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March 3, 1999

Inhaled Corticosteroids and Likelihood of Cataract Extraction

Author Affiliations

Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor

JAMA. 1999;281(9):791-793. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-9-jbk0303

To the Editor: The study by Dr Garbe and colleagues1 should not deter clinicians from using inhaled steroids aggressively to treat the diseases for which they are indicated. First, the patients at greatest risk for cataract removal were those who were receiving high doses of inhaled steroids for prolonged periods—a very small number of patients. Second, patients rarely require sustained, high-dose inhaled corticosteroid therapy. Rather, most patients subsequently have doses tapered to the lowest dose that will control symptoms. Third, it is possible that, for some patients receiving prolonged high-dose corticosteroid treatment, such treatment was not clinically indicated.