Ophthalmology. Retina · 2026
Systemic Statin Use and Reduced Risk of Repeat Retinal Detachment Repair: A Retrospective Cohort Study.
СтатьяНазвание и аннотация: Перевод в очереди
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Bantounou Maria Anna, Foteinou Dimitra, Baroutis Konstantinos G, Emfietzoglou Maria, Bordbar Darius D, Brant Arthur R, Miller Joan W, Vavvas Demetrios G
Аннотация
OBJECTIVE: Recurrent retinal detachment (RD) is a major determinant of vision loss after primary repair, largely driven by proliferative vitreoretinopathy, a fibroinflammatory wound-healing process implicating hypoxia-inducible factor (HIF). Statins possess anti-inflammatory and antifibrotic properties and indirectly inhibit HIF. We evaluated whether preoperative statins reduced the 1-year risk of repeat RD repair after primary repair.
DESIGN: Single health system propensity-matched retrospective cohort study.
PARTICIPANTS: Using the Patient Data Science Repository, we identified patients aged ≥30 years who underwent primary RD repair between 2005 and 2025. A 1:1 propensity score-matched control group was generated based on demographics, smoking, hypertension, diabetes, obesity, myopia, uveitis, cataract surgery, and open globe injury.
METHODS: Statin exposure was defined as >90 cumulative use-days in the year before primary RD repair.
MAIN OUTCOME MEASURES: Repeat RD repair within 1 year of primary RD surgery was evaluated using Cox proportional hazards models to estimate hazard ratios (HRs). Sensitivity analyses included a negative control (proton pump inhibitors [PPIs] vs. unexposed), active comparator (statins vs. PPIs), and analyses by statin subclass and individual agents.
RESULTS: We identified 1232 statin-exposed patients and 1232 matched controls. At 1 year, repeat RD repair occurred in 16.1% of statin users versus 21.1% of controls (HR = 0.75; 95% confidence interval [CI], 0.62-0.89; P = 0.0014), with an absolute risk difference of 5.0%. The negative control showed no difference (17.2% vs. 18.0%; HR = 0.95; 95% CI, 0.74-1.22; P = 0.685). In the active-comparator analysis (PPI; n = 370 vs. statin n = 681), recurrent RD occurred in 14.5% of statin users versus 19.7% of PPI users (HR = 0.71; 95% CI, 0.54-0.95; P = 0.0224). After Bonferroni correction, only simvastatin (simvastatin n = 42/284 [14.8%] vs. control n = 67/284 [23.6%]) among statin subclasses and individual agent comparisons was significantly associated with a reduced risk of repeat RD repair (HR = 0.59; 95% CI, 0.41-0.86; P = 0.0059, Bonferroni-adjusted P = 0.0356).
CONCLUSIONS: Statin use was associated with a lower risk of repeat RD repair, with the clearest signal for simvastatin. Prospective studies are needed to confirm causality and explore delivery approaches to reduce recurrence risk.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
DESIGN: Single health system propensity-matched retrospective cohort study.
PARTICIPANTS: Using the Patient Data Science Repository, we identified patients aged ≥30 years who underwent primary RD repair between 2005 and 2025. A 1:1 propensity score-matched control group was generated based on demographics, smoking, hypertension, diabetes, obesity, myopia, uveitis, cataract surgery, and open globe injury.
METHODS: Statin exposure was defined as >90 cumulative use-days in the year before primary RD repair.
MAIN OUTCOME MEASURES: Repeat RD repair within 1 year of primary RD surgery was evaluated using Cox proportional hazards models to estimate hazard ratios (HRs). Sensitivity analyses included a negative control (proton pump inhibitors [PPIs] vs. unexposed), active comparator (statins vs. PPIs), and analyses by statin subclass and individual agents.
RESULTS: We identified 1232 statin-exposed patients and 1232 matched controls. At 1 year, repeat RD repair occurred in 16.1% of statin users versus 21.1% of controls (HR = 0.75; 95% confidence interval [CI], 0.62-0.89; P = 0.0014), with an absolute risk difference of 5.0%. The negative control showed no difference (17.2% vs. 18.0%; HR = 0.95; 95% CI, 0.74-1.22; P = 0.685). In the active-comparator analysis (PPI; n = 370 vs. statin n = 681), recurrent RD occurred in 14.5% of statin users versus 19.7% of PPI users (HR = 0.71; 95% CI, 0.54-0.95; P = 0.0224). After Bonferroni correction, only simvastatin (simvastatin n = 42/284 [14.8%] vs. control n = 67/284 [23.6%]) among statin subclasses and individual agent comparisons was significantly associated with a reduced risk of repeat RD repair (HR = 0.59; 95% CI, 0.41-0.86; P = 0.0059, Bonferroni-adjusted P = 0.0356).
CONCLUSIONS: Statin use was associated with a lower risk of repeat RD repair, with the clearest signal for simvastatin. Prospective studies are needed to confirm causality and explore delivery approaches to reduce recurrence risk.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.