Are blue-light-filtering (BLF) intraocular lenses (IOLs) protective against age-related macular degeneration (AMD)? An exploratory analysis using a retrospective cohort of 66,778 eyes in the UK

Session Details

Session Title: Presented Poster Session: After Surgery

Venue: Poster Village: Pod 1

First Author: : P.Ursell UK

Co Author(s): :    R. Hamilton   D. O'Boyle   A. Venerus   L. Raiteri   M. Dhariwal           

Abstract Details

Purpose:

BLF IOLs limit the transmission of shorter-wavelength visible light and have been suggested to play a protective role in terms of the development and/or progression of AMD. This hypothesis is derived primarily from animal and cell culture studies, although, findings from two recent observational studies also indicate a potential protective effect. However, in both cases – these studies were limited due to small patient populations and short follow-up periods (1-2 years). The objective of this exploratory analysis was to describe the long-term (5 years) post-cataract surgery incidence of AMD in BLF vs. non-BLF IOLs implanted patients.

Setting:

This feasibility study is a retrospective analysis of anonymized electronic medical records (EMR) of cataract procedures from a selected sample of 3 UK NHS (National Health Service) ophthalmology clinics using the Cataract and Retina modules of Medisoft EMR system.

Methods:

EMR data relating to cataract procedures in patients (≥50 years) who underwent cataract surgery between 1 Jan 2005 and 5 Feb 2018, was retrospectively analyzed. Eyes with at least one subsequent visit post-cataract surgery, and AMD-free at the time of surgery were included for analysis (n=66,778). Presence of AMD was assessed using a disease algorithm based on clinical findings, diagnoses and treatments to identify Early/Intermediate AMD, Geographic Atrophy (GA) and Choroidal neovascularization (CNV) cases, and track transition between AMD states in time. At 5 years, product-limit survival estimates (Kaplan-Meier method) and in a sub-group, post-cataract cumulative AMD incidence were generated.

Results:

In the survival analysis conducted on AMD naive eyes at the time of cataract surgery (n=66,778), the probability curves demonstrate that BLF IOLs seem to be protective against AMD (Log-rank test, P< 0.0001). In the subgroup analysis of eyes with at least 5 years of follow-up, the 5-year cumulative incidence of AMD post-cataract surgery was lower in BLF group (11.8%; N=2,296) vs. non-BLF group (13.0%, N=6,056). The results are unadjusted for confounding factors.

Conclusions:

This retrospective database exploratory study highlights the value of large population-based database studies to test associations that exist between an exposure and a disease state. This feasibility study demonstrates the potential of a protective effect of BLF IOLs vs. non-BLF IOLs. Further research is warranted to validate these findings.

Financial Disclosure:

... is employed by a for-profit company with an interest in the subject of the presentation, ... research is funded, fully or partially, by a competing company, ... receives consulting fees, retainer, or contract payments from a competing company