Some clinicians have raised concerns regarding the potential for lens opacities (cataracts) as a result of statin use. Statins are prescribed to reduce total cholesterol and low-density lipoprotein cholesterol (LDL).
Researchers used data from the British Columbia (BC) Ministry of Health databases from 2000-2007 and the IMS LifeLink U.S. database from 2001-2011 to form two patient cohorts. In the BC cohort, there was about a 27% increased risk of developing cataracts requiring surgical intervention, while in the IMS cohort, the increased risk was only 7%, but still statistically significant.
AdvertisementLead investigator G.B. John Mancini, MD, of the Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada, said, "Further assessment of the clinical impact of this relationship is recommended, especially given increased statin use for primary prevention of cardiovascular disease (CVD) and the importance of acceptable vision in old age where CVD is common. Future studies addressing the possible underlying mechanisms to explain this association are also warranted. However, because the RR is low and because cataract surgery is both effective and well tolerated, this association should be disclosed but not be considered a deterrent to use of statins when warranted for CV risk reduction."
In an accompanying editorial, Steven Gryn, MD, FRCPC, and Robert A. Hegele, MD, FRCPC, of the Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada, wrote, "Any medication that has beneficial effects has potential adverse effects; weighing the benefits against the risks is an integral part of the informed consent process, and is central to any decision to initiate treatment. Among patients who are at high CVD risk, like most of those seen by cardiologists...the prevention of CVD, stroke, and their associated morbidity and mortality vastly outweighs the risk of cataracts. Even among lower risk patients, for whom the benefit-risk ratio is less dramatic, most patients would still probably prefer having to undergo earlier non-life-threatening cataract surgery over suffering a major vascular event. A randomized double-blinded placebo-controlled clinical trial is the best way to mitigate confounding, and such studies so far have shown no association of statins with cataracts."
The article is published in the Canadian Journal of Cardiology.