Do blue light filter lenses really protect the retina?

During the last decades in the ophthalmic sector there has been a great debate about filters for ophthalmic lenses that attenuate the transmission of short-wavelength visible (blue) light.

The blue light glasses reduces eye exposure to both ultraviolet (UV) radiation at some wavelengths, and short-wavelength visible light. This filter can be found in both spectacle lenses and intraocular lenses that contain or are coated with chromophores that absorb a proportion of the incident wavelengths.
Manufacturers of these filters claim that blue light filters can relieve eye fatigue, improve sleep quality, or provide retinal protection against phototoxicity, particularly in the macula.

The hypothesis of putative retinal protection is supported by animal and cell culture data demonstrating that high-level exposure to short-wavelength visible light can induce cellular damage to the retina.
Extrapolating these findings to humans, it has been suggested that blue light may contribute to the development or progression of age-related macular degeneration.
AMD or macular degeneration is currently the main cause of visual impairment in adults in developed countries and any solution that can mean a relative reduction in the risk of developing the disease has a great benefit for individual and public health.
Sunlight is the predominant source of ambient blue light, and of growing concern is the proliferation of modern lighting sources, which emit higher levels of short-wavelength visible light than traditional incandescent bulbs.

There are guidelines set by the International Commission on Non-Ionizing Radiation Protection (ICNIRP) which is an international commission specialized in non-ionizing radiation protection. The organization's activities include reporting safety limits for human ocular exposure to optical radiation.
The level (lightness-weighted) of blue light emission from modern lighting sources, including computer screens, tablets and mobile phones, is estimated to be approximately 100 times lower than the eye risk level specified in the guidelines.
Therefore, the risk of retinal damage attributed to blue light emitted by digital devices and household light sources has been determined to be minimal, even under "extreme long-term viewing conditions."

Despite these findings, there is a growing number of blue light filtering ophthalmic lenses that have received regulatory approval for use in refractive correction.
Cataract surgery with intraocular lens implantation is the most common eye surgery, with approximately 10 million surgeries performed annually worldwide. In 2011, blue light filtering intraocular lenses were estimated to account for 1 in 4 implants. Recently the scientific journal JAMA Ophtalmology has published an interesting article “Analysis of a Systematic Review About Blue Light–Filtering Intraocular Lenses for Retinal ProtectionUnderstanding the Limitations of the Evidence.
The article analyzes and interprets the existing scientific literature including Cochrane Systematic Reviews data, a database of randomized controlled trials (RCTs) on blue light filtering and the relationship of intraocular lenses to protecting macular health.

But data could not be well combined across trials, to be able to draw any overall conclusions, due to the use of different measurement techniques for outcomes, incomplete reporting of data, and varied follow-up periods. Substantial deficiencies in the internal validity of many of the included studies were identified, particularly with regard to trial design, conduct and reporting.

To rigorously assess whether blue-light filtering intraocular lenses have an association with macular health, robust long-term trials with sufficient power would be needed. But, it can be determined that the use of intraocular lenses with a blue light filter as a benefit for the macula has solid clinical research to support it