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

  • Jiahn-Shing Lee
    Affiliations
    Department of Ophthalmology (J.-S.L., C.-H.H., K.-K.L.), Chang Gung Memorial Hospital at Linkou and Chang Gung University
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  • Pei-Ru Li
    Affiliations
    Department of Public Health (P.-R. L., L.-C.S.), College of Medicine, Chang Gung University
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  • Chiun-Ho Hou
    Affiliations
    Department of Ophthalmology (J.-S.L., C.-H.H., K.-K.L.), Chang Gung Memorial Hospital at Linkou and Chang Gung University
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  • Ken-Kuo Lin
    Affiliations
    Department of Ophthalmology (J.-S.L., C.-H.H., K.-K.L.), Chang Gung Memorial Hospital at Linkou and Chang Gung University
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  • Author Footnotes
    1 Drs Kuo and See contributed equally to this work and are joint senior authors.
    Chang-Fu Kuo
    Correspondence
    Inquiries to: Chang-Fu Kuo, Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, 5 Fu-Shin St, Kweisan, Taoyuan 333, Taiwan
    Footnotes
    1 Drs Kuo and See contributed equally to this work and are joint senior authors.
    Affiliations
    Division of Rheumatology, Allergy and Immunology (C.-F. K., L.-C. S.), Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou
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  • Author Footnotes
    1 Drs Kuo and See contributed equally to this work and are joint senior authors.
    Lai-Chu See
    Correspondence
    Lai-Chu See, Department of Public Health, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Rd, Kweisan, Taoyuan 333, Taiwan
    Footnotes
    1 Drs Kuo and See contributed equally to this work and are joint senior authors.
    Affiliations
    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
    Search for articles by this author
  • Author Footnotes
    1 Drs Kuo and See contributed equally to this work and are joint senior authors.
Published:August 15, 2021DOI:https://doi.org/10.1016/j.ajo.2021.08.002

      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

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