People on statin therapy to lower their cholesterol may derive an additional benefit if they undergo intraocular surgery to repair a retinal detachment caused by a retinal tear: a slightly lower risk for complications that can lead to a difficult-to-repair detachment in the future, according to a study of almost 55,000 eyes.

“Our study did show a decreased risk of proliferative vitreoretinopathy formation, but there’s certainly more work that needs to be done to better understand this because the risk of reoperation was essentially the same between the two cohorts,” Sidra Zafar, MD, retina fellow at Wills Eye Hospital in Philadelphia, told Medscape Medical News.

Zafar presented the findings at the American Academy of Ophthalmology (AAO) 2025 Annual Meeting.

The study included 54,876 adult eyes that had undergone a standalone scleral buckle procedure or pars plana vitrectomy plus scleral buckle for repair of a rhegmatogenous retinal detachment. The cohort was drawn from a national retina database that included operations from 2015 to 2024. One third of eyes were in people with a history of taking a statin.

Within 90 days of undergoing retinal detachment repair, 6.7% of statin users had proliferative vitreoretinopathy vs 8.2% of those not taking the lipid-lowering drugs (P < .001). At 180 days, the rates were 8.1% and 9.8%, respectively (P < .001). Overall, statin users had a 30% lower rate of proliferative vitreoretinopathy after surgery.

The rate for undergoing a second operation for repair of a complex retinal detachment was similar in both groups, 2.9% (P = .94), the researchers reported. 

Statin Users Had More Risk Factors

Statin users in the study were older (age 67 vs 59 years), were more likely to have an intraocular lens for cataract (57% vs 40%), and had higher rates of diabetes (26% vs 9%) and hypertension (67% vs 33%) than did those not taking the medications. 

The study also defined other risk factors for proliferative vitreoretinopathy after repairing a retinal detachment. They included patients aged 60 years or older, which varied by decade from a 28% greater risk for those aged 61-70 years to almost double the risk for patients aged 80 years or older; a 72% greater risk when the crystalline lens of the eye was absent; a 9% greater risk for diabetes; and a 27% increased risk for active smokers and 22% for former smokers.

The new study builds on previous research from Europe that showed potential protective effects of statins on the eyes, Zafar said. One study from Finland found that levels of potentially harmful proteins after vitrectomy were lower in patients on statins. The same researchers later reported that statin patients had a 28% lower rate of needing a second vitrectomy after retinal detachment repair surgery.

“Proliferative vitreoretinopathy and preventing it are still not understood well,” Zafar said. “We know statins, with their properties have been shown to be protective for other diseases such as age-related macular degeneration and diabetic retinopathy, but could their anti-inflammatory properties translate into preventing the risk of proliferative vitreoretinopathy?”

A prospective study that randomizes patients would help to answer that question, she said, but more retrospective studies would be needed in the meantime. At this stage, her group’s work “is in its infancy,” Zafar added.

“This is a good study,” Nikhil Bommakanti, MD, vitreoretinal surgeon at Tufts Medical Center in Boston, told Medscape Medical News. “For us vitreoretinal surgeons treating patients with retinal detachments, proliferative vitreoretinopathy is one of the main problems that keeps us up at night because it can lead to recurrent retinal detachment and vision loss.”

Bommakanti agreed that a prospective, randomized controlled clinical trial would be “ideal,” but this finding and other data on statin use in patients who undergo retinal detachment repair surgery make the case for further research. 

“As a field, we have several ongoing efforts investigating interventions after surgery that might reduce these risks,” he said. “It’s exciting to see more work being done that suggests that an existing, commonly used oral medication might be helpful to mitigate this very serious problem.”

A primary strength of the study was the large dataset and its consistency with smaller studies, he said. Limitations were its retrospective design and use of procedure and diagnosis codes to track outcomes, which may miss details of the pathology and surgical procedures. 

“The authors also reported that they lacked information on statin dosage, duration of treatment, and treatment adherence, which would naturally be important in determining the magnitude of the potential effect, as well as optimal doses,” he added.

The fact that statin users were older and had higher rates of diabetes and hypertension, known risk factors for surgical complications, yet had slightly lower rates of postsurgery proliferative vitreoretinopathy “might actually add support for a possible protective effect” of statins, Bommakanti said.

Zafar reported having no relevant financial conflicts of interest. Bommakanti reported consulting for EyePoint Pharmaceuticals, Regenxbio, and Alimera Sciences. 

Richard Mark Kirkner is a medical journalist based in Philadelphia.