The Effect of Blue-Light Filtering Intraocular Lenses on the Development and Progression of Neovascular Age-Related Macular Degeneration

Achiron, Asaf; Elbaz, Uri; Hecht, Idan; Spierer, Oriel; Einan‐Lifshitz, Adi; Karesvuo, Petteri; Laine, Ilkka; Tuuminen, Raimo

doi:10.1016/j.ophtha.2020.07.039

Cited by 21 publications

(16 citation statements)

References 25 publications

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“…In the present study, only non-blue-light filtering IOLs were implanted; nevertheless, we still could not show wet AMD progression after cataract surgery. Indeed, in a recent study by our group, nonblue-light filtering IOLs were ruled out as a possible explanation for wet AMD progression, as they were found equal to blue-light filtering IOLs in terms of the development and progression of wet AMD (Achiron et al 2021). (de Silva et al 2014).…”

Section: Discussionmentioning

confidence: 95%

“…For sample size calculations, the standard deviation of CSMT was set at 70 μm (according to previous studies ranging from 61 to 80 μm) (Berg et al 2015;Achiron et al 2021) with a minimal clinically significant difference of 10 μm in CSMT. Using a paired model, we found that a sample size of 98 patients was required to detect a significant difference between measurements with a significance level of 0.05 and a power of 80%.…”

Section: Sample Size Calculationmentioning

confidence: 99%

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Effect of cataract surgery on wet age‐related macular degeneration activity

Karesvuo

Elbaz

Achiron

et al. 2021

Acta Ophthalmologica

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Background: Wet age-related macular degeneration (AMD) and age-related cataract are often coexisting causes of visual impairment. Yet, the timing of cataract surgery in wet AMD patients is controversial. Methods: One hundred and eleven eyes of 111 patients with wet AMD underwent cataract surgery at Helsinki University Hospital in Finland during 2014-2018. Best-corrected visual acuity and central subfield macular thickness (CSMT) were analysed at the time of wet AMD diagnosis, at the last recording prior to cataract surgery and at the first recording and at 1 year after surgery. The cumulative number of antivascular endothelial growth factor (anti-VEGF) injections at surgery, systemic and topical medication and postoperative anti-VEGF burden were recorded. Results: Mean age was 78.9 AE 5.6 years at the time of surgery. Central subfield macular thickness (CSMT) significantly decreased (280.1 AE 75.0 µm preoperatively to 268.6 AE 67.6 µm at the first postoperative recording, p = 0.001, and to 265.9 AE 67.9 µm at 1 year, p = 0.003), visual acuity improved (0.70 AE 0.46 logMAR units preoperatively to 0.39 AE 0.40 at the first postoperative recording, and to 0.33 AE 0.34 at 1 year, p < 0.001 for both) and anti-VEGF treatment intervals lengthened despite the surgery (6.53 AE 2.08 weeks prior to surgery to 7.03 AE 2.23 weeks at 1 year, p = 0.246, and to 7.05 AE 2.57 weeks at the last documented visit, p = 0.035). A CSMT increase of over 30% from the preoperative values was seen in only one case (1 out of 111 eyes, 0.9%). Macular status at surgery, wet AMD subtype, comorbidity of type II diabetes, systemic drugs and topical anti-inflammatory medication were not associated with macular changes nor with treatment intervals after surgery. The cumulative number of anti-VEGF injections correlated neither with CSMT change postoperatively (r = −0.051, p = 0.619) nor with CSMT change at 1 year (r = 0.091, p = 0.426). Conclusion: Satisfactory visual outcomes and controlled disease activity were seen in patients with wet AMD undergoing cataract surgery. We found no evidence to support delaying surgery in patients who require it.

