Statin Use and Cataract Surgery: A Nationwide Retrospective Cohort Study in Elderly Ethnic Chinese Patients

Abstract

Background

Since a report of lenticular opacities in dogs treated with high dosages of statins, the debate on the relationship between statin therapy and cataracts has not reached a conclusion.

Objective

The aim of this study was to evaluate the association between statin therapy and the risk of cataract surgery in an elderly ethnic Chinese population using time-dependent analysis to minimize immortal time bias.

Methods

A retrospective cohort study using the Longitudinal Health Insurance Database 2005 randomly sampled from the National Health Insurance Research Database, Taiwan, was conducted. A total of 50,165 adults aged between 65 and 90 years in 1998 without records of statin therapy or diagnosis of cataracts between July 1997 and December 1997 were included in the analysis. The first record of lens extraction within the follow-up period (1998–2009) was set as the study endpoint. A propensity score was derived using a logistic regression model to model the receipt of statin therapy as a function of the baseline characteristics for every subject. We used the time-dependent Cox regression model to test the relative hazard of undergoing cataract surgery between statin users and non-users, while use of statins was treated as a time-dependent variable, controlling for baseline age and individual propensity score.

Results

Of the 50,165 enrolled subjects, 17,670 individuals with an incident lens extraction were identified during a median follow-up of 10.7 years. The incidence of cataract surgery was 49.7/1,000 person-years in the statin-using period compared with 38.5/1,000 person-years in the statin-non-using period. The adjusted hazard ratio of cataract surgery was 1.20 (95 % CI 1.14–1.27; P < 0.001) in statin users compared with statin non-users.

Conclusion

Statin therapy was associated with a modestly increased risk of cataract surgery. We suggest regular checks for lens opacity in statin users.

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Acknowledgments

This study is based in part on data from the NHIRD provided by the Bureau of National Health Insurance, Department of Health, Taiwan, and managed by National Health Research Institutes, Taiwan. The interpretation and conclusions contained herein do not represent those of the Bureau of National Health Insurance, Department of Health, Taiwan or National Health Research Institutes, Taiwan.

Authors’ contributions

Conception and design: C-L Lai, W-Y Shau, C-H Chang, M-F Chen, M-S Lai. Acquisition of data: C-L Lai. Analysis and interpretation of the data: C-L Lai. Drafting of the article: C-L Lai. Critical revision of the article for important intellectual content: W-Y Shau, C-H Chang, M-S Lai. Statistical analysis: C-L Lai. Obtaining of funding: M-F Chen, M-S Lai. Administrative, technical, or material support: W-Y Shau, C-H Chang. Supervision: M-F Chen, M-S Lai. Final approval of the article: C-L Lai, W-Y Shau, C-H Chang, M-F Chen, M-S Lai.

Source of funding

This work was supported by Grant 98HP0021 from the Ministry of Education Aiming for the Top University and Elite Research Center Development Plan (MoEATU Plan) in Taiwan.

Conflicts of interest

Chao-Lun Lai, Wen-Yi Shau, Chia-Hsuin Chang, Ming-Fong Chen, and Mei-Shu Lai have no conflicts of interest that are directly relevant to the content of this manuscript.

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Correspondence to Mei-Shu Lai.

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Lai, CL., Shau, WY., Chang, CH. et al. Statin Use and Cataract Surgery: A Nationwide Retrospective Cohort Study in Elderly Ethnic Chinese Patients. Drug Saf 36, 1017–1024 (2013). https://doi.org/10.1007/s40264-013-0076-0

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Keywords

  • Statin
  • Cataract
  • Statin Therapy
  • Statin User
  • Lens Opacity