Jiahn-Shing Lee, Pei-Ru Li, Yi-Ling Hu, Ken-Kuo Lin, Lai-Chu See
{"title":"蓝光滤光及优质人工晶体在术后跌倒中的作用：台湾一项全国性的目标试验模拟。","authors":"Jiahn-Shing Lee, Pei-Ru Li, Yi-Ling Hu, Ken-Kuo Lin, Lai-Chu See","doi":"10.1016/j.bj.2025.100917","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Falls are a leading cause of injury and premature death in older adults, and cataract surgery reduces fall risk. Concerns existed that blue-light filtering (BF) intraocular lenses (IOLs) might impair light transmittance and increase fall risk. We aimed to compare fall incidence and injury diagnoses among patients who received bilateral cataract surgery with premium BF, premium non-BF, and standard non-BF IOLs.</p><p><strong>Material and methods: </strong>We emulated a target trial by enrolling 26,730 well-matched patients per IOL cohort who underwent bilateral cataract surgeries between 2011 and 2017 from the Taiwan National Health Insurance Research Database. They were followed until a fall, death, withdrawal, or December 31, 2022. Propensity score matching minimized baseline differences across groups.</p><p><strong>Results: </strong>Fall incidence increased over time, from 9.07 to 21.13 per 1,000 person-years. The premium BF-IOL (12.94) and premium non-BF-IOL (13.12) groups had lower fall rates than the standard non-BF-IOL group (14.85). Both Cox and Fine-Gray models showed significantly lower fall risks for premium BF-IOL (HR 0.86, SHR 0.92) and premium non-BF-IOL (HR 0.88, SHR 0.91) compared to standard IOLs. There was no significant difference in fall risk between premium BF-IOL and premium non-BF-IOL (HR/SHR 0.99). While hospitalization rates post-fall (68.6%) and 30-day fatal fall rate (1.29%) were comparable, standard IOLs were associated with significantly higher fracture rates.</p><p><strong>Conclusions: </strong>We found no evidence that BF-IOLs increase fall incidence. Both premium IOL groups consistently had lower fall rates than standard non-BF-IOLs, suggesting that socioeconomic factors, in addition to IOL type, may contribute to this reduction.</p>","PeriodicalId":8934,"journal":{"name":"Biomedical Journal","volume":" ","pages":"100917"},"PeriodicalIF":4.4000,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Role of Blue Light-Filtering and Premium Intraocular Lenses on Postoperative Falls: A Nationwide Target Trial Emulation in Taiwan.\",\"authors\":\"Jiahn-Shing Lee, Pei-Ru Li, Yi-Ling Hu, Ken-Kuo Lin, Lai-Chu See\",\"doi\":\"10.1016/j.bj.2025.100917\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Falls are a leading cause of injury and premature death in older adults, and cataract surgery reduces fall risk. Concerns existed that blue-light filtering (BF) intraocular lenses (IOLs) might impair light transmittance and increase fall risk. We aimed to compare fall incidence and injury diagnoses among patients who received bilateral cataract surgery with premium BF, premium non-BF, and standard non-BF IOLs.</p><p><strong>Material and methods: </strong>We emulated a target trial by enrolling 26,730 well-matched patients per IOL cohort who underwent bilateral cataract surgeries between 2011 and 2017 from the Taiwan National Health Insurance Research Database. They were followed until a fall, death, withdrawal, or December 31, 2022. Propensity score matching minimized baseline differences across groups.</p><p><strong>Results: </strong>Fall incidence increased over time, from 9.07 to 21.13 per 1,000 person-years. The premium BF-IOL (12.94) and premium non-BF-IOL (13.12) groups had lower fall rates than the standard non-BF-IOL group (14.85). Both Cox and Fine-Gray models showed significantly lower fall risks for premium BF-IOL (HR 0.86, SHR 0.92) and premium non-BF-IOL (HR 0.88, SHR 0.91) compared to standard IOLs. There was no significant difference in fall risk between premium BF-IOL and premium non-BF-IOL (HR/SHR 0.99). While hospitalization rates post-fall (68.6%) and 30-day fatal fall rate (1.29%) were comparable, standard IOLs were associated with significantly higher fracture rates.</p><p><strong>Conclusions: </strong>We found no evidence that BF-IOLs increase fall incidence. Both premium IOL groups consistently had lower fall rates than standard non-BF-IOLs, suggesting that socioeconomic factors, in addition to IOL type, may contribute to this reduction.</p>\",\"PeriodicalId\":8934,\"journal\":{\"name\":\"Biomedical Journal\",\"volume\":\" \",\"pages\":\"100917\"},\"PeriodicalIF\":4.4000,\"publicationDate\":\"2025-10-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Biomedical Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.bj.2025.100917\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"BIOCHEMISTRY & MOLECULAR BIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Biomedical Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.bj.2025.100917","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"BIOCHEMISTRY & MOLECULAR BIOLOGY","Score":null,"Total":0}
The Role of Blue Light-Filtering and Premium Intraocular Lenses on Postoperative Falls: A Nationwide Target Trial Emulation in Taiwan.
Background: Falls are a leading cause of injury and premature death in older adults, and cataract surgery reduces fall risk. Concerns existed that blue-light filtering (BF) intraocular lenses (IOLs) might impair light transmittance and increase fall risk. We aimed to compare fall incidence and injury diagnoses among patients who received bilateral cataract surgery with premium BF, premium non-BF, and standard non-BF IOLs.
Material and methods: We emulated a target trial by enrolling 26,730 well-matched patients per IOL cohort who underwent bilateral cataract surgeries between 2011 and 2017 from the Taiwan National Health Insurance Research Database. They were followed until a fall, death, withdrawal, or December 31, 2022. Propensity score matching minimized baseline differences across groups.
Results: Fall incidence increased over time, from 9.07 to 21.13 per 1,000 person-years. The premium BF-IOL (12.94) and premium non-BF-IOL (13.12) groups had lower fall rates than the standard non-BF-IOL group (14.85). Both Cox and Fine-Gray models showed significantly lower fall risks for premium BF-IOL (HR 0.86, SHR 0.92) and premium non-BF-IOL (HR 0.88, SHR 0.91) compared to standard IOLs. There was no significant difference in fall risk between premium BF-IOL and premium non-BF-IOL (HR/SHR 0.99). While hospitalization rates post-fall (68.6%) and 30-day fatal fall rate (1.29%) were comparable, standard IOLs were associated with significantly higher fracture rates.
Conclusions: We found no evidence that BF-IOLs increase fall incidence. Both premium IOL groups consistently had lower fall rates than standard non-BF-IOLs, suggesting that socioeconomic factors, in addition to IOL type, may contribute to this reduction.
期刊介绍：
Biomedical Journal publishes 6 peer-reviewed issues per year in all fields of clinical and biomedical sciences for an internationally diverse authorship. Unlike most open access journals, which are free to readers but not authors, Biomedical Journal does not charge for subscription, submission, processing or publication of manuscripts, nor for color reproduction of photographs.
Clinical studies, accounts of clinical trials, biomarker studies, and characterization of human pathogens are within the scope of the journal, as well as basic studies in model species such as Escherichia coli, Caenorhabditis elegans, Drosophila melanogaster, and Mus musculus revealing the function of molecules, cells, and tissues relevant for human health. However, articles on other species can be published if they contribute to our understanding of basic mechanisms of biology.
A highly-cited international editorial board assures timely publication of manuscripts. Reviews on recent progress in biomedical sciences are commissioned by the editors.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
