The Effect of Blue Light Exposure on AMD after Cataract Surgery
There has been controversy regarding the susceptibility to retinal damage and AMD from blue light exposure in individuals who have surgical removal of cataracts. This controvery results primarily from the publication of one paper, Progression of Age-Related Macular Degeneration After Cataract Surgery. published in Archives of Ophthalmology in November 2009; 127(11): 1412-1419 by Dong et al. which concluded "The low incidence rate of neovascular AMD development between 1 week and 1 year after cataract surgery did not support the hypothesis that cataract surgery increases the risk of AMD progression".1
Some have claimed that this paper establishes serious doubts regarding an increased susceptibility to AMD from blue light exposure, and also posit that these results indicate that blue light exposure is not a major contributing factor in the development of AMD. However, The results and implications of this study have been controversial from the outset, as expressed in an editorial by BE Klein, "Is the Risk of Incidence or Progression of Age-Related Macular Degeneration Increased After Cataract Surgery?", published in that same issue.
In addition to the many earlier studies, such as Age-Related Maculopathy and the Impact of Blue Light Hazard, by Algarve et al. which found the opposite to be true2, subsequent studies, such as, Ocular Risk Factors for Age-Related Macular Degeneration by Fraser-Bell et al. in the American Journal of Ophthalmology (May 20, 2010) have also determined that cataract surgery increases susceptibility to AMD from blue light exposure. These authors concluded "Cross-sectional associations of ocular factors such as cataract, cataract surgery, and refractive errors with early AMD lesions found in Latinos are consistent with those in non-Hispanic Whites. Additionally, prior cataract surgery was associated with advanced AMD". 3
This subject was also discussed at the recent 1st World Congress on Controversies in Ophthalmology (COPHy)
in Prague, Czech Republic March 4-7, 2010. A. Pollack, of the Kaplan Medical Center at the Hebrew University in
Israel, presented data from 6 studies they performed which concluded "These studies describe an acceleration of
the course of dry AMD progression after cataract surgery. ... The most substantial difference was seen in patients
converting to wet AMD within 2 years of cataract surgery in study Six." See THE COURSE OF MACULOPATHY AFTER
CATARACT SURGERY IN PATIENTS WITH EARLY DRY AMD, presented at that conference4.
S. Bressler, a co-author of the Dong et al paper cited above, also spoke at the COPHy Conference and acknowledged
"inconsistent findings” in the literature. He stated that “Both cataract and macular degeneration are common
age-related diseases. Many individuals simultaneously manifest both conditions. The literature contains inconsistent
findings describing adverse relationships between performance of cataract surgery and development and progression of AMD."
Users of bright light therapy or blue light therapy must determine whether its worth the risk of increased retinal damage
to continue with their products, or to convert to a Lo-LIGHT therapy lamp using the low-intensity GreenLIGHT
technology that poses no hazard of retinal damage.
1.
Progression of Age-Related Macular Degeneration After Cataract Surgery
2.
Age-Related Maculopathy and the Impact of Blue Light Hazard
3.
Ocular Risk Factors for Age-Related Macular Degeneration
4.
See THE COURSE OF MACULOPATHY AFTER CATARACT SURGERY IN PATIENTS WITH EARLY DRY AMD
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