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Cochrane Database of Systematic Reviews

Lentes intraoculares con filtro para luz azul (LIO) para la protección de la salud macular

Información

DOI:
https://doi.org/10.1002/14651858.CD011977.pub2Copiar DOI
Base de datos:
  1. Cochrane Database of Systematic Reviews
Versión publicada:
  1. 22 mayo 2018see what's new
Tipo:
  1. Intervention
Etapa:
  1. Review
Grupo Editorial Cochrane:

  1. Grupo Cochrane de Salud ocular y de la visión

Copyright:
  1. Copyright © 2018 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

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Autores

  • Laura E Downie

    Correspondencia a: Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Australia

    [email protected]

  • Ljoudmila Busija

    Institute for Health and Ageing, Australian Catholic University, Melbourne, Australia

  • Peter R Keller

    Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Australia

Contributions of authors

Review: LED drafted the initial review, with substantial input, discussion and editing from LB and PRK. All of the statistical analyses were confirmed by LB. All authors provided final approval of the review.

Protocol: LED drafted the initial protocol, with substantial input, discussion and editing from LB and PRK. All authors provided final approval of the protocol.

LED is the guarantor of the review.

Sources of support

Internal sources

  • The University of Melbourne, Australia.

  • Australian Catholic University, Australia.

External sources

  • National Health and Medical Research Council (NHMRC), Australia.

    This review is undertaken as part of a 2015 NHMRC Translating Research Into Practice (TRIP) Fellowship (APP1091833, CIA: Dr Laura Downie).

  • National Institute for Health Research (NIHR), UK.

    • Richard Wormald, Co‐ordinating Editor for Cochrane Eyes and Vision (CEV) acknowledges financial support for his CEV research sessions from the Department of Health through the award made by the NIHR to Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology for a Specialist Biomedical Research Centre for Ophthalmology.

    • This review was supported by the NIHR, via Cochrane Infrastructure funding to the CEV UK editorial base.

    The views expressed in this publication are those of the authors and not necessarily those of the NIHR, NHS, or the Department of Health.

Declarations of interest

Laura Downie: none known
Ljoudmila Busija: none known
Peter Keller: none known

Acknowledgements

Cochrane Eyes and Vision (CEV) created and executed the electronic search strategies. The methods section of this protocol includes some text from a standard template prepared by CEV. We thank Jennifer Evans and Anupa Shah for their assistance during the writing of the review. We thank Sharon Bentley, Catey Bunce, John Lawrenson, Ruth Hogg and Ana Quartilho for comments on the protocol, review or both. We thank the following translators: Covadonga Bascarán for translating a Spanish study (Cristobal 2005), Justin Wormald for translating a Russian study (Shpak 2012), Wu Taixiang and Hsin‐Wen Wu for translating the following Chinese studies (Chen 2013; Sun 2007; Wen 2012), Alex Schuster for translating the following German studies (Mayer 2006; Mester 2008b), Piotr Kanclerz for translating the following Polish papers (Lak 2007; Stopyra 2012).

Version history

Published

Title

Stage

Authors

Version

2018 May 22

Blue‐light filtering intraocular lenses (IOLs) for protecting macular health

Review

Laura E Downie, Ljoudmila Busija, Peter R Keller

https://doi.org/10.1002/14651858.CD011977.pub2

2015 Nov 27

Blue‐light filtering intraocular lenses (IOLs) for protecting macular health

Protocol

Laura E Downie, Ljoudmila Busija, Peter R Keller

https://doi.org/10.1002/14651858.CD011977

Differences between protocol and review

After discussion with the editorial base it was decided to redefine the scope of the search strategy to fulfil the stated objectives of the review. Therefore the search strategy has been re‐designed to reflect this amendment. Medline now contains Epub Ahead of Print records so PubMed is not being searched.

Contrast sensitivity has been expressed as log Contrast Sensitivity, as reported by the study authors, rather than log Contrast Threshold (%).

Keywords

MeSH

Medical Subject Headings (MeSH) Keywords

Medical Subject Headings Check Words

Humans;

PICO

Population
Intervention
Comparison
Outcome

El uso y la enseñanza del modelo PICO están muy extendidos en el ámbito de la atención sanitaria basada en la evidencia para formular preguntas y estrategias de búsqueda y para caracterizar estudios o metanálisis clínicos. PICO son las siglas en inglés de cuatro posibles componentes de una pregunta de investigación: paciente, población o problema; intervención; comparación; desenlace (outcome).

Para saber más sobre el uso del modelo PICO, puede consultar el Manual Cochrane.

