Three-year retinal and visual outcomes after ultraviolet- and blue light-filtering intraocular lenses

Intraocular lens selection following cataract surgery has implications beyond refractive correction, with different lens chromophore compositions potentially affecting retinal light exposure and downstream visual and circadian outcomes. Understanding the long-term retinal and functional consequences of ultraviolet versus blue light filtration is of clinical importance for evidence-based intraocular lens counselling.

Blue light-filtering intraocular lenses have been proposed to reduce photochemical retinal damage, but their effects on retinal structure and self-reported visual function remain uncertain.

This retrospective study included 127 eyes of 85 patients who underwent phacoemulsification between January 2020 and December 2021. Group 1 (n = 76) received blue light-filtering intraocular lenses and Group 2 (n = 51) received ultraviolet-filtering intraocular lenses. Spectral-domain optical coherence tomography was performed preoperatively and at a mean follow-up of 34.8 ± 4.4 months. The self-reported visual function questionnaire was administered once at the time of imaging data collection. Primary outcomes included central macular thickness and thickness of the retinal nerve fibre layer, ganglion cell layer and inner plexiform layer. Secondary outcomes included retinal pigment epithelium reflectivity, ellipsoid zone reflectivity, choroidal vascularity index and self-reported visual function outcomes.

No significant differences were observed between groups in demographics or baseline parameters. Preoperative and postoperative central macular thickness values were similar between groups, with no significant postoperative change. Retinal nerve fibre layer thickness, quadrant measurements, ganglion cell layer, inner plexiform layer and ganglion cell complex thickness were comparable preoperatively and postoperatively. Retinal pigment epithelium reflectivity, ellipsoid zone reflectivity, subfoveal choroidal thickness and choroidal vascularity index were also similar and remained stable. No retinal pathology developed. Self-reported visual function questionnaire results showed no significant differences in low-light vision, night vision, sleep pattern, daytime alertness or colour vividness.

Ultraviolet-filtering and blue light-filtering intraocular lenses showed similar effects on retinal structure and self-reported visual function over approximately three years. Both lens types appeared safe regarding retinal structural integrity, and intraocular lens selection may therefore be guided by patient-specific factors.