Recent Statin Use and Cataract Surgery

PURPOSE: To investigate whether the statin class of drugs reduces the risk of cataract extraction. DESIGN: Case-control study. METHOD: SETTING: Kaiser Permanente Southern California, which provides prepaid healthcare for 3.2 million residents by 6000 physicians. PATIENT POPULATION: Eligible patients were those who had 5+ years of continuous enrollment in 2009. Cases were 13 982 patients who underwent cataract surgery in their first eye in 2009. Controls were the 34 049 patients who had an eye examination, but did not undergo cataract surgery or have a diagnosis of cataract in their medical record. OBSERVATION PROCEDURE: The primary source of data to assess cataract surgery, treatment with statins, and other risk factors is the electronic database of Kaiser Permanente. MAIN OUTCOME MEASURE: Use of the statin class of drug. RESULTS: Patients who had cataract surgery were older, were more likely to be white, and appeared to have more coronary artery disease but less diabetes. The proportion of statin users appeared to be greater among those with cataract surgery (64.3%) compared to those without a diagnosis of cataract or cataract surgery (55.5%). After adjustment for age, sex, race, smoking status, diabetes, and coronary artery disease, longer-term statin use was found to be protective against cataract extraction (OR: 0.93, P = .02), while shorter-term use was associated with cataract surgery (OR: 1.11, P < .0001). Age-stratified logistic regression analysis showed that statin use of 5 years or more was protective against cataract surgery in the younger age group (50-64 years), while shorter-term use ( <5 years) was associated with an increased risk of surgery in both the younger and older age groups (60+ years). CONCLUSION: The current study finds that recent longer-tern statin use was protective against cataract surgery in younger patients (50-64 years of age), while shorter-term use was associated with an increased risk of surgery. One strength of the current study is information on the large number of incident cases of cataract extraction and the electronic database on drug use. Additional studies will be needed to understand the difference in effect between longer- and shorter-term users of statins. (Am J Ophthalmol 2012;153:222-228. (C) 2012 by Elsevier Inc. All rights reserved.)