Glaucoma Can Develop After Vitreoretinal Surgery, But Statins May Help Mitigate Risk

High-speed vitrector being used during eye operation, during a pars plana vitrectomy. Close-up, High-speed vitrector is introduced into the wound to carry out the remainder of the liquefaction. Sometimes instruments do not perform as well as a surgeon would like, so they can be replaced mid-surgery. (Photo by Universal Images Group via Getty Images)
Long-term systemic statin use may reduce glaucoma risk after vitreoretinal surgery, according to a report.

Vitreoretinal surgery is associated with an increased risk of developing glaucoma, according to a study published in Acta Ophthalmologica. The researchers also report that statin therapy during the long-term preoperative period may reduce glaucoma risk after vitreoretinal surgery.  

The population-based nested case-control study included patients aged 18 years and older who underwent single vitrectomy, vitrectomy with retinal procedure, or combined phaco-vitrectomy between 2001 and 2010. The end of follow-up was 2017. The study population (n=37,687) consisted of 6552 individuals diagnosed with glaucoma and 31,135 controls matched by age, sex, and hospital district. Among the cohort, 52.8% (n=19,895) were women. Researchers noted that the 3 most used systemic medications were metformin (n=10,370, 27.5%), beta-blockers (n=9529, 25.3%), and statins (n=7830, 20.8%). In total, vitrectomy was performed on 103 eyes in the glaucoma group and 158 eyes in the control group. 

According to the conditional logistic regression model, the risk of any glaucoma increased after all 3 types of vitreoretinal surgeries. Glaucoma risk was lowest in eyes that underwent combined phaco-vitrectomy (OR: 2.7, 95% CI: 1.8–4.1), followed by single vitrectomy (OR: 3.15, 95% CI: 2.1–4.8), and highest in eyes that underwent vitrectomy with retinal procedure (OR: 4.5, 95% CI: 2.7–7.4). Diabetes was not associated with any type of glaucoma risk after vitreoretinal surgery (adjusted OR: 0.94, 95% CI: 0.87–1.03), while 5-year systemic statin use slightly lowered glaucoma risk (OR: 0.86, 95% CI: 0.77–0.97).

“Although exposure to statin in the long-term preoperative period was associated with reduced glaucoma risk after vitreoretinal surgery, no strong conclusions can be drawn from the sub-analysis without information on the dose or type of statin,” according to the researchers. 

This study was limited by its observational design.

Disclosure: One study author declared affiliations with biotech, pharmaceutical, and/or devices companies. Please see the original reference for a full list of authors’ disclosures. 


Loukovaara S, Gucciardo E, Korhonen A, Virtanen A, Harju M, Haukka J. Risk of glaucoma after vitreoretinal surgery – Findings from a population-based cohort study. Acta Ophthalmol. Published online April 26, 2022. doi:10.1111/aos.15161