Risk of Depression in Persistent Blue Light Deprivation after Cataract Surgery A Population-Based Cohort Study

Abstract

Purpose: To identify the risk of depression in individuals exposed to persistent blue light deprivation through blue light-filtering (BLF) intraocular lenses (IOLs) based on previous studies that found blue light to promote affective arousal and modulate emotional responses. Design: Population-based cohort analysis. Participants: Individuals who underwent cataract removal and IOL implantation in both eyes within 1 year between January 2012 and December 2018. Methods: Participants were categorized into either clear IOL or BLF IOL groups. The National Health Insurance Sharing Service of South Korea database was queried for new diagnoses of depressive disorders. The full observation period spanned from January 1, 2008 through December 31, 2022. Main Outcome Measures: Incidence rates and hazard ratios (HRs) were calculated for depressive disorders in individuals with BLF IOLs and clear IOLs using Cox proportional hazards model. Outcomes were adjusted for demographics, income, and comorbidities. Results: A total of 14 010 individuals (35.5% men; mean +/- standard deviation age, 71.4 +/- 9.20 years) who underwent BLF IOL implantation in both eyes within 1 year between 2012 and 2018 were age-matched and sex-matched to 14 010 individuals with clear IOLs in both eyes. The incidence rate of depressive disorders was 27.8 per 1000 person-years for the BLF IOL group compared with 24.1 per 1000 person-years for the clear IOL group. The risk of depressive disorders increased by 1.16-fold (95% confidence interval [CI], 1.09-1.23; P < 0.001) among individuals with BLF IOLs relative to those with clear IOLs after adjusting for systemic comorbidities and follow-up duration. The risk of depressive disorders was especially high for individuals with BLF IOLs between 50 and 64 years of age (HR, 1.30; 95% CI, 1.14-1.48; P < 0.001) and women (HR, 1.17; 95% CI, 1.09-1.25; P < 0.001). Similar trends were observed in the sensitivity analysis and unmatched cohort analysis. Conclusions: The risk of depressive disorders increases for individuals with BLF IOLs relative to those with clear IOLs. In the long term, persistent blue light deprivation may increase risks of depression, and particular age cohorts and women may be more vulnerable to the light deprivation than others. (c) 2025 by the American Academy of Ophthalmology