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Blue light-filtering IOL may inhibit onset, progression of AMD
Invest Ophthalmol Vis Sci. 2009;50(10):4777-4785.
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Implantation of a blue light-filtering IOL may prevent or delay the development of age-related macular degeneration, according to a study.
Previous studies have shown an association between cataract surgery and exposure of the retina to blue light, a factor in AMD development. Macular pigment may protect the retina against AMD resulting from blue light exposure, the study authors said.
The prospective, randomized study included 42 patients; 21 patients were implanted with an AcrySof Natural IOL (Alcon) and 21 patients received an AcrySof three-piece acrylic IOL (Alcon). The AcrySof Natural has blue light-filtering capability. Mean patient age was 74 years in the AcrySof Natural group and 71 years in the AcrySof group.
Investigators measured macular pigment optical density 1 week before surgery, 1 week after surgery, and 3, 6 and 12 months after surgery. Serum concentrations of the carotenoids lutein and zeaxanthin were assessed at each follow-up visit.
Study data showed that average macular pigment optical density across the retina was significantly increased at 3 months in the AcrySof Natural group; macular pigment optical density was stable in the AcrySof group. Results showed that implantation of a blue light-filtering IOL increased macular pigment optical density in the absence of raised lutein and zeaxanthin serum levels.
"However, further study is required in the form of controlled long-term trials to investigate whether implantation of a blue light-filtering IOL is effective in preventing or delaying development or progression of AMD," the authors said.
Blue blocking IOLs theoretically provide better photoprotection but worse photoreception than conventional UV-only blocking IOLs. Dr. Nolan reports the unexpected result that macular pigment density remains unchanged after cataract surgery with a UV-only blocking IOL but increases after cataract surgery with a blue blocking IOL. The significance of the variation in pigmentation remains unknown.
– Mark Packer, MD
Drs. Fine, Hoffman and
Packer, Eugene, Ore.