Blue-light filtering IOLs help prevent glaucoma after cataract surgery
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Key takeaways:
- Patients who underwent cataract surgery and received blue-light filtering IOLs had fewer glaucoma diagnoses.
- No differences were seen in patients who had glaucoma prior to surgery.
Blue-light filtering IOLs exhibited an advantage in favorable glaucoma outcomes after cataract surgery over non-blue-light filtering lenses, according to a study published in the Journal of Glaucoma.
“Whether a [blue-light filtering] design has any clinical implications regarding glaucoma development or progression remains unsolved,” Idan Hecht, MD, of the department of ophthalmology at Shamir Medical Center in Israel, and colleagues wrote. “The aim of this study was to evaluate real-life data from cataract surgery patients receiving either [blue-light filtering] or non-[blue-light filtering] IOLs and to assess the development and progression of glaucoma between the two groups.”
In the retrospective registry-based cohort study, Hecht and colleagues evaluated the overall risk for glaucoma among 11,028 patients who had uneventful cataract surgery between 2007 and 2018, including 5,188 (47%) who received blue-light filtering IOLs and 5,840 (53%) who did not. The researchers also analyzed patients with preexisting glaucoma separately.
There were 316 cases of glaucoma diagnosed at a minimum of 12 months after surgery (mean, 55 months). The blue-light filtering IOLs showed a statistical advantage in patients not developing glaucoma (P = .036). Additionally, the blue-light filtering group had fewer glaucoma diagnoses compared with the non-blue light filtering group at 5 years (2.3% vs. 2.5%), 7 years (3.9% vs. 4.8%) and 9 years (6.7% vs. 9.6%) after surgery.
When the researchers used Cox regression analysis to control for age and sex, the blue-light filtering group exhibited a lower ratio of patients developing glaucoma (adjusted HR = 0.778; P = .029), as well as an advantage in glaucoma procedure-free survival rate (aHR = 0.616; P = 0.23).
The researchers found no significant differences in any outcomes in the group that had glaucoma prior to surgery.
“These findings could expand our understanding of the potential benefits of short-wavelength filtering IOLs,” Hecht and colleagues wrote.
Perspective
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Publications on blue light’s effect on ocular tissues have nearly doubled in the last decade, in comparison to the previous three. There is limited laboratory evidence showing that short-wavelength light can negatively impact the function of retinal ganglion cell mitochondria. Given that retinal ganglion cells are principally targeted in glaucoma, it has been speculated that blue light might exacerbate an already diseased state.
This study aimed to assess whether implantation of blue-light filtering IOLs have the potential to improve the postoperative course of glaucoma in patients already diagnosed and whether they can reduce development of glaucoma in patients undiagnosed preoperatively. Results demonstrated that there was no advantage to blue-light filtering IOLs in preexisting glaucoma cases when compared with non-blue-light filtering IOLs.
Interestingly, the authors stated there was a trend showing blue-light filtering IOLs were associated with lesser glaucoma development in those undiagnosed preoperatively, when compared with those not having blue-light filtering IOLs implanted. However, they noted this trend did not achieve statistical significance.
Ultimately, from a clinical and statistical standpoint, this study does not support a change in practice patterns and should not influence any preoperative conversations we have with our patients regarding whether they should consider blue-light filtering IOLs.
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