Despite enthusiasm about the potential for blue light filtering IOLs to protect the macula, a new study reports these lenses had no effect on the incidence of wet AMD, nor did they appear to impact disease progression.

The large cohort study included more than 11,000 patients who underwent uneventful cataract surgery from 2007 to 2018 at the Ophthalmology Unit of Kymenlaakso Central Hospital in Finland.

The study compared wet AMD rates between subjects who received blue light IOLs and individuals in the control group who received a non–blue light IOL. The study’s main outcome was the overall risk of developing wet AMD, and secondary outcomes included best-corrected visual acuity (BCVA), foveal thickness, treatment interval and the total number of intravitreal injections. Investigators performed a separate analysis on patients with pre-existing wet AMD to assess the effect of blue light IOLs on disease progression.

A blue light IOL was used in 5,425 eyes (47.6%) and the non-blue light IOL was implanted in 5,972 eyes (52.4%).

During follow up (approximately 55 months for blue light IOL patients and 51 months for traditional IOL implantations), 164 cases of new-onset wet AMD were recorded, including 88 patients in the blue light IOL group and 76 patients with traditional IOLs.

Overall, the wet AMD–free survival was similar between the groups. In an analysis that considered age, gender and a documented macular degeneration diagnosis, the use of a blue light filter IOL was not predictive of wet AMD development.

Also of note: in wet AMD patients, outcomes at one year were comparable for BCVA (0.57 LogMAR vs. 0.45LogMAR), foveal thickness (285μm vs. 299μm), number of anti-VEGF injections (6.5 vs. 6.2) and treatment interval (7.5 weeks vs. 8.1 weeks) for blue light filtering and non-blue light filter IOLs, respectively. The researchers observed similar results in patients who developed wet AMD after surgery: among patients with wet AMD prior to surgery (71 with blue light filtering IOLs and 74 with non-blue light filter lenses), the clinical outcomes were again comparable.

The use of blue light filtering IOLs resulted in no apparent advantage over non-blue light filtering IOLs in the incidence of wet AMD or its progression, in addition to other clinical variables related to disease severity, the researchers noted.

Achiron A, Elbaz U, Hecht I, et al. The effect of blue-light filtering intraocular lenses on the development and progression of neovascular age-related macular degeneration. Ophthalmology. July 23, 2020. [Epub ahead of print].