Blue light filtering intraocular lenses not associated with reduced risk of injury
A recent cohort study reported a lack of benefit from blue light filtering (BLF) intraocular lenses (IOLs) in terms of injury risk and quality of vision while driving after bilateral cataract surgery.
In addition, the data suggest that cumulative injury-free survival, all-cause or road-traffic, did not differ between patients with BLF and non-BLF IOLs.
“Patient age at second eye surgery was the most important variable influencing injury risk,” wrote study corresponding author Raimo Tuuminen, MD, PhD, Department of Ophthalmology, Hospital center of Kymenlaakso. “Additionally, despite higher glare levels when driving in the evening or at night, BLF IOLs were no worse than non-BLF IOLs in terms of ride comfort.”
Despite their wide use in clinical practice for patients with cataracts, there is little evidence available on the association of BLF IOLs with injury. The retrospective study included consecutive cataract surgeries performed between September 2007 and December 2018 and all adult patients who underwent uneventful phacoemulsification surgery and bag implantation of non-BLF IOLs or BLF IOLs in both eyes.
The primary outcome of the study was the association of BLF IOLs with the incidence of all-cause and motor vehicle-related injuries after second eye cataract surgery. An exploratory analysis by gender and age was performed as a post hoc analysis, according to the investigators.
The investigators used the coding of the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) to specify injury subtype and assess visual performance using a structured questionnaire. In addition, they generated Kaplan-Meier curves and multivariate Cox proportional hazards regression controlling for age and sex was used to estimate risk ratios (RRs) for injury.
The study included in the analysis a total of 4986 patients, or 9972 eyes, who underwent cataract surgery. The population was composed of 1707 (34.2%) men and 3279 (65.8%) women with an average age of 73.2 years at the first intervention and 74.3 years at the second.
Using multivariate Cox proportional hazards regression analysis, age- and sex-adjusted injury-free survival before first eye surgery remained comparable between patients with non-BLF versus BLF IOLs (HR, 0, 95 [95% CI, 0.81 – 1.13]; P = 0.57)
Using ICD-10 coding, the data suggest that the total number of injuries after the second eye surgery was 1226. Of these, 602 injuries and 727 injury subtypes were in patients with non-BLF IOLs and 624 injuries and 723 injury subtypes were among patients with BLF IOLs.
Additionally, in the multivariate Cox proportional hazards regression analysis, females have a lower injury incidence than males (HR, 0.89 [95% CI, 0.79 – 1.01]; P = 0.07) and age at second eye injury was associated with a higher injury rate (2.6% for each year; HR, 1.03 [95% CI, 1.02 – 1.03]; P <.001>
However, IOL type (BLF vs. non-BLF IOL) was not associated with all-cause injury rates (HR, 0.99 [95% CI, 0.88 – 1.11]; P = 0.85).
Results on subjective visual performance parameters for driving suggested that all were comparable between the non-BLF and BLF IOL groups, except for glare when driving in the dark (evening and night). Data show that this was impaired in 9 of 80 patients with BFL IOLs compared to 0 of 83 with non-BLF IOLs (P <.001>
“These findings could expand our understanding of the potential advantages and disadvantages of short-wavelength filtration of IOLs,” Tuuminen concluded.
The study, “Association of blue light filtering intraocular lenses with all-cause and road traffic injuries in patients undergoing bilateral cataract surgery in Finlandwas published in Open JAMA Network.