CATARACTS AND STATINS

Cataracts and Statins

Cataracts are a common problem as we age. In people over the age of 75, two-thirds have the most common type of cataract. There are at least 300 to 400, 000 new visually disabling cataracts annually in the U.S. So preventing them would be key; but we really don’t have a good handle on how to do this. Now, though, it appears popular cholesterol lowering medicines might be able to help do just that. “Someone hit me with a cane in a bus yes a lady hit me with a cane in the bus,” cries Betty Brissett. Certainly, it’s not the most common way someone gets a cataract, but yes, the blow caused her to develop the degenerative condition that clouds the lense of the eye. And of course, there was no way she could have prevented that from happening.

But now, new research in the Journal of the American Medical Association shows the use of the cholesterol-lowering statin drugs is linked with a lower frequency of nuclear cataracts--the most common type, usually caused by simple aging. One of the major reasons for cataracts is smoking…the reason: smoking causes oxidative stress--when antioxidant levels are lower than normal, allowing so called free radicals to damage the eye.

The statins are believed to replace the antioxidants…and thus prevent the cataracts from forming. The odds of developing cataract were 40 percent lower for statin users after adjusting for several factors compared to those who didn’t use statins. The authors say that zocor, or simvastatin, may have a greater effect on cataract prevention. But there may not be a difference at all…what they saw in the study may have to do with how long a person was on the drug rather than which drug they were taking.

“I think more research is needed and we probably have to design a prospective study looking at this, but there most certainly be a benefit at least demonstrated in this one retrospective study of 210 patients. So this may actually represent an added benefit for those elderly patients with cardiovascular disease that are using cholesterol lowering drugs,” says Dr. Douglas Lazzaro, Chairman of the Department of Ophthalmology at Long Island College Hospital.

The authors analyzed found the odds of developing nuclear cataract were 60 percent lower among statin who don’t smoke or have diabetes. Still, statins are not for use as a cataract preventative only--at least not yet. “Only patients that have elevated LDL cholesterols should be using it, I would not prescribe satins just for the sake of possible preventing cataract,” Dr. Lazzarro advises.

Dr. Lazzaro says there are other things one can do to possibly prevent cataracts. “Reduction in smoking is one of the things, use of sunglasses to prevent ultraviolet rays, from causing free radicals and damage. Antioxidants which can be found in vitamins and a number of foods are felt to be protective against the progression of cataracts and even maybe the formation of cataracts.” It’s been a hazy picture, but it looks like the path to preventing cataracts is at least getting a little clearer now.