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Desmettre T, Baillif S, Mathis T, Gatinel D, Mainster M. [Blue light and intraocular lenses (IOLs): Beliefs and realities]. J Fr Ophtalmol 2024; 47:104043. [PMID: 38241770 DOI: 10.1016/j.jfo.2023.104043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/18/2023] [Accepted: 10/22/2023] [Indexed: 01/21/2024]
Abstract
The first intraocular lenses (IOLs) used for cataract surgery transmitted both ultraviolet (UV) radiation and visible light to the retina. Colorless UV-blocking IOLs were introduced and rapidly adopted in the 1980s. Yellow-tinted blue-blocking (also known as blue-filtering) IOLs were marketed in the early 1990s. Blue-blocking IOLs were intended to simulate age-related crystalline lens yellowing to reduce the cyanopsia that some patients experienced after cataract surgery. When blue-filtering IOLs were introduced in North America, however, blue-blocking chromophores were advocated as a way to protect patients from age-related macular degeneration (AMD) despite the lack of evidence that normal environmental light exposure causes AMD. The "blue light hazard" is a term that describes the experimental finding that acute, abnormally intense light exposures are potentially more phototoxic to the retina when short rather than long wavelengths are used. Thus, in brief exposures to intense light sources such as welding arcs, ultraviolet radiation is more hazardous than blue light, which is more hazardous than longer wavelength green or red light. International commissions have cautioned that the blue light hazard does not apply to normal