Statin Therapy Linked to Slightly Increased Risk of Dry Eye Disease: Study
Researchers have found in a new study that statin use was associated with a small but statistically significant increase in the risk of dry eye disease (DED), although the evidence supporting this association is of very low certainty. Clinicians should remain vigilant for ocular surface symptoms, particularly in patients with existing risk factors for DED, and provide appropriate patient education. Further research using standardized diagnostic criteria is needed to clarify the effects of statin type, dosage, and treatment duration on dry eye risk.
This systematic review and meta-analysis evaluated the literature-pooled association between statins and dry eye disease (DED). Statins, a common treatment modality for dyslipidemia, have been proposed as a potential contributor to DED via their activity in meibomian gland epithelial cells. However, single studies show mixed evidence, and there remains an unmet clinical need to clarify whether statin exposure is associated with DED.
Ovid MEDLINE, Embase, CINAHL, Web of Science, CENTRAL, and the reference lists of relevant reviews were searched from inception to November 2025 for studies reporting the association between statin use and DED. Random-effects meta-analysis using inverse-variance weighting was conducted to pool effect estimates as odds ratios (ORs) with 95% confidence intervals (CIs). Study risk of bias was appraised using the ROBINS-E tool and the certainty of the evidence was reported using the GRADE framework.
Six observational studies were included in the meta-analysis. The pooled analysis revealed a significant positive association between statins and DED, with an absolute risk difference of 10.2 more DED cases per 1,000. This result was derived from very low certainty evidence given limitations in study design and serious inconsistency. Subgroup and sensitivity analyses for risk of bias (p = 0.123), method of outcome ascertainment (p = 0.737), type of effect estimate (p = 0.496), and leave-one-out analyses showed no evidence of effect modification and demonstrated consistent direction of association across studies.
Statin use was associated with a small but statistically significant increase in DED, limited by very low certainty evidence. Physicians should monitor for and educate patients on ocular surface symptoms in patients using statins with pre-existing DED risk factors. Future studies should use standardized DED diagnostic criteria to investigate the impact of statin dose, type, and duration to better characterize this potential association.
Reference:
Gou D, Qiu W, Chang V. Association between statin use and dry eye disease: A systematic review and meta-analysis. American Journal of Ophthalmology, 2026; 0
