Lens Color and Macular Pigment Density after Cataract Surgery: A Randomized Clinical Trial

To investigate the relationship between macular pigment optical density (MPOD) and intraocular lens (IOL) color after cataract surgery.

A single-center subanalysis study of a randomized clinical trial (CLOCK-IOL color study).

This study included patients who underwent cataract surgery at our hospital from July 1, 2014, to June 30, 2017, whose MPOD could be measured at least once after surgery.

Patients were randomly assigned in a 1:1 ratio to either the yellow-tinted lens (TL) or clear lens (CL) groups.

The primary outcome was the time-averaged difference in MPOD over time between the CL and yellow TL groups, up to 3 years postoperatively.

Overall, 155 patients (79 and 76 in CL and TL groups, respectively) were analyzed. At 1 year postoperatively, MPOD was significantly higher in the CL group than in the TL group (0.63 vs. 0.44; P < 0.01), and this difference persisted for 3 years. The mixed-effects modeling confirmed a consistent association between IOL color and MPOD over time (adjusted difference: 0.14; 95% confidence intervals, 0.10-0.18; P < 0.001).

The CL group was associated with higher MPOD levels than the TL group over 3 years after cataract surgery. This suggests a more complex interaction between tinted IOL and macular pigment than previously recognized, warranting further investigation.

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.