Statin use may increase patients’ risk of cataract development, according to a study in the September 19 online version of JAMA Ophthalmology.1

Studies disagree whether statins contribute to cataract.
But these findings contradict the results of a similar study presented in early September at the European Society of Cardiology Congress in Amsterdam, Netherlands, which indicated that statin therapy significantly reduces patients’ overall likelihood of cataract development.2

In the JAMA Ophthalmology study, the researchers analyzed the incidence of cataractogenesis in 13,626 statin users and 32,623 nonusers over a seven-year period. After adjusting for age, sex and pre-existing medical conditions, they found that patients who used statins were approximately 27% more likely to develop cataracts than those who didn’t.1 Yet, in the European study, which included nearly 2.4 million subjects, patients who remained on statin therapy for an average of 54 months were approximately 20% less likely to develop cataracts than those with no history of statin use.2

So, why such disparity between study conclusions? The devil’s in the details, says Stuart P. Richer, OD, PhD, director of ocular preventive medicine at the James A. Lovell Federal Health Care Center in North Chicago.

“If statin use yielded a large biological effect [on overall cataract incidence], it would be obvious to the patient or doctor within a matter of months,” Dr. Richer said. “In this case, however, you need 2,000,000 patients to tease out clinically significant absolute risk reduction and risk elevation numbers.”

From a larger public health standpoint, Dr. Richer suggests that such confusion regarding cataract risk and statin use easily could be avoided altogether.“If physicians encouraged patients merely to increase their vegetable and fruit consumption, while lowering their carbohydrate intake, there would be a dramatic overall decrease in cataracts and cholesterol––and therefore less of a need to use statins in the first place,” he says.

1. Leuschen J, Mortensen EM, Frei CR, et al. Association of statin use with cataracts: A propensity score-matched analysis. JAMA Ophthalmol. 2013 Sep 19. [Epub ahead of print]
2. Kostis JB, Dobrzynski JM. Statins prevent cataracts: a meta-analysis. Presented at the European Society of Cardiology Congress 2013. Aug 31-Sept 4; Amsterdam, Netherlands.