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  • Impact of IOLs That Filter Blue Light on AMD

    By Lynda Seminara
    Selected By: Stephen D. McLeod, MD
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    Journal Highlights

    Ophthalmology, March 2021

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    Although early evidence suggested that IOLs which filter blue light can protect the retina and mitigate the occurrence or progression of neovas­cular age-related macular degeneration (AMD) after cataract surgery, results of recent studies have been equivocal. In a large registry-based study, Achiron et al. added to the debate. Their analysis showed no clear advantage to blue light–filtering (BLF) lenses with respect to incidence or progression of neo­vascular AMD or in secondary clinical outcomes such as best-corrected visual acuity (BCVA) or foveal thickness.

    For this retrospective study, the investigators studied consecutive cases of uneventful cataract surgery per­formed in Finland since September 2007. Patients received BLF or standard IOLs per the surgeon’s discretion. The main outcome measure was wet AMD development over time. Secondary outcomes were BCVA, foveal thickness, treatment interval, and total number of intravitreal injections. To assess the effect of BLF lenses on progression, the authors conducted a separate analysis among patients with preexisting disease.

    Altogether, the researchers evaluated one eye of 11,397 patients (mean age, 75.4 years). Of these, 5,425 eyes (47.6%) had received a BLF lens, and 5,972 eyes (52.4%) had a standard IOL. Follow-up was somewhat longer for BLF users (55.2 vs. 50.5 months), and the inci­dence of new-onset AMD was higher in this group (88 vs. 76 patients).

    AMD-free survival rates did not dif­fer significantly between the cohorts. In a regression analysis controlled for age, sex, and AMD diagnosis, BLF lens use did not affect AMD development (haz­ard ratio, 1.075; p = .652). One year after diagnosis of AMD, secondary clin­ical outcomes were comparable for the BLF and non-BLF groups: BCVA (0.57 vs. 0.45 logMAR), foveal thickness (285 vs. 299 μm), number of anti-VEGF injections (6.5 vs. 6.2), and treatment interval (7.5 vs. 8.1 weeks), respectively. Secondary outcomes were comparable for patients with preexisting AMD.

    The authors noted that the lack of preventive effect of BLF lenses on wet AMD was supported by results of the multivariate analysis, which account­ed for possible confounders. They acknowledge that these findings are specific to neovascular AMD and may not be applicable to other forms of AMD.

    The original article can be found here.