Study flow diagram
Figuras y tablas -
Figure 1

Study flow diagram

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Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
Figuras y tablas -
Figure 2

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

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Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
Figuras y tablas -
Figure 3

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

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Forest plot of comparison 1. Blue‐light filtering IOL vs non‐blue‐light filtering IOL, outcome: 1.1 Change in distance best‐corrected visual acuity (BCVA), between baseline and 12 months (accepting measures for 6‐18 months' follow‐up. If change in distance BCVA not reported, we have utilised data reported at the end of the follow‐up period).
Figuras y tablas -
Figure 4

Forest plot of comparison 1. Blue‐light filtering IOL vs non‐blue‐light filtering IOL, outcome: 1.1 Change in distance best‐corrected visual acuity (BCVA), between baseline and 12 months (accepting measures for 6‐18 months' follow‐up. If change in distance BCVA not reported, we have utilised data reported at the end of the follow‐up period).

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Forest plot of comparison 1. Blue‐light filtering IOL vs non‐blue‐light filtering IOL, outcome: 1.2 Change in distance best‐corrected visual acuity (BCVA) for paired‐eye trials, between baseline and 12 months (accepted measures for 6‐18 months' follow‐up. If change in distance BCVA was not reported, we utilised data reported at the end of the follow‐up period.
Figuras y tablas -
Figure 5

Forest plot of comparison 1. Blue‐light filtering IOL vs non‐blue‐light filtering IOL, outcome: 1.2 Change in distance best‐corrected visual acuity (BCVA) for paired‐eye trials, between baseline and 12 months (accepted measures for 6‐18 months' follow‐up. If change in distance BCVA was not reported, we utilised data reported at the end of the follow‐up period.

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Forest plot of comparison 1. Blue‐light filtering IOL vs non‐blue‐light filtering IOL, outcome: 1.2 Effect on photopic contrast sensitivity function, measured in log Contrast Threshold (%) using the mid‐range of the available spatial frequencies (between 6‐12 cycles/deg) at 6 months (with an acceptable follow‐up range of 3‐9 months).
Figuras y tablas -
Figure 6

Forest plot of comparison 1. Blue‐light filtering IOL vs non‐blue‐light filtering IOL, outcome: 1.2 Effect on photopic contrast sensitivity function, measured in log Contrast Threshold (%) using the mid‐range of the available spatial frequencies (between 6‐12 cycles/deg) at 6 months (with an acceptable follow‐up range of 3‐9 months).

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Forest plot of comparison 1. Blue‐light filtering IOL vs non‐blue‐light filtering IOL, outcome: 1.4 Contrast sensitivity function, measured in log Contrast Sensitivity, using the mid‐range of the available spatial frequencies (between 6‐12 cycles/deg) at 6 months (acceptable follow‐up range of 3‐9 months) [logCT].
Figuras y tablas -
Figure 7

Forest plot of comparison 1. Blue‐light filtering IOL vs non‐blue‐light filtering IOL, outcome: 1.4 Contrast sensitivity function, measured in log Contrast Sensitivity, using the mid‐range of the available spatial frequencies (between 6‐12 cycles/deg) at 6 months (acceptable follow‐up range of 3‐9 months) [logCT].

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Forest plot of comparison 1. Blue‐light filtering IOL vs non‐blue‐light filtering IOL, outcome: 1.5 Proportion of eyes with a finding of pathological structural change at the macula, detected by clinical observation or optical coherence tomography or retinal fundus photography, at 12 months (acceptable follow‐up range of 6‐18 months).
Figuras y tablas -
Figure 8

Forest plot of comparison 1. Blue‐light filtering IOL vs non‐blue‐light filtering IOL, outcome: 1.5 Proportion of eyes with a finding of pathological structural change at the macula, detected by clinical observation or optical coherence tomography or retinal fundus photography, at 12 months (acceptable follow‐up range of 6‐18 months).

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Comparison 1 Blue‐light filtering IOL vs non‐blue‐light filtering IOL, Outcome 1 Change in distance best‐corrected visual acuity (BCVA) for single‐eye trials, between baseline and 12 months (accepted measures for 6‐18 months' follow‐up). If studies did not report change in distance BCVA, we utilised data reported at the end of the follow‐up period..
Figuras y tablas -
Analysis 1.1

Comparison 1 Blue‐light filtering IOL vs non‐blue‐light filtering IOL, Outcome 1 Change in distance best‐corrected visual acuity (BCVA) for single‐eye trials, between baseline and 12 months (accepted measures for 6‐18 months' follow‐up). If studies did not report change in distance BCVA, we utilised data reported at the end of the follow‐up period..

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Comparison 1 Blue‐light filtering IOL vs non‐blue‐light filtering IOL, Outcome 2 Change in distance best‐corrected visual acuity (BCVA) for paired‐eye trials, between baseline and 12 months (accepted measures for 6‐18 months follow‐up. If change in distance BCVA was not reported, we utilised data reported at the end of the follow‐up period..
Figuras y tablas -
Analysis 1.2

Comparison 1 Blue‐light filtering IOL vs non‐blue‐light filtering IOL, Outcome 2 Change in distance best‐corrected visual acuity (BCVA) for paired‐eye trials, between baseline and 12 months (accepted measures for 6‐18 months follow‐up. If change in distance BCVA was not reported, we utilised data reported at the end of the follow‐up period..

