Systemic medications associate with surgically treated cataract among adults over 50 years in Finland

To identify associations between systemic drugs and cataract surgery in Finland.

A historic cohort study based on administrative data. Endpoint event was cataract surgery. Use of drugs in question was based on redeemed prescriptions and consisted of 156 drugs. Study population consisted of 106 127 individuals aged ≥50 years without diabetes originating from the 1996-2017 Fin-CARING population. We constructed a nested case-control study design comparing 17 811 cases undergoing cataract surgery to 76 532 age-, sex- and hospital district-matched controls without cataract surgery. Results are reported as odds ratios (ORs) with 95% confidence intervals (CIs) based on conditional logistic regression models.

Use of ramipril (1.14; 1.04-1.25), losartan (1.20; 1.07-1.35), bisoprolol (1.24; 1.18-1.31), amlodipine (1.16; 1.07-1.25), diltiazem (1.26; 1.06-1.49), isosorbide mononitrate (1.56; 1.44-1.70), furosemide (1.31; 1.18-1.45), simvastatin (1.17; 1.11-1.24), atorvastatin (1.17; 1.06-1.29), prednisolone (2.00; 1.64-2.42), allopurinol (1.47; 1.24-1.75), pramipexole (1.45; 1.13-1.86), testosterone (1.62; 1.03-2.55), estradiol (1.13; 1.03-1.24), oxazepam (1.26; 1.07-1.47), sertraline (1.74; 1.13-2.67) and zopiclone (1.31; 1.20-1.43) showed some evidence for an association with cataract surgery. Use of memantine (OR 0.24; 0.15-0.40), risperidone (0.72; 0.51-1.00), rivastigmine (0.35; 0.21-0.58) and donepezil (0.55; 0.40-0.76) was associated with a lower risk of cataract surgery.

Our large nested case-control study suggests that certain systemic medications may increase the incidence of surgically treated cataract, but with the possibility of residual confounding.