Effect of oral statin use on mitomycin-C augmented trabeculectomy outcomes

Abstract

Purpose The effect of statins on wound healing is controversial, and their effect on trabeculectomy outcomes remains unclear. This study aimed to examine the relationship between oral statin use and trabeculectomy outcomes. Methods Medical records of patients who underwent primary mitomycin-C augmented trabeculectomy with 2 years of follow-up were reviewed. Pre- and postoperative intraocular pressures (IOP) and numbers of medications, subconjunctival 5-fluorouracil (5-FU) injections, and bleb-needling procedures were compared between statin users and nonusers. Failure was defined as an eye that failed to achieve a 20% lowering of IOP from baseline or had an IOP > 21 mm Hg, as well as an eye that required further surgical intervention, developed hypotony, or had no light perception visual acuity. Results In total, 158 subjects were enrolled, with 47 eyes from statin users and 111 eyes from statin nonusers. The 24-month cumulative probability of failure was 78.7% for statin users and 60.4% for nonusers (P = .013). Cox proportional-hazards modeling showed a significantly higher hazard risk in statin users (adjusted hazard ratio 1.61, P = .026). There were no significant between-group differences in mean IOPs or number of medications (both P > .05) at 24 months. Multivariable Poisson regression analysis that statin use was associated with increased numbers of 5-FU injections (P = .014) and bleb-needling procedures (P = .031). Conclusions This study demonstrated that oral statin use was associated with higher rates of trabeculectomy failure and increased numbers of 5-FU injections and bleb-needling procedures.

Hydroxycamptothecin regulates scar formation of the filtration channel under scleral flap by inhibiting the proliferation of scleral fibroblasts

“…Third, antimetabolites, such as MMC and 5-FU, used during and after surgery can prevent excessive scar proliferation following glaucoma filtration. However, the toxic side effects of MMC and 5-FU restrict their applications [ 35 , 36 ].…”

One Molecule, Many Faces: Repositioning Cardiovascular Agents for Advanced Wound Healing

“…Furthermore, the effects of LDL cholesterol and pitavastatin treatment on fibroblast migration and wound healing have been explored, indicating potential effects on cell migration and wound healing in patients on statin therapy [ 106 ]. Reports have also suggested that statins play a role in fibrosis, which could affect the wound healing process following certain medical procedures [ 107 ]. These findings collectively suggest that statins may indeed have a role in promoting wound healing, potentially through various molecular and cellular mechanisms.…”