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Comparison 1 Blue‐light filtering IOL vs non‐blue‐light filtering IOL, Outcome 3 Contrast sensitivity, measured in log Contrast Sensitivity at 6 months (acceptable follow‐up range of 3‐9 months).
Figuras y tablas -
Analysis 1.3

Comparison 1 Blue‐light filtering IOL vs non‐blue‐light filtering IOL, Outcome 3 Contrast sensitivity, measured in log Contrast Sensitivity at 6 months (acceptable follow‐up range of 3‐9 months).

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Comparison 1 Blue‐light filtering IOL vs non‐blue‐light filtering IOL, Outcome 4 Contrast sensitivity function, measured in log Contrast Sensitivity, using the mid‐range of the available spatial frequencies (between 6‐12 cycles/deg) at 6 months (acceptable follow‐up range of 3‐9 months; logCT).
Figuras y tablas -
Analysis 1.4

Comparison 1 Blue‐light filtering IOL vs non‐blue‐light filtering IOL, Outcome 4 Contrast sensitivity function, measured in log Contrast Sensitivity, using the mid‐range of the available spatial frequencies (between 6‐12 cycles/deg) at 6 months (acceptable follow‐up range of 3‐9 months; logCT).

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Comparison 1 Blue‐light filtering IOL vs non‐blue‐light filtering IOL, Outcome 5 Proportion of eyes with a finding of pathological structural change at the macula, detected by clinical observation or OCT or retinal fundus photography, at 12 months (acceptable follow‐up range of 6‐18 months).
Figuras y tablas -
Analysis 1.5

Comparison 1 Blue‐light filtering IOL vs non‐blue‐light filtering IOL, Outcome 5 Proportion of eyes with a finding of pathological structural change at the macula, detected by clinical observation or OCT or retinal fundus photography, at 12 months (acceptable follow‐up range of 6‐18 months).

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Summary of findings for the main comparison. Blue‐light filtering intraocular lenses (IOL) compared to non blue‐light filtering IOL for protecting macular health

Blue‐light filtering IOL compared to non‐blue‐light filtering IOL for protecting macular health

Patient or population: adults undergoing cataract surgery with IOL implantation
Setting: eye hospitals
Intervention: blue‐light filtering IOL
Comparison: non‐blue‐light filtering IOL

Outcomes

Anticipated absolute effects* (95% CI)

Relative effect
(95% CI)

№ of participants
(studies)

Certainty of the evidence
(GRADE)

Comments

Risk with non‐blue‐light filtering IOL

Risk with blue‐light filtering IOL

Change in distance BCVA, between baseline and 12 months

Mean change in distance BCVA between baseline and 12 months was 0 logMAR

MD 0.01 logMAR lower
(0.03 lower to 0.02 higher)

‐

131
(2 RCTs)

⊕⊕⊕⊝
Moderatea

A lower BCVA (in logMAR) indicates a higher level of visual acuity. Studies in this analysis reported data at the end of the follow‐up period rather than change from baseline.

Distance BCVA, considered as a dichotomous outcome (being the proportion of eyes that experienced loss of 15 or more letters from baseline BCVA), at six months

See comments

Not estimable

63
(2 RCTs)

⊕⊝⊝⊝
Very lowb,c

There were no eyes, in either intervention group that had a loss of 15 or more letters from baseline BCVA.

Contrast sensitivity function, measured in log Contrast Sensitivity at six months

‐

‐

‐

‐

‐

No relevant combinable data available for this outcome

Colour discrimination, measured as the proportion of eyes that had a measurable loss from baseline using Farnsworth‐Munsell 100‐hue colour test score under photopic conditions at six months

‐

‐

‐

‐

‐

No relevant combinable data available for this outcome

Proportion of participants with adverse events with a probable causal link with the study interventions at six months follow‐up

‐

‐

‐

‐

‐

No relevant combinable data available for this outcome

Proportion of eyes that developed late‐stage AMD, being CNV and/or GA, at three years of follow‐up

See comments

Not estimable

50
(1 RCT)

⊕⊝⊝⊝
Very lowd

In the 1 trial (Kara Junior 2011) there were no eyes, in either intervention group that developed late‐stage AMD at five years of follow‐up.

Proportion of eyes that developed any stage of AMD at 12 months

See comments

Not estimable

144
(2 RCTs)

⊕⊝⊝⊝
Very lowe

In both studies, there were no eyes, in either intervention group that developed any stage of AMD over the nominated follow‐up period.

*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).

