How do statins potentially reduce glaucoma risk and the need for eye surgeries?

A 15% reduction in the likelihood of developing open-angle glaucoma has been observed among individuals using statins, according to new findings published online in the British Journal of Ophthalmology. The study also suggests these patients are less prone to disease progression requiring surgical intervention or intensified medication.

Database analysis reveals trends

Researchers examined a global database encompassing 165 million people to strengthen the evidence base regarding statins' potential role in eye health. While primarily prescribed for lowering cholesterol, prior studies indicated these drugs might prevent or slow nerve cell death, though their specific impact on glaucoma remained poorly understood.

The team compared more than 210,000 individuals with records of statin use between August 2006 and August 2026 against a matched control group of 210,000 non-users. Both groups required documented ophthalmological follow-up. Glaucoma, a leading cause of irreversible blindness, results from permanent damage to the optic nerve.

Surgery rates decline significantly

Over five years, the statin group recorded 4,771 new glaucoma diagnoses (2.3%), compared to 5,491 (2.6%) in the control group. A separate analysis focused on over 30,000 existing glaucoma patients taking statins versus nearly 250,000 who were not.

Statin use correlated with a decreased need for escalating treatments. Specifically, it was associated with a 36% lower risk of incisional glaucoma surgery and a 55% reduced risk of minimally invasive glaucoma surgery (MIGS), a keyhole procedure designed to lower intraocular pressure. Additionally, the risk of selective laser trabeculoplasty (SLT), which uses laser pulses to reduce eye pressure, dropped by 60%. Patients on statins also showed a 12% reduced risk of needing pressure-lowering eye drops.

Study limitations noted

These associations persisted after 10 years across all measured outcomes: incision surgery, MIGS, SLT, and eye drop usage. However, as an observational study, firm conclusions about cause and effect cannot be drawn. Limitations include the lack of access to individual patient data, such as intraocular pressure measurements or specific surgical details.

Consequently, researchers could not determine if surgeries resulted from increased disease severity or poor adherence to treatment protocols. Despite this, the authors state their findings contribute to growing literature on the neuroprotective effects of statins. They emphasize that prospective randomised trials are now necessary to better understand how statin use affects glaucoma incidence and treatment needs.

"Our findings suggest that statin usage is associated with both lower incidence of primary open-angle glaucoma as well as decreased treatment escalation," the researchers say. The study carries the DOI: 10.1136/bjo-2026-330339.