Copyright 1999 American Medical Association.
All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.1999
To the Editor: In their article addressing the risk
of cataract extraction in individuals using inhaled corticosteroids, Dr
Garbe and colleagues1 conclude, "In summary, the results
of our study demonstrate an increased risk of cataract for prolonged
use of high doses of inhaled corticosteroids." We believe that this
article does not provide the evidence to take a leap between risk of
cataract extraction and risk of cataract overall. Since the focus of
this article was to show a positive correlation between extraction and
corticosteroid use, the final conclusion should mirror these
objectives. Second, while Garbe et al studied a huge population, when
all factors were taken into consideration, the pertinent population was
quite small. According to the article, only 15 patients had cataract
extraction between 1992 and 1994 with no major risk factors as defined
by the article, did not receive systemic corticosteroids after the age
of 65 years, and were using inhaled corticosteroids for longer than 3
years. This group was compared with a control group of 28 patients
without cataract extraction who met the other criteria. Using such a
small population always causes concern when such serious conclusions
are being drawn.
Frantz EA, Shenenberger DW. Inhaled Corticosteroids and Likelihood of Cataract Extraction. JAMA. 1999;281(9):791–793. doi:10.1001/jama.281.9.791
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