Blue light-filtering IOL fails to arrest AMD after cataract surgery: Study

Taiwan: After cataract surgery, the incidence rate of age-related macular degeneration (AMD) was 11.59 per 1000 person-years in Taiwan.

The use of blue light-filtering intraocular lenses (BF-IOLs) for up to ten years exhibited no discernible advantage over non-BF-IOLs in terms of AMD incidence. This was the result of a study conducted by Jiahn-Shing Lee and the team.

The findings of this study were published in the American Journal of Ophthalmology on 15th August 2021.

The purpose of this study was to assess the rate of age-related macular degeneration (AMD) after cataract surgery and to evaluate the relative incidence of AMD in pseudophakes with blue light-filtering intraocular lenses (BF-IOLs) vs non-BF-IOLs.

The Taiwan National Health Insurance Research Database was used in this countrywide cohort research. The researchers included 186,591 patients who had cataract surgery in both eyes between 2008 and 2013 and followed them from the index date (the date of the first cataract surgery) until AMD, death, loss to follow-up, or December 31, 2017; whichever occurred first. The baseline characteristics of the two IOL groups, BF-IOL, and non-BF-IOL, were balanced using propensity score matching (PSM).

There were 21,126 BF-IOL implants and 165,465 non-BF-IOL implants in total. When compared to the non-BF-IOL group, patients in the BF-IOL group were younger, had fewer males, had different cataract surgery years, had higher income, more non-manual workers, more patients from urban and suburban regions, and less chronic illnesses. After a mean of 6.1 years of follow-up after cataract surgery, 12,533 and 1,655 patients acquired non-exudative AMD and exudative AMD, respectively. Non-exudative AMD and exudative AMD incidence rates (per 1000 person-years) were 9.95 and 1.22 for the BF-IOL group, respectively, and 11.13 and 1.44 for the non-BF-IOL group. There was no significant difference in the incidence rate of non-exudative AMD and exudative AMD between the two IOL groups after PSM.

The authors of the study acknowledge several limitations of their work, including the fact that IOL group assignment was not randomized, confounders due to the study's retrospective nature, the use of ICD codes to identify patients, and that a longer follow-up period may be more sensitive in detecting the effect of blue light-filtering IOLs on AMD incidence.

Reference:

Lee, J.-S., Li, P.-R., Hou, C.-H., Lin, K.-K., Kuo, C.-F., & See, L.-C. (2021). Effect of blue light-filtering intraocular lenses on age-related macular degeneration: A nationwide cohort study with 10-year follow-up. In American Journal of Ophthalmology. Elsevier BV. https://doi.org/10.1016/j.ajo.2021.08.002