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The following is a summary of “Effect of Blue-light Filtering Intraocular Lenses on the Development and Progression of Macular Atrophy in Eyes With Neovascular Age-related Macular Degeneration,” published in the April 2024 issue of Ophthalmology by Achiron et al.

Researchers conducted a retrospective study assessing how to blue-light filtering (BLF) intraocular lenses (IOLs) affect the progression of macular atrophy (MA) in eyes with neovascular age-related macular degeneration (nAMD).

They studied patients with nAMD on anti-VEGF injections who had cataract surgery (2007 and 2018), with follow-up until June 2023. The MA rates were compared between BLF-IOL and recipients of non-BLF IOL. The OCT scans were reviewed blindly, and Heidelberg software was used to measure and calculate MA areas (mm²). Risk and progression of MA based on IOL type were evaluated, considering death as a censoring event.

The results showed 373 eyes of 373 patients (mean age 78.6 ±6.7 years, 67.4% females). The BLF-IOLs were implanted in 206 eyes and non-BLF IOL in 167, with similar baseline parameters and follow-up times (3164 ±1420 vs. 3180 ±1403 days, P=0.908), 9 pre-existing and 77 new-onset MA cases were detected, distributed similarly between BLF and non-BLF eyes (P=0.598 and P=0.399, respectively): both univariate Kaplan-Meier (P=0.366) and multivariate Cox regression analysis adjusted for age and gender. The BLF-IOLs had a comparable hazard for new-onset MA to non-BLF-IOLS (HR 1.236, 95% CI: 0.784-1.949, P=0.363). Final MA area was 5.14 ±4.71 mm² for BLF IOLs and 8.56 ±9.17 mm² for non-BLF IOLs (P=0.028), with annual MA area increase of 0.78 ±0.84 mm² and 1.26 ±1.32mm², respectively (P=0.042). 

Investigators concluded that BLF-IOLs didn’t improve MA-free survival compared to non-BLF IOLs but were linked to slower progression in patients with nAMD.

Source: ajo.com/article/S0002-9394(24)00171-5/fulltext