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Section: Discussionmentioning

confidence: 95%

Section: Sample Size Calculationmentioning

confidence: 99%

Effect of cataract surgery on wet age‐related macular degeneration activity

Karesvuo

Elbaz

Achiron

et al. 2021

Acta Ophthalmologica

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“…Recently, Achiron et al published a retrospective cohort study of 11,397 patients which did not show any evidence of reduction of the incidence of neovascular AMD with blue light-filtering IOL. 26 A total of 164 cases of new neovascular AMD were identified. The vast majority of patients were lost to follow-up after the 1-month post-operative visit.…”

Section: Discussionmentioning

confidence: 99%

The Influence of Blue-Filtering Intraocular Lenses Implant on Exudative Age-Related Macular Degeneration: A Case–Control Study

Hamel¹,

Rheault²,

Simonyan³

et al. 2021

OPTH

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Purpose To determine whether the use of a blue light-filtering intraocular lens (IOL) prevents the onset of wet age-related macular degeneration (AMD). More precisely, we examined the proportion of blue light-filtering IOL in a wet AMD patients’ sample and compared it with a general North American pseudophakic population sample. Design Retrospective case–control study. Methods Case patients were diagnosed and treated for wet AMD and had prior IOL implantation at least 3 years before the diagnosis of wet AMD. Control patients were randomly selected among patients who had cataract surgery at our institution. They were exempt of AMD and paired for the year of surgery, sex and age at cataract surgery. A total of 196 patients were included in each study group. Results Among patients with wet AMD, 62.8% had a blue light-filtering IOL compared with 63.3% among control patients (p = 0.92). Mean time between implantation and injection of anti-VEGF in AMD patients was 6.62 years (95% confidence interval (CI): 6.04–7.19) in non-blue light-filtering IOL group and 5.76 years (95% CI: 5.41–6.11) in blue light-filtering IOL group (p = 0.0120). Conclusion No correlations could be established between the presence of a blue light filter in the IOL and the occurrence of wet AMD. AMD patients without blue light-filtering IOL were injected significantly later than patients with an IOL filtering blue light, which contradict the potential clinical benefit of the blue light filter.

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“…Pipis and collaborators [24] observed significant differences using blue-filtering lenses which slowed the progress of geographic atrophy in AMD patients following cataract surgery. A clinical study recently published [48] showed no differences, in terms of neuroprotection, between the use of UV- or UV/blue-filtering IOLs in a cohort of more than 11,000 patients.…”

Section: Discussionmentioning

confidence: 99%

Protector Role of Intraocular Lenses under Artificial Light Conditions

et al. 2021

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Introduction: The aim of this work is to analyse, in an in vitro model, the possible protective effects of ultraviolet- (UV-) or UV/ blue-filtering intraocular lens (IOLs) under LED lighting conditions. Methods: 10 models of IOLs were evaluated. Light transmission spectrum was recorded from 300 to 800 nm, in steps of 1 nm. Photodamage in vitro model was induced in ARPE-19 cells by blue LED light (465-475 nm). Changes in cell viability and oxidative stress variables were studied to assess the protective effect of IOLs. Results: UV/blue-filtering IOLs models block blue light spectrum in different proportion and UV-filtering IOLs blocking wavelength below 400 nm. However, in vitro study under blue LED light exposure does not show protective effects related with mitochondrial dysfunction and oxidative stress of UV/blue-filtering IOLs. Conclusions: The current in vitro study suggest that UV/blue filtering IOLs are not useful in terms of photoprotection in artificial light conditions. The results obtained indicate that it is needed to give attention to other IOLs parameters besides the type of filter, as it seems they could have influence also protective role.

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The Effect of Blue-Light Filtering Intraocular Lenses on the Development and Progression of Neovascular Age-Related Macular Degeneration

Cited by 21 publications

References 25 publications

Effect of cataract surgery on wet age‐related macular degeneration activity

Effect of cataract surgery on wet age‐related macular degeneration activity

The Influence of Blue-Filtering Intraocular Lenses Implant on Exudative Age-Related Macular Degeneration: A Case–Control Study

Protector Role of Intraocular Lenses under Artificial Light Conditions

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