AMD: age‐related macular degeneration; BCVA: best‐corrected visual acuity; CI: confidence interval; CNV: choroidal neovascularisation; GA: geographic atrophy; MD: mean difference; RCT: randomised controlled trial

GRADE Working Group grades of evidence
High‐certainty: we are very confident that the true effect lies close to that of the estimate of the effect
Moderate‐certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
Low‐certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect
Very low‐certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect

aDowngraded for risk of bias (‐1). Data derive from two relatively small studies, with one (Caporossi 2009) judged to have a high risk of bias in both masking domains, and the other (Vuori 2006) having an unclear risk of bias in most domains.
bDowngraded for imprecision (‐2). Schmack 2012 excluded participants with surgical or postoperative complications, including vitreous loss, capsule tears or prolonged intraocular inflammation from the analysis, and hence did not capture these outcomes (which may affect BCVA) in this study. In addition, there were no events in either study group.
cDowngraded for risk of bias (‐1). Data derive from two relatively small studies (Leibovitch 2006; Schmack 2012), which both had an unclear risk of bias in at least three key domains.
dDowngraded for risk of bias (‐1) and imprecision (‐2). Data derive from one small trial involving 60 participants (Kara Júnior 2006), with an unknown risk of bias in multiple domains. In this trial, there were no events in either study group.
eDowngraded for risk of bias (‐2) and imprecision (‐1). Data derive from two small trials (Kara Junior 2011; Mester 2008a). The Kara Junior 2011 study has an unknown risk of bias in multiple domains, and we judged Mester 2008a as having a high risk of bias in multiple domains, including performance bias and detection bias. In both trials, there were no events in either study group.

Figuras y tablas -
Summary of findings for the main comparison. Blue‐light filtering intraocular lenses (IOL) compared to non blue‐light filtering IOL for protecting macular health
Ir a la tabla de la revisión
Table 1. Details of the intraocular lenses (IOLs) used as interventions in each study

Study

Blue‐light filtering IOL name(s)a (Manufacturer)

Non‐blue‐light filtering IOL name(s)a
(Manufacturer)

Aose 2006

YA‐60BB (Hoya)

AcrySof SA60AT (Alcon) or AcrySof MA60BM (Alcon) or VA‐60BB (Hoya)

Bandyopadhyay 2016

AcrySof Natural SN60AT (Alcon) or PC4406 (Optech)

AcrySof SA60AT (Alcon)

Barisic 2007

AcrySof Natural (Alcon)

AcrySof MA60BM (Alcon)

Behrens‐Baumann 2005

YA‐60BB (Hoya)

VA‐60BB (Hoya)

Bhattacharjee 2006

AcrySof Natural SN60AT (Alcon)

AcrySof SA60AT (Alcon)

Brøndsted 2014

Not reported

Not reported

Brøndsted 2015

AcrySof IQ SN60WF (Alcon)

AMO ZCBOO (Abbott Medical Optics)

Brøndsted 2017

AcrySof IQ SN60WF (Alcon)

AMO ZCBOO (Abbott Medical Optics)

Caporossi 2007

AcrySof Natural SN60AT (Alcon) or AcrySof IQ SN60WF (Alcon)

Sensar AR40e (Abbott Medical Optics) or Tecnis Z9000 (Abbott Medical Optics) or Sofport L161AO (Bausch & Lomb)

Caporossi 2009b

AcrySof Natural SN60AT (Alcon) or AcrySof IQ SN60WF (Alcon)

Sensar AR40e (Abbott Medical Optics) or Tecnis Z9000 (Abbott Medical Optics)

Cionni 2003

AcrySof SB30AL (Alcon)

AcrySof SA30AL (Alcon)

Cristobal 2005

AcrySof Natural SN60AT (Alcon)

AcrySof SA60AT (Alcon)

Cui 2009

AcrySof Natural SN60AT (Alcon) or AcrySof IQ SN60WF (Alcon)

Tecnis Z9001 (Abbott Medical Optics)

Cuthbertson 2009

AcrySof Natural SN60AT (Alcon) or AcrySof IQ SN60WF (Alcon)

Tecnis Z9000 (Abbott Medical Optics) or Cee On Edge (Abbott Medical Optics) or Akreos AO (Bausch & Lomb) or Akreos Adapt (Bausch & Lomb)

Espindle 2005

AcrySof Natural (Alcon)

AcrySof single‐piece (Alcon)

Espíndola 2012a

AcrySof Natural SN60AT (Alcon)

Akreos Fit (Bausch & Lomb) or Akreos AO (Bausch & Lomb) or AcrySof SA60AT as described in the methods (but appears to be inadvertently described as the MA60AC in the reporting of the results)

Falkner Radler 2008

AcrySof Natural (Alcon) or AF‐1 UY (Hoya)

AcrySof single‐piece (Alcon) or AF‐1 UV (Hoya)

Hahsler 2004

SN60 (Alcon)

