Recent studies provide an updated clinical perspective on blue light-filtering IOLs

Abstract

BackgroundRecent reviews of blue light-filtering intraocular lenses (IOLs) have stated their potential risks for scotopic vision and circadian photoentrainment. Some authors have challenged the rationale for retinal photoprotection that these IOLs might provide. Our objective is to address these issues by providing an updated clinical perspective based on the results of the most recent studies.MethodsThis article evaluates the currently available published papers assessing the potential risks and benefits of blue light-filtering IOLs. It summarizes the results of seven clinical and two computational studies on photoreception, and several studies related to retinal photoprotection, all of which were not available in the previous reviews. These results provide a clinical risk/benefit analysis for an updated review for these IOLs.ResultsMost clinical studies comparing IOLs with and without the blue light-filtering feature have found no difference in clinical performance for; visual acuity, contrast sensitivity, color vision, or glare. For blue light-filtering IOLs, three comparative clinical studies have shown improved contrast sensitivity and glare reduction; but one study, while it showed satisfactory overall color perception, demonstrated some compromise in mesopic comparative blue color discrimination. Comparative results of two recent clinical studies have also shown improved performance for simulated driving under glare conditions and reduced glare disability, better heterochromatic contrast threshold, and faster recovery from photostress for blue light-filtering IOLs. Two computational and five clinical studies found no difference in performance between IOLs with or without blue light-filtration for scotopic vision performance and photo entrainment of the circadian rhythm. The rationale for protection of the pseudophakic retina against phototoxicity is discussed with supporting results of the most recent computational, in-vitro, animal, clinical, and epidemiological investigations.ConclusionsThis analysis provides an updated clinical perspective which suggests the selection of blue light-filtering IOLs for patients of any age, but especially for pediatric and presbyopic lens exchange patients with a longer pseudophakic life. Without clinically substantiated potential risks, these patients should experience the benefit of overall better quality of vision, reduced glare disability at least in some conditions, and better protection against retinal phototoxicity and its associated potential risk for AMD.Electronic supplementary materialThe online version of this article (doi:10.1007/s00417-011-1697-6) contains supplementary material, which is available to authorized users.

Multifocal Intraocular Lens Exchange in Patients with Ocular Comorbidities: Indications and Outcomes

“…We have anecdotal experience suggesting that blue light ltering eyeglasses (470nm) reduces photic phenomena in some patients. This is consistent with published ndings demonstrating that blue-ltering IOL's may play a role in glare reduction in pseudophakic patients [31].…”

Multifocal Intraocular Lens Exchange in Patients with Ocular Comorbidities: Indications and Outcomes

“…We have anecdotal experience suggesting that blue light ltering eyeglasses (470nm) reduces photic phenomena in some patients. This is consistent with published ndings demonstrating that blue-ltering IOL's may play a role in glare reduction in pseudophakic patients [31].…”

WITHDRAWN: Role of Short-wavelength Blue Light in the Formation of Cataract and Expression of Caspase-1, -11 and Gasdermin D in rat Lens Epithelium Cells: Insight into the Novel Pathogenesis of Cataract.

“…Previous studies have shown that blue light induced oxidative stress and cellular damage in retinal tissues [30][31][32]. In agreement with these findings, blue light-filtering IOLs have been thought to be a protective measure against blue light damage to the retina [33]. Studies have confirmed that cumulative visible light exposure may accelerate the development of cataracts [34].…”

RETRACTED ARTICLE: Role of short-wavelength blue light in the formation of cataracts and the expression of caspase-1, caspase-11, Gasdermin D in rat lens epithelial cells: insights into a novel pathogenic mechanism of cataracts

“…Previous studies have shown that blue light induced oxidative stress and cellular damage in retinal tissues [ 30 – 32 ]. In agreement with these findings, blue light-filtering IOLs have been thought to be a protective measure against blue light damage to the retina [ 33 ]. Studies have confirmed that cumulative visible light exposure may accelerate the development of cataracts [ 34 ].…”

Multifocal Intraocular Lens Exchange in Patients with Ocular Comorbidities: Indications and Outcomes

“…We have anecdotal experience suggesting that blue light ltering eyeglasses (470nm) reduces photic phenomena in some patients. This is consistent with published ndings demonstrating that blue-ltering IOL's may play a role in glare reduction in pseudophakic patients [31].…”

WITHDRAWN: Role of Short-wavelength Blue Light in the Formation of Cataract and Expression of Caspase-1, -11 and Gasdermin D in rat Lens Epithelium Cells: Insight into the Novel Pathogenesis of Cataract.

“…Previous studies have shown that blue light induced oxidative stress and cellular damage in retinal tissues [30][31][32]. In agreement with these findings, blue light-filtering IOLs have been thought to be a protective measure against blue light damage to the retina [33]. Studies have confirmed that cumulative visible light exposure may accelerate the development of cataracts [34].…”

RETRACTED ARTICLE: Role of short-wavelength blue light in the formation of cataracts and the expression of caspase-1, caspase-11, Gasdermin D in rat lens epithelial cells: insights into a novel pathogenic mechanism of cataracts

“…Previous studies have shown that blue light induced oxidative stress and cellular damage in retinal tissues [ 30 – 32 ]. In agreement with these findings, blue light-filtering IOLs have been thought to be a protective measure against blue light damage to the retina [ 33 ]. Studies have confirmed that cumulative visible light exposure may accelerate the development of cataracts [ 34 ].…”

Multifocal Intraocular Lens Exchange in Patients with Ocular Comorbidities: Indications and Outcomes

“…We have anecdotal experience suggesting that blue light ltering eyeglasses (470nm) reduces photic phenomena in some patients. This is consistent with published ndings demonstrating that blue-ltering IOL's may play a role in glare reduction in pseudophakic patients [31].…”

WITHDRAWN: Role of Short-wavelength Blue Light in the Formation of Cataract and Expression of Caspase-1, -11 and Gasdermin D in rat Lens Epithelium Cells: Insight into the Novel Pathogenesis of Cataract.

“…Previous studies have shown that blue light induced oxidative stress and cellular damage in retinal tissues [30][31][32]. In agreement with these findings, blue light-filtering IOLs have been thought to be a protective measure against blue light damage to the retina [33]. Studies have confirmed that cumulative visible light exposure may accelerate the development of cataracts [34].…”

RETRACTED ARTICLE: Role of short-wavelength blue light in the formation of cataracts and the expression of caspase-1, caspase-11, Gasdermin D in rat lens epithelial cells: insights into a novel pathogenic mechanism of cataracts

“…Previous studies have shown that blue light induced oxidative stress and cellular damage in retinal tissues [ 30 – 32 ]. In agreement with these findings, blue light-filtering IOLs have been thought to be a protective measure against blue light damage to the retina [ 33 ]. Studies have confirmed that cumulative visible light exposure may accelerate the development of cataracts [ 34 ].…”