Inhibitors of Cholesterol Synthesis and Cataracts

To the Editor.— The results presented in the article entitled "Therapeutic Response to Lovastatin (Mevinolin) in Nonfamilial Hypercholoesterolemia"¹ clearly indicate that lovastatin (a potent inhibitor of the rate-limiting step in cholesterol biosynthesis) could be a useful agent for the management of an elevated low-density lipoprotein cholesterol level. The purpose of this letter is to caution against the possible complication of cataract development that might result from long-term use of this agent. Although the authors reported no apparent increases in lens opacities in adult subjects treated for 18 weeks with lovastatin, they should be aware that serious consequences could result from long-term inhibition of cholesterol synthesis by the ocular lens, especially in children and young adults.

The avascular lens grows throughout life by laying down layer upon layer of permanently retained fiber cells that are enclosed by an extremely cholesterol-rich plasma membrane. The human lens increases in size with each