SA60 (Alcon)

Hahsler 2005

YA (Hoya) or SN60 (Alcon)

VA (Hoya) or SA60 (Alcon)

Hayashi 2006

YA‐60BB (Hoya)

VA‐60BB (Hoya)

Hyunseok 2007

AcrySof Natural SN60AT (Alcon)

Tecnis ZA9003 (Abbott Medical Optics)

Kara Junior 2011

AcrySof Natural SN60AT (Alcon)

AcrySof SA60AT (Alcon)

Kara Júnior 2006

AcrySof Natural SN60AT (Alcon)

AcrySof MA30AC (Alcon)

Kennis 2004

AcrySof Natural SN60AT (Alcon)

Tecnis Z9000 (Pfizer) or Opti‐Edge (Abbott Medical Optics)

Kim 2011a

AcrySof IQ SN60WF (Alcon)

OII Biovue3 (BioVue) or YA60BBR (Hoya)

Kim 2011b

AcrySof IQ SN60WF (Alcon)

Tecnis Z9003 (Abbott Medical Optics)

Kuchenbecker 2004

YA‐60BB (Hoya)

VA‐60BB (Hoya)

Leibovitch 2006

AcrySof Natural SN60AT (Alcon)

AcrySof single‐piece SA60AT (Alcon)

Marshall 2005

AcrySof Natural IOL SB30AL (Alcon) (the current marketed version of this lens is the SN60AT)

AcrySof SA30AL (Alcon)

Mester 2008a

AF‐1 UY (Hoya)

AF‐1 UV (Hoya)

Monnet 2009

AcrySof SN60AT (Alcon)

AcrySof MA60AC (Alcon) or AcrySof SA60AT (Alcon)

Neumaier‐Ammerer 2010

AF1 UY (Hoya) or AcrySof SN60AT (Alcon)

AF1 UV (Hoya) or AcrySof SA60AT (Alcon)

Nolan 2009

AcrySof Natural SN60AT (Alcon)

AcrySof SA60AT (Alcon)

Pandita 2007

AcrySof SN60AT (Alcon) or AcrySof SN60WF (Alcon)

AcrySof SA60AT (Alcon)

Raj 2005

AcrySof Natural SN60AT (Alcon)

AcrySof SA60AT (Alcon)

Rocha 2006a

AcrySof IQ (Alcon) or AcrySof Natural (Alcon)

Sensar (Abbott Medical Optics)

Rocha 2006b

AcrySof IQ (Alcon) or AcrySof Natural (Alcon)

Sensar (Abbott Medical Optics)

Rocha 2007

AcrySof IQ (Alcon) or AcrySof SN60AT (Alcon)

Sensar AR40 (Allergan)

Schmack 2012

Oculaid PC 440Y Orange Series (Ophtec BV)

Oculaid PC 430Y Elite Series (Ophtec BV)

Schmidinger 2008

AF‐1 UY (Hoya)

AF‐1 UV (Hoya)

Schmoll 2014

AcrySof SN60WF (Alcon)

Tecnis ZCB (Abbott Medical Optics)

Soriano 2006

AcrySof SN60AT (Alcon) or AcrySof SN60WF (Alcon)

Sensar (Abbott Medical Optics)

Ueda 2005

ENV‐13 (Menicon)

ES‐13 (Menicon)

Ueda 2006

YA‐60BB (Hoya)

VA‐60BB (Hoya)

Vuori 2006

AcrySof Natural SN60AT (Alcon)

AcrySof SA60AT (Alcon)

Walter 2005

AF‐1 YA‐60BB (Hoya)

AF‐1 UV‐60BB (Hoya)

Wang 2010

AY‐1 UY (Hoya) or Arium Matrix Model 4000 (Medennium)

MC611MI (HumanOptics)

Wirtitsch 2009

YA‐60BB (Hoya)

VA‐60BB (Hoya)

Yamaguchi 2009

AcrySof SN60WF (Alcon) or AcrySof SN60AT (Alcon) or Py60AD (Hoya)

Tecnis Z9003 (Abbott Medical Optics)

Yamaguchi 2011

AcrySof SN60WF (Alcon) or AcrySof SN60AT (Alcon) or Py60AD (Hoya)

Tecnis Z9003 (Abbott Medical Optics)

Yuan 2004

Not reported (Hoya)

Not reported (not reported)

aDetails of the interventions are provided as per the details available in the included studies.
bCaporossi 2009, reported two‐year follow‐up data for four out of five of the intervention groups from the Caporossi 2007 study (data from the Sofport L161AO group were not provided, although no explanation was provided).

