Association of statin use with cataracts: a propensity score-matched analysis.
OBJECTIVE
Cataracts are a main cause of low vision; with the growing elderly population, the incidence of cataracts is likely to increase. Investigators have previously hypothesized that statin antioxidant effects may slow the natural aging process of the lens.


OBJECTIVE
To compare the risks for development of cataracts between statin users and nonusers.


METHODS
A propensity score-matched cohort analysis using retrospective data from October 1, 2003, to March 1, 2010. A propensity score-matched cohort of statin users and nonusers was created using 44 variables.


METHODS
Database of a military health care system.


METHODS
Based on medication fills during fiscal year 2005, patients were divided into 2 groups: (1) statin users (received at least a 90-day supply of statin) and (2) nonusers (never received a statin throughout the study). Among 46,249 patients meeting study criteria, we identified 13,626 statin users and 32,623 nonusers.


METHODS
Use of statin therapy for more than 90 days.


METHODS
Primary analysis examined the risks for cataract in the propensity score-matched cohort. Secondary analyses examined the risks for cataract in patients with no comorbidities according to the Charlson Comorbidity Index (patients with no Charlson comorbidity). A sensitivity analysis was conducted to repeat the secondary analysis in patients taking statins for durations of 2, 4, and 6 years.


RESULTS
For our primary analysis, we matched 6972 pairs of statin users and nonusers. The risk for cataract was higher among statin users in comparison with nonusers in the propensity score-matched cohort (odds ratio, 1.09; 95% CI, 1.02-1.17). In secondary analyses, after adjusting for identified confounders, the incidence of cataract was higher in statin users in comparison with nonusers (odds ratio, 1.27; 95% CI, 1.15-1.40). Sensitivity analysis confirmed this relationship.


CONCLUSIONS
The risk for cataract is increased among statin users as compared with nonusers. The risk-benefit ratio of statin use, specifically for primary prevention, should be carefully weighed, and further studies are warranted.
Wilford Hall Ambulatory Surgery Center, San Antonio, Texas2San Antonio Military Medical Center, San Antonio, Texas.
Jessica
J
Leuschen
Eric M
EM
Mortensen
Christopher R
CR
Frei
Eva A
EA
Mansi
Vasudha
V
Panday
Ishak
I
Mansi
D002318:Cardiovascular Diseases / Q000517:prevention & control; D002386:Cataract / Q000139:chemically induced / Q000453:epidemiology*; D008078:Cholesterol, LDL / Q000097:blood; D015331:Cohort Studies; D016208:Databases, Factual; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D015994:Incidence; D008075:Lipoproteins, HDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D008887:Military Medicine; D016017:Odds Ratio; D057216:Propensity Score; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008075:Lipoproteins, HDL