Dry Eye Disease Risk Increases With Lipid-Lowering Agent Use

Statin users have a higher risk of dry eye disease; however, statin type, duration of use, and the intensity of use are not significantly associated with dry eye disease risks.

Dry eye disease risk increases with statin use, according to research published in Acta Ophthalmologica. However, there are no noted associations between dry eye disease risk and statin type, statin use duration, and the intensity of statin therapy, according to the report

Investigators retrospectively reviewed data from a national health insurance database that included 780,786 patients who underwent statin treatment between 2002 and 2016 — 17, 409 were newly diagnosed with dry eye disease within a follow-up period of 2 or more years. The dry eye disease diagnosis was determined by a diagnosis code or treatment with cyclosporine, lubricants, or punctal occlusion. The team matched individuals with dry eye disease (mean age, 54 years; women, 51.8%) with age- and sex-matched control group participants (n=69,636; mean age, 53.9 years; women, 51.8%) in a 1:4 ratio and calculated dry eye disease odds ratios.

Overall, individuals who used the lipid-lowering agents experienced an increased dry eye disease risk compared with control group participants (adjusted odds ratio [OR], 1.12; 95% CI, 1.08-1.16; P <.0001). Individuals who underwent fibrate treatment did not have a greater risk compared with individuals not treated with fibrates (adjusted OR, 1.04; 95% CI, 0.99-1.10; P =.125). Statin type did not affect the risk, as lipophilic statin users did not demonstrate a higher risk compared with hydrophilic statin users (adjusted OR, 0.99; 95% CI, 0.93-1.06; P =.729). 

Treatment duration also did not influence dry eye disease risk. Patients undergoing statin therapy for more than 180 days experienced a similar risk compared with participants undergoing therapy for 90 days or less (adjusted OR, 1.00; P =.922) and similarly, patients receiving treatment between 91 and 180 days experienced a comparable risk vs individuals undergoing treatment for 90 days or less (adjusted OR, 0.94; P =.541). Dry eye disease risk was not statistically different among patients receiving low, moderate, and high-intensity statin therapy, according to the report.

[O]ur results concluded that any effects of the statin on DED may not be related to the duration and the intensity of statin therapy.

“DED risks did not differ significantly among patients taking low-intensity statins, those taking moderate-intensity statins, and those taking high-intensity statins,” according to the researchers. “Therefore, our results concluded that any effects of the statin on DED may not be related to the duration and the intensity of statin therapy.”

The study’s retrospective nature, inability to determine patient compliance, and inclusion of an ethnically homogenous cohort that may limit globalization of the findings are acknowledged limitations to the research.


Chien L-N, Chou Y-I, Tsai Y-J, et al. Association of lipid-lowering agent use and dry eye disease: a nationwide matched case–control study in Taiwan, 2002–2016Acta Ophthalmol. Published online March 20, 2023. doi:10.1111/aos.15656