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Q J Med 2003; 96: 337-343
© 2003 Association of Physicians

Cataract and the use of statins: a case-control study

L. Smeeth1,, R. Hubbard2 and A.E. Fletcher1

From the 1 Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London and 2 Division of Respiratory Medicine, University of Nottingham, Nottingham City Hospital, Nottingham, UK

Received 28 January 2003 and in revised form 13 February 2003

Background: In animal studies, statins have induced cataract formation. Because incident cataract is relatively uncommon, studies in humans have been unable to exclude a clinically important effect.

Aims: To assess the risk of cataract associated with the use of statins, and whether it is increased by concurrent use of drugs that inhibit the cytochrome P450 system.

Design: Population-based case-control study.

Methods: Patients were randomly sampled from the UK General Practice Research Database. The study included 15 479 people with cataract and 15 479 controls matched for age, sex, practice and observation period.

Results: The crude odds ratio (OR) for the association between any recorded exposure to statins and cataract was 1.41 (95%CI 1.21–1.65), but this reduced to 1.04 (95%CI 0.89–1.23, p=0.6) after adjustment for consultation rate. There was no evidence that the risk increased with higher doses or longer duration of statin use, or that the risk varied by individual statin. There was no evidence that the risk of cataract was increased by concurrent use of statins and drugs that inhibit the cytochrome P450 system.

Discussion: In the short- and medium-term, statins do not seem to be associated with an increased risk of cataract. The need to assess the effects of long-term statin exposure on the eye remains.

Address correspondence to Dr L. Smeeth, Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT. e-mail: liam.smeeth{at}lshtm.ac.uk


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