Another consideration is whether or not to use a blue-blocking IOL. These lenses reduce the amount of blue and violet (shorter wavelength) light in the eye. However, there is no consensus on the value of using these lenses.
Mainster and Turner have provided a comprehensive discussion about this topic.1 They concluded that the use of blue-blocking IOLs offers no evidence-based medicine. They pointed out that most age-related macular degeneration (AMD) occurs in phakic adults, 60 years and older, despite crystalline lens photoprotection that is greater than that of blue-blocking IOLs. If light is involved in AMD pathogenesis, senescent crystalline lenses cannot prevent it and neither can blue-blocking IOLs.
Obviously, it is important to make the best IOL selection for each patient. Considering the patient’s current and future eye health will provide the best information for the proper decision.
There are clear reasons why certain lenses should not be used in some patients. This should be discussed with the patient and an informed decision made. For an optional choice, such as the blue-blocking lenses, educating the patient on what is known can be helpful to allow them to be involved in the decision.
1. Mainster MA, Turner PL. Blue-blocking IOLs decrease photoreception without providing significant photoprotection. Surv Ophthalmol. 2010 May-Jun;55(3):272-89. doi: 10.1016/j.survophthal.2009.07.006. Epub 2009 Nov