Incidence of cataract operations in Finnish male smokers unaffected by alpha tocopherol or beta carotene supplements

OBJECTIVE: To examine the effect of alpha tocopherol and beta carotene supplementation on the incidence of age related cataract extraction. SETTING: The Alpha-tocopherol Beta-carotene (ATBC) Study was a randomised, double blind, placebo controlled, 2 x 2 factorial trial conducted in south western Finland. The cataract surgery study population of 28,934 male smokers 50-69 years of age at the start. INTERVENTION: Random assignment to one of four regimens: alpha tocopherol 50 mg per day, beta carotene 20 mg per day, both alpha tocopherol and beta carotene, or placebo. Follow up continued for five to eight years (median 5.7 years) with a total of 159,199 person years. OUTCOME MEASURE: Cataract extraction, ascertained from the National Hospital Discharge Registry. RESULTS: 425 men had cataract surgery because of senile or presenile cataract during the follow up. Of these, 112 men were in the alpha tocopherol alone group, 112 men in the beta carotene alone group, 96 men in the alpha tocopherol and beta carotene group, and 105 men in the placebo group. When supplementation with alpha tocopherol and with beta carotene were introduced to a Cox proportional hazards model with baseline characteristics (age, education, history of diabetes, body mass index, alcohol consumption, number of cigarettes smoked daily, smoking duration, visual acuity, and total cholesterol), neither alpha tocopherol (relative risk, RR, 0.91, 95% confidence intervals, CI, 0.74, 1.11) nor beta carotene (RR 0.97, 95% CI 0.79, 1.19) supplementation affected the incidence of cataract surgery. CONCLUSION: Supplementation with alpha tocopherol or beta carotene does not affect the incidence of cataract extractions among male smokers.