Statin Use and Cataracts Among Patients with Diabetes

Despite data linking prolonged statin use with cataract development,  a recent study shows that patients with diabetes who take statins for a long period of time have no greater risk of developing cataracts than patients who have not taken prolonged coursed of statins.  Conducted by Hermans et al from Cliniques Universitaires St. - Luc, Belgium (Diabetes Metab, 2011), the analysis studied 780 patients with type 2 diabetes (T2D) at very high risk for diabetic retinopathy (DR) and cataract, and determined that chronic statin therapy was neither cataractogenic nor was cataract presence associated with increased use of statin or other lipid-lowering drugs. 

According to the authors, studying patients with T2D offers "an ideal condition in which to assess the potential beneficial/detrimental effects of satins or other lipid-lowering drugs (LLD) on cataract, because T2D patients have a high prevalence of atherogenic dyslipidaemia as part of the associated metabolic syndrome, and also exhibit an increased incidence/prevalence of both hyperglycaemia and age-related cataracts(s)."

Major risk factors for cataract in T2D patients include hyperglycemia, diabetes duration and the presence of DR.  Additionally, the study noted that certain risk factors or markers may differ according to cataract subtype; for example, smoking is associated with nuclear opacities, ultraviolet radiation increase the risk for cortical opacities, and high blood pressure and corticosteroids raise the odds for subcapsular cataract. 

The diagnosis of cataract was made by an ophthalmologist in 16.8% of the study population during annual or biannual retinal checkups.  Lens extraction was considered a surrogate for cataract prevalence in patients who had undergone prior lens surgery for cataract.  Both age and duration of diabetes were significantly higher in the group with cataracts compared with those without.  DR was diagnosed in 23% of the patients.  According to the researchers, the "benefits of statin therapy in T2D may far outweigh any potential ocular drawbacks as a side effect which, in any case, were not supported by our findings."