Figuras y tablas -
Table 1. Details of the intraocular lenses (IOLs) used as interventions in each study
Ir a la tabla de la revisión
Table 2. Adverse effects: intraoperative complications

Study

Study population:

number of participants (number of eyes)

Number of intraoperative complication(s)

Details of intraoperative complication(s)

Bandyopadhyay 2016

Blue‐light filtering IOLs: n = 65 (65); this group combined individuals assigned to 2 different blue‐light filtering IOLs

Non‐blue‐light filtering IOL: n = 33 (33)

Blue‐light filtering IOL: none

Non‐blue‐light filtering IOL: none

Not applicable

Barisic 2007

Blue‐light filtering IOL: n = 30 (60)

Non‐blue‐light filtering IOL: n = 30 (60)

Blue‐light filtering IOL: none

Non‐blue‐light filtering IOL: none

Not applicable

Caporossi 2007

Blue‐light filtering IOL: n = 50 (100); this group combined individuals assigned to 2 different blue‐light filtering IOLs

Non‐blue‐light filtering IOL: n = 75 (150); this group combined individuals assigned to 3 different non‐blue‐light filtering IOLs

Blue‐light filtering IOL: none

Non‐blue‐light filtering IOL: none

Not applicable

Cui 2009

Blue‐light filtering IOL: n = 39 (41)

Non‐blue‐light filtering IOL: n = 18 (20)

Blue‐light filtering IOL: none

Non‐blue‐light filtering IOL: none

Not applicable

Cuthbertson 2009

Overall: n = 31 (31)

Not reported

One participant developed endophthalmitis and was removed from the trial, being replaced (after re‐randomisation) by another individual. There was one anterior capsular rim tear and one posterior capsule tear without vitreous loss. No details were provided in relation to which group(s) the adverse events occurred in.

Espíndola 2012a

Blue‐light filtering IOL: n = 27 (27)

Non‐blue‐light filtering IOL: n = 52 (77)

Blue‐light filtering IOL: none

Non‐blue‐light filtering IOL: none

Not applicable

Falkner Radler 2008

Blue‐light filtering IOL: n = 30 (30)

Non‐blue‐light filtering IOL: n = 30 (30)

Blue‐light filtering IOL: none

Non‐blue‐light filtering IOL: none

Not applicable

Kim 2011a

Blue‐light filtering IOL: n = ? (42)

Non‐blue‐light filtering IOL: n = ? (26)

Blue‐light filtering IOL: none

Non‐blue‐light filtering IOL: none

Not applicable

Kim 2011b

Blue‐light filtering IOL: n = 23 (23)

Non‐blue‐light filtering IOL: n = 16 (16)

Blue‐light filtering IOL: none

Non‐blue‐light filtering IOL: none

Not applicable

Leibovitch 2006

Blue‐light filtering IOL: n = 9 (9)

Non‐blue‐light filtering IOL: n = 10 (10)

Blue‐light filtering IOL: none

Non‐blue‐light filtering IOL: none

Not applicable

Marshall 2005

Blue‐light filtering IOL: n = 150 (300)

Non‐blue‐light filtering IOL: n = 147 (294)

Blue‐light filtering IOL: n = 1

Non‐blue‐light filtering IOL: none

There was one case of lens dislocation during surgery in the blue‐light filtering IOL group, in a case in which a posterior capsule rupture had occurred during cataract extraction.

Monnet 2009

Blue‐light filtering IOL: n = 19 (19)

Non‐blue‐light filtering IOL: n = 40 (40); this group combined individuals assigned to 2 different non‐blue‐light filtering IOLs.

Blue‐light filtering IOL: n = 2

Non‐blue‐light filtering IOL: none

In the blue‐light filtering IOL lens group "two IOLs were placed with 1 haptic in the capsular bag and 1 haptic outside the capsular bag; these 2 patients were also excluded from the final statistical analysis."

Pandita 2007

Blue‐light filtering IOL: n = 73 (73); this group combined individuals assigned to 2 different blue‐light filtering IOLs.

Non‐blue‐light filtering IOL: n = 36 (36)

Blue‐light filtering IOL: none

Non‐blue‐light filtering IOL: none

Not applicable

Raj 2005

Blue‐light filtering IOL: n = 30 (30)

Non‐blue‐light filtering IOL: n = 30 (30)

Blue‐light filtering IOL: none

Non‐blue‐light filtering IOL: none

Not applicable

Schmidinger 2008

Blue‐light filtering IOL: n = 31 (31)

Non‐blue‐light filtering IOL: n = 31 (31)

Blue‐light filtering IOL: none

Non‐blue‐light filtering IOL: none

Not applicable

Vuori 2006

Blue‐light filtering IOL: n = 19 (25)

Non‐blue‐light filtering IOL: n = 18 (27)

Blue‐light filtering IOL: none

Non‐blue‐light filtering IOL: none

Not applicable

IOL: intraocular lens

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Table 2. Adverse effects: intraoperative complications
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Table 3. Adverse effects: postoperative complications and Nd:YAG capsulotomies

Study

Study population: number of participants (number of eyes)

Number of postoperative complication(s)

Details of postoperative complication(s)

Bandyopadhyay 2016

Blue‐light filtering IOLs: n = 65 (65); this group combined individuals assigned to 2 different blue‐light filtering IOLs.

