Statins and Cataracts--a visual insight

Cataract is the leading cause of visual impairment, other than uncorrected refractive errors, and the number one cause of preventable blindness worldwide. Common adverse events of statins include statin-related muscle toxicity, elevation of transaminases, diabetes, and possible association with cancer. Publications on the relationship of cataract to statins have reported inconsistent findings. A meta-analysis indicated a 19 % decrease in cataract among statin users. The pleiotropic effects of statins including effects on inflammation and oxidation may mediate a decrease in the rate of cataract formation. On the other hand, bidirectional effects of statins on oxidation and inhibition of appropriate lens epithelial cell development may promote cataractogenesis. Younger age and longer duration of statin therapy was associated with greater benefit while a benefit was not observed among older persons. A definitive way to settle the issue of the relationship of statins to cataract is to perform a randomized clinical trial or include cataract as an end point in epidemiologic studies. An increased risk of cataract may be balanced by the marked benefits of statins for those at high risk for cardiovascular events, while a decreased risk may help increase adherence to statin therapy.