Ocular drug safety and HMG-CoA-reductase inhibitors

150 patients suffering from primary hypercholesterolemia were divided into three different groups receiving (1) lovastatin, (2) simvastatin, or (3) fenofibrate as controls. The aim of the study was to detect possible drug-induced ocular side effects, especially in the lens. The study period was 2 years. Ophthalmological examination and Scheimpflug photography were performed at the beginning and every 6 months. Increases or decreases in the visual acuity were distributed very similarly in the three groups. Definite evidence of side effects was not found, nor was there evidence of deleterious effects on refraction. The intraocular pressure revealed intraindividual fluctuations without clinical significance. Many changes were observed in the lens, all were minimal, including those of the extreme lens periphery which had no effect on visual acuity. The present study shows the great value of Scheimpflug photography with densitometric image analyses because of its objectivity when compared with other methods. Our observations provide good evidence that lovastatin and simvastatin have no undesirable toxic effects on the lens and other ocular tissues, compared with fenofibrate.