Based on the best available clinical evidence, the impact of blue light–filtering intraocular lenses (IOLs) on retinal health and function remains unclear. The results of a systematic review have led researchers to propose different ways to improve the rigor of potential future research in the field, such as developing a core set of outcome measures, the inclusion of sample size calculations, the masking of trial participants and outcome assessors and prospective clinical trial registration.
The study interpreted the key findings of the 2018 Cochrane systematic review that evaluated the efficacy and safety of blue light–filtering IOLs for providing protection to macular health and function. The systematic review included 51 randomized controlled trials that were performed in 17 countries and resulted in clinical outcomes of more than 5,000 eyes.
Nevertheless, the researchers found it difficult to combine data and draw conclusions due to varying measurement techniques for outcomes, incomplete data reporting and inconsistent follow-up periods.
The researchers noted that a truly rigorous assessment would require sufficiently powered, robust long-term trials, as they deem them necessary to detect any potential long-term protection from light-related retinal damage. However, because such IOL devices already hold marketing authorization for their intended use in various regulatory jurisdictions, there is arguably minimal commercial incentive for lengthy and costly clinical trials on assessing the blue light–blocking effects of these devices on retinal health.
Without future trials that consider the design limitations noted in previous research, investigators conclude that IOLs would likely continue to be used as approved medical devices but with any potential blue light–blocking benefits unresolved.
|Downie LE, Wormald R, Evans J, et al. Analysis of a systematic review about blue light–filtering intraocular lenses for retinal protection: understanding the limitations of the evidence. JAMA Ophthalmol. February 21, 2019. [Epub ahead of print].|