[Cataract prevention. Therapeutic approaches and critical review of current status].

Research on the pathophysiology of the lens already in the early days of the last century led to first attempts to clinically influence cataract development with vitamins. More detailed investigation of lens aging and its interaction with internal and external cataract risk factors led to two different therapeutic strategies: (1) compounds or mixtures expected to slow down the aging processes in the lens (food additives) and (2) compounds to reduce or even arrest the effect of a specific harmful factor. Various mixtures expected to influence aging processes were even developed into approved OTC drugs although their effectiveness was never demonstrated. Among those compounds designed to act on a specific pathomechanism, mainly aldose reductase inhibitors were designed and successfully tested in animal studies. None of these,however, could be developed into a market-approved drug. Larger controlled clinical studies have been performed with various compositions of food additives, but also with nonsteroidal anti-inflammatory drugs such as salicylic acid and ibuprofen. None of the clinical trials,however, evidenced any convincing anti-cataract effect of the compounds or mixtures tested such that a successful anti-cataract drug still remains to be developed.