Non‐blue‐light filtering IOL: n = 33 (33)

Blue‐light filtering IOL: none

Non‐blue‐light filtering IOL: none

None at four weeks of follow‐up

Barisic 2007

Blue‐light filtering IOL: n = 30 (60)

Non‐blue‐light filtering IOL: n = 30 (60)

Blue‐light filtering IOL: n = 3 eyes

Non‐blue‐light filtering IOL: n = 4 eyes

Although the study authors reported that "there were no postoperative complications", n = 3 eyes from the blue‐light filtering IOL group and n = 4 eyes from the non‐blue‐light filtering IOL group required Nd:YAG capsulotomy at six months of follow‐up.

Brøndsted 2015

Blue‐light filtering IOL: n = 38 (38)

Non‐blue‐light filtering IOL: n = 35 (35)

Blue‐light filtering IOL: none

Non‐blue‐light filtering IOL: none

None at six months of follow‐up.

Caporossi 2007

Blue‐light filtering IOL: n = 50 (100); this group combined individuals assigned to 2 different blue‐light filtering IOLs.

Non‐blue‐light filtering IOL: n = 75 (150); this group combined individuals assigned to three different non‐blue‐light filtering IOLs.

Blue‐light filtering IOL: none

Non‐blue‐light filtering IOL: none

None at two months of follow‐up

Caporossi 2009

Blue‐light filtering IOL: n = 50 (100); this group combined individuals assigned to 2 different blue‐light filtering IOLs

Non‐blue‐light filtering IOL: n = 50 (100); this group combined individuals assigned to 2 different non‐blue‐light filtering IOLs

Blue‐light filtering IOL: n = 1 for Nd:YAG capsulotomy

Non‐blue‐light filtering IOL: n = 1 for Nd:YAG capsulotomy

This study reports the two‐year follow‐up data for a subset of participants from Caporossi 2007. The study authors reported that "patients who underwent a capsulotomy before two‐year follow‐up (two patients) were excluded as it was not possible to perform aberrometric analysis. Two Nd:YAG laser capsulotomies were required in two patients who had AcrySof SN60AT IOL (blue‐light filtering IOL) and Tecnis Z9000 IOL (non‐blue‐light filtering IOL) implantation."

Cui 2009

Blue‐light filtering IOL: n = 39 (41); this group combined individuals assigned to 2 different blue‐light filtering IOLs.

Non‐blue‐light filtering IOL: n = 18 (20)

Blue‐light filtering IOL: none

Non‐blue‐light filtering IOL: none

None at two months of follow‐up

Espíndola 2012a

Blue‐light filtering IOL: n = 27 (27)

Non‐blue‐light filtering IOL: n = 52 (77)

Blue‐light filtering IOL: none for glaucoma or Nd:YAG capsulotomy

Non‐blue‐light filtering IOL: none for glaucoma or Nd:YAG capsulotomy

The study authors reported that "at two years after surgery, all lenses were well centered and there was no evidence of posterior capsule opacity or glaucoma."

Falkner Radler 2008

Blue‐light filtering IOL: n = 30 (30)

Non‐blue‐light filtering IOL: n = 30 (30)

Blue‐light filtering IOL: n = 3 eyes

Non‐blue‐light filtering IOL: n = 1 eye

Blue‐light filtering IOL:

n = 1 postoperative iris capture,

n = 1 spontaneously reabsorbed vitreous haemorrhage,

n = 1 cystoid macular oedema at nine months after surgery

Non‐blue‐light filtering IOL: n = 1 postoperative iris capture

Kim 2011b

Blue‐light filtering IOL: n = 23 (23)

Non‐blue‐light filtering IOL: n = 16 (16)

Blue‐light filtering IOL: none

Non‐blue‐light filtering IOL: none

None at eight weeks of follow‐up

Hayashi 2006

Blue‐light filtering IOL: n = 38 (38)

Non‐blue‐light filtering IOL: n = 36 (36)

(In both groups, data were obtained from both eyes and averaged)

Glare symptoms

Blue‐light filtering IOL: n = 3 participants

Non‐blue‐light filtering IOL: n = 2 participants

Cyanopsia

Blue‐light filtering IOL: none

Non‐blue‐light filtering IOL: none

Postoperative complications (as measured by participant report of glare symptoms and cyanopsia) at three months after surgery

One participant was reported to have a clinically significant epiretinal membrane in the macula (it is unclear which group the participant belonged to)

Kara Junior 2011

Blue‐light filtering IOL: n = 30 (30)

Non‐blue‐light filtering IOL: n = 30 (30)

"Three patients required neodymium:YAG laser capsulotomy for posterior capsule opacification," however group allocations were not specified.

