Augmentation of Macular Pigment following Implantation of Blue Light–Filtering Intraocular Lenses at the Time of Cataract Surgery

PURPOSE. (Photo)-oxidative stress is believed to play a role in the pathogenesis of age-related macular degeneration (AMD), with the threshold for retinal damage being lowest for shortwavelength (blue) light. Macular pigment (MP), consisting of the carotenoids lutein (L), zeaxanthin (Z) and meso-Z, has a maximum absorption at 460 nm and protects the retina from (photo)-oxidative injury. This study was designed to investigate whether the blue light–filtering properties of the Alcon Acry- Sof Natural intraocular lens (ANIOL) implanted during cataract surgery affects MP optical density (MPOD). METHODS. Forty-two patients scheduled for cataract surgery were recruited for the study. These patients all had a preoperative best corrected visual acuity rating (BCVAR) of at least 0.5 (logMAR) in the study eye. The patients were randomized to have either the standard Alcon AcrySof three-piece acrylic intraocular lens (AIOL) (controls) or the ANIOL implanted at the time of cataract surgery. The spatial profile of MPOD (i.e., at 0.25°, 0.5°, 1.0°, and 1.75° eccentricity) was measured with customized heterochromatic flicker photometry (cHFP) 1 week before and 1 week after surgery, and at 3, 6, and 12 months after surgery. Serum concentrations of L and Z were also measured at each study visit. RESULTS. There was a highly significant and positive correlation between all MPODs (e.g., at 0.25°) recorded 1 week before and after surgery in eyes with an AIOL implant (r � 0.915, P � 0.01; paired samples t-test, P � 0.631) and in those ANIOL implants (r � 0.868, P � 0.01; paired samples t-test, P � 0.719). Average MPOD across the retina increased significantly with time (after 3 months) in the ANIOL group (repeatedmeasures, general linear model, P � 0.05), but remained stable in the AIOL group (repeated-measures, general linear model, P � 0.05). There were no significant time or lens effects observed for serum L over the study period (P � 0.05). There was a significant time effect for serum Z over the study perio