To the Editor We read with interest the retrospective study titled “Association of Statin Use With Cataracts: A Propensity Score–Matched Analysis.”1
The definition of cataract includes lenticular opacities, a condition with high interobserver variability.2 Although lens opacities are objective changes and, as such, can be evaluated and recorded, they may or may not have associated visual impairment or functional consequences.3 The hard end point of cataract extraction may be available in the database used by Leuschen and colleagues, and examination of this may clarify their message. An increase in the rate of cataract surgery was reported by Lai et al4 among patients with an average age of 70 years, 15 years older than patients in the study by Leuschen and colleagues. The effect of statins on cataract may depend on age, with a neutral or protective effect when statin use begins in early age and continues for decades.
Kostis JB, Dobrzynski JM. Statin Use and Cataract. JAMA Ophthalmol. 2014;132(3):363-364. doi:10.1001/jamaophthalmol.2013.8263