Three participants (although this was not distinguished by the IOL intervention) at five years of follow‐up

Kim 2011a

Blue‐light filtering IOL: n = 23 (23)

Non‐blue‐light filtering IOL: n = 16 (16)

Blue‐light filtering IOL: none

Non‐blue‐light filtering IOL: none

None at eight weeks of follow‐up

Leibovitch 2006

Blue‐light filtering IOL: n = 9 (9)

Non‐blue‐light filtering IOL: n = 10 (10)

Blue‐light filtering IOL: none

Non‐blue‐light filtering IOL: none

None at six months of follow‐up

Marshall 2005

Blue‐light filtering IOL: n = 150 (300)

Non‐blue‐light filtering IOL: n = 147 (294)

Blue‐light filtering IOL: n = 12

Non‐blue‐light filtering IOL: n = 6

At six months of follow‐up, in the blue‐light filtering IOL group, six eyes developed cystoid macula oedema and six eyes required secondary surgical intervention; none of the occurrences were considered IOL‐related.

At six months of follow‐up, in the non‐blue‐light filtering IOL group, three eyes developed cystoid macula oedema and three eyes required secondary surgical intervention; none of the occurrences were considered IOL‐related.

The study authors stated that "no Nd:YAG capsulotomy was performed in the first‐eye subgroup in either the test or control groups throughout the study period."

Monnet 2009

Blue‐light filtering IOL: n = 19 (19)

Non‐blue‐light filtering IOL: n = 40 (40); this group combined individuals assigned to 2 different non‐blue‐light filtering IOLs.

Blue‐light filtering IOL: none

Non‐blue‐light filtering IOL: none

None at three months of follow‐up

Schmidinger 2008

Blue‐light filtering IOL: n = 31 (31)

Non‐blue‐light filtering IOL: n = 31 (31)

Blue‐light filtering IOL: none

Non‐blue‐light filtering IOL: none

None at three months of follow‐up

Wang 2010

Blue‐light filtering IOL: n = 80 (80); this group combined individuals assigned to 2 different blue‐light filtering IOLs.

Non‐blue‐light filtering IOL: n = 38 (38)

Blue‐light filtering IOL: none

Non‐blue‐light filtering IOL: none

None at 3 months of follow‐up

Vuori 2006

Blue‐light filtering IOL: n = 19 (25)

Non‐blue‐light filtering IOL: n = 18 (27)

Blue‐light filtering IOL: none

Non‐blue‐light filtering IOL: none

The study authors stated that "in the biomicroscopic examination (at one month postoperatively) the posterior capsule appeared clear in all test eyes."

Yamaguchi 2011

Blue‐light filtering IOL: n = ? (120); this group combined individuals assigned to 3 different blue‐light filtering IOLs.

Non‐blue‐light filtering IOL: n = ? (30)

Blue‐light filtering IOL: none

Non‐blue‐light filtering IOL: none

Reported at one month of follow‐up

IOL: intraocular lens

Figuras y tablas -
Table 3. Adverse effects: postoperative complications and Nd:YAG capsulotomies
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Comparison 1. Blue‐light filtering IOL vs non‐blue‐light filtering IOL

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Change in distance best‐corrected visual acuity (BCVA) for single‐eye trials, between baseline and 12 months (accepted measures for 6‐18 months' follow‐up). If studies did not report change in distance BCVA, we utilised data reported at the end of the follow‐up period. Show forest plot

2

131

Mean Difference (IV, Fixed, 95% CI)

‐0.01 [‐0.03, 0.02]

2 Change in distance best‐corrected visual acuity (BCVA) for paired‐eye trials, between baseline and 12 months (accepted measures for 6‐18 months follow‐up. If change in distance BCVA was not reported, we utilised data reported at the end of the follow‐up period. Show forest plot

4

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

3 Contrast sensitivity, measured in log Contrast Sensitivity at 6 months (acceptable follow‐up range of 3‐9 months) Show forest plot

2

79

Mean Difference (IV, Fixed, 95% CI)

0.00 [‐0.14, 0.14]

4 Contrast sensitivity function, measured in log Contrast Sensitivity, using the mid‐range of the available spatial frequencies (between 6‐12 cycles/deg) at 6 months (acceptable follow‐up range of 3‐9 months; logCT) Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

5 Proportion of eyes with a finding of pathological structural change at the macula, detected by clinical observation or OCT or retinal fundus photography, at 12 months (acceptable follow‐up range of 6‐18 months) Show forest plot

3

808

Peto Odds Ratio (Peto, Fixed, 95% CI)

2.21 [0.63, 7.68]
Figuras y tablas -
Comparison 1. Blue‐light filtering IOL vs non‐blue‐light filtering IOL
Ir a la tabla de la revisión