Effect of Blue Light-Filtering Intraocular Lenses on Age-Related Macular Degeneration: A Nationwide Cohort Study With 10-Year Follow-up

Jiahn-Shing Lee; Pei-Ru Li; Chiun-Ho Hou; Ken-Kuo Lin; Chang-Fu Kuo; Lai-Chu See

doi:10.1016/j.ajo.2021.08.002

Effect of Blue Light-Filtering Intraocular Lenses on Age-Related Macular Degeneration: A Nationwide Cohort Study With 10-Year Follow-up

Am J Ophthalmol. 2022 Feb:234:138-146. doi: 10.1016/j.ajo.2021.08.002. Epub 2021 Aug 16.

Authors

Jiahn-Shing Lee¹, Pei-Ru Li², Chiun-Ho Hou¹, Ken-Kuo Lin¹, Chang-Fu Kuo³, Lai-Chu See⁴

Affiliations

¹ Department of Ophthalmology (J.-S.L., C.-H.H., K.-K.L.), Chang Gung Memorial Hospital at Linkou and Chang Gung University.
² Department of Public Health (P.-R. L., L.-C.S.), College of Medicine, Chang Gung University.
³ Division of Rheumatology, Allergy and Immunology (C.-F. K., L.-C. S.), Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou. Electronic address: zandis@gmail.com.
⁴ Department of Public Health (P.-R. L., L.-C.S.), College of Medicine, Chang Gung University; Division of Rheumatology, Allergy and Immunology (C.-F. K., L.-C. S.), Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou; Biostatistics Core Laboratory, Molecular Medicine Research Center (L.-C.S.), Chang Gung University, Taoyuan, Taiwan. Electronic address: lichu@mail.cgu.edu.tw.

PMID: 34411525
DOI: 10.1016/j.ajo.2021.08.002

Abstract

Purpose: To determine the incidence rate of age-related macular degeneration (AMD) after cataract surgery and compare the relative incidence of AMD in pseudophakes with blue light-filtering intraocular lenses (BF-IOLs) and non-BF-IOLs.

Design: A nationwide cohort study conducted using the Taiwan National Health Insurance Research Database.

Methods: We enrolled 186,591 patients who underwent cataract surgery in both eyes between 2008 and 2013 and monitored them from the index date (the date of first cataract surgery) until AMD, death, loss to follow-up, or December 31, 2017, whichever occurred first. Propensity score matching (PSM) was used to balance the baseline characteristics between the BF-IOL and non-BF-IOL groups.

Results: BF-IOLs were implanted in 21,126 patients (11.3%) and non-BF-IOLs were implanted in 165,465 patients (88.7%). Patients in the BF-IOL group tended to be younger, with fewer men, different cataract surgery years, higher income, more nonmanual workers, more patients from urban and suburban areas, and fewer chronic diseases compared with the non-BF-IOL group. With a mean follow-up period of 6.1 years (range, 1-10 years) after cataract surgery, 12,533 and 1655 patients developed non-exudative AMD and exudative AMD, respectively. The incidence rate of non-exudative AMD and exudative AMD (per 1000 person-years) was 9.95 and 1.22 for the BF-IOL group and 11.13 and 1.44 for the non-BF-IOL group, respectively. After PSM, no statistical difference in the incidence rate of nonexudative AMD (hazards ratio, 0.95; 95% CI, 0.88-1.03) and exudative AMD (hazard ratio, 0.96; 95% CI, 0.77-1.18) was observed between the BF-IOL and non-BF-IOL groups.

Conclusions: In Taiwan, the incidence rate of AMD after cataract surgery was 11.59 per 1000 person-years. The use of a BF-IOL for up to 10 years had no apparent advantage over a non-BF-IOL in the incidence of AMD.

Keywords: Age-related macular degeneration; Cataract Surgery; blue light-filtering; intraocular lens.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cataract Extraction* / adverse effects
Cohort Studies
Follow-Up Studies
Humans
Lenses, Intraocular* / adverse effects
Macular Degeneration* / epidemiology
Macular Degeneration* / etiology
Male