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Study finds blue-light filtering IOL less compatible in children than earlier models
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KEYSTONE, Colorado – A blue-light filtering IOL was found to be generally well tolerated in children in a study presented here, although significant inflammation occurred in some cases, according to one of the researchers in the study.
David R. Stager Jr., MD, presented the results of the study, which evaluated the Alcon AcrySof Natural IOL in the treatment of pediatric aphakia, at the American Academy of Pediatric and Strabismus meeting here.
“The question we wanted to answer was, Does [the AcrySof Natural] maintain the biocompatibility of its predecessors [in children]?” Dr. Stager said. By “predecessors,” he meant previous models in Alcon’s AcrySof acrylic IOL line without the yellow chromophore that that lends the Natural its blue-light filtering properties.
Dr. Stager and colleagues conducted a retrospective review of 38 eyes of 30 patients implanted with the lens, aged 1 month to 13 years. They collected data including cataract type, age, type of surgery and postoperative course, paying particular attention to postoperative inflammation. Eyes with coexisting ocular pathology were excluded.
There were no postoperative complications in about 60% of eyes, Dr. Stager said. In about 40% of eyes, significant amounts of postoperative inflammation were observed, including fibrinous membranes on the optic, posterior synechiae, significant cell and flare, and rapid development and recurrence of posterior capsular opacification.
Patients with these complications were treated with systemic and topical steroids and cycloplegic agents. A lens was explanted from one eye due to the presence of inflammatory membranes, Dr. Stager said.
“Our data suggest that there exists a higher incidence of inflammatory events with the [AcrySof] Natural IOL compared with [previous AcrySof models],” he said.
He noted that these findings are puzzling because the lens is chemically similar to other AcrySof models. The key question, according to Dr. Stager, is whether these events were caused by the yellow chromophore or by other confounding factors such as packaging or contamination.
“These results are suggestive and not conclusive,” he said, adding that the study was limited by its retrospective nature.