 17.2% in nonusers (odds ratio [OR], 0.55; 95% confidence interval [CI], 0.36-0.84), controlling for age. When only never smokers without diabetes were assessed, the age-, lipid level-, and sex-adjusted OR was 0.40 (95% CI, 0.18-0.90). Five-year incidence of cortical cataract was 9.9% in statin users and 7.5% in nonusers (OR, 1.28; 95% CI, 0.79-2.08); posterior subcapsular cataract occurred in 3.0% of statin users and 3.4% of nonusers (OR, 0.82; 95% CI, 0.39-1.71).