All About Cataracts

Persistent use of statin drugs, such as Lipitor and Crestor, may lower your risk of developing cataracts, according to a new study.

In recent years, a growing body of evidence suggests statin drugs, used to lower cholesterol and reduce the risk of heart attack, may have anti-inflammatory effects, and these effects could possibly reduce cataract formation.

Statin drugs are among the most commonly prescribed medications in America. They are designed to lower “bad” cholesterol levels and thereby reduce the risk of heart attack and stroke.

Researchers in Israel conducted a retrospective study that reviewed the medical charts of more than 180,000 new statin drug users from 1998 to 2007 to determine if these individuals developed cataracts or needed cataract removal. During the study period, 27,301 cataracts were diagnosed and 6,976 cataract extractions were performed among the study participants.

Continuous use of statin medications throughout the study period was associated with a significant reduction in the risk of cataracts and cataract surgery among men and women ages 45 to 74 years.  No protective effect was seen in participants who were age 75 or older.

The authors of the study concluded that persistent statin use by adults under age 75 has a protective effect against the development of cataracts.

SOURCE: Persistence with statins and incident cataract: A population-based historical cohort study. Annals of Epidemiology. February 2010.

When a cataract surgery is canceled on the day of surgery, it is stressful for both the patient and the cataract surgeon.

To determine the reasons why cataract surgery gets cancelled at the last moment, researchers in Kuwait performed a retrospective study of 1,952 patients who were scheduled for elective cataract surgery. A total of 234 cases (12 percent) were canceled on the day of surgery.

Primary reasons for short-notice cataract surgery cancellation included:

• Poor control of high blood pressure (32.9 percent)
• Canceled by patient for unspecified reason (19.6 percent)
• Improper control of diabetes (8.5 percent)
• Chest infection or influenza (7.3 percent)
• Eye infection (5.6 percent)
• Heart problems (4.7 percent)
• High eye pressure after local anesthesia (3.4 percent)

The researchers concluded that most cancellations of cataract removal are avoidable, and efforts should be made to reduce the number of canceled and postponed cataract operations.

SOURCE: Why is cataract surgery canceled? A retrospective evaluation. European Journal of Ophthalmology. January-February 2010.

Researchers in Canada have found that expedited cataract surgery among older patients improves visual acuity but does not appear to significantly reduce the risk of falls among this population.

The investigators conducted a systematic review of several studies that evaluated the effect of surgical removal of cataracts shortly after they were discovered as a measure to improve vision and reduce the risk of injury among older adults. Both published and unpublished studies dating from 1950 to 2008 were included in the research.

Vision data from 737 patients were included in the analysis. Analysis of the data showed that expedited cataract surgery significantly improved visual acuity in most cases. But analysis of pooled data from 535 patients showed only a nonsignificant reduction of falls after cataract surgery.

The researchers concluded that accumulating evidence indicates expedited cataract surgery is effective in significantly enhancing vision but is inconclusive in preventing falls.

The full report of the research appears in this month’s issue of Journal of Cataract and Refractive Surgery.

The results of the study are contrary to research reported in the April 2007 issue of the Canadian Medical Association Journal (CMAJ),* which found evidence that vision and quality of life decrease, and the rate of falls increases, among patients during the waiting period for cataract surgery.

*The consequences of waiting for cataract surgery: a systematic review. CMAJ. Vol 176, No 9. April 24, 2007.

If you have cataracts and also are being treated for glaucoma, cataract surgery may reduce your need for glaucoma medications and surgery, according to a new study.

Researchers in Korea recently conducted a retrospective study of 96 people with glaucoma who underwent phacoemulsification cataract surgery with intraocular lens (IOL) implantation for the treatment of clinically significant cataracts. Forty-eight of the patients had primary open-angle glaucoma (POAG) and 48 had primary angle-closure glaucoma (PACG).

While previous studies have shown that cataract extraction with IOL implantation lowers intraocular pressure (IOP) in patients with and without glaucoma, the focus of this study was to determine which type of glaucoma patients are most likely to achieve the greatest IOP-lowering effect of cataract surgery.

The follow-up period ranged from 24 to 54 months, with a mean of 31 months.

The researchers found that cataract surgery successfully controlled the IOP of 39.6 percent of eyes with POAG and 62.5 percent of eyes with PACG. The criteria of success was attaining an IOP of 21 mm Hg or lower without medical glaucoma treatment or with fewer anti-glaucoma medications than before surgery.

Among eyes with primary open-angle glaucoma, pre-operative factors increasing the likelihood of successful IOP control after cataract surgery were a maximum IOP lower than 31 mm Hg and use of fewer than three anti-glaucoma medications.

Pre-operative factors increasing the likelihood of success among eyes with primary angle-closure glaucoma were a maximum IOP lower than 42 mm Hg, use of fewer than three anti-glaucoma medications and less than 30 percent of the drainage angle of the anterior chamber of the eye being affected by iris adhesions called peripheral anterior synechiae.

The researchers concluded that modern small-incision cataract surgery using phacoemulsification and foldable IOL implantation may help control IOP in some glaucoma patients, reducing or eliminating their need for anti-glaucoma medicine and/or glaucoma surgery.

The study was published in this month’s issue of Canadian Journal of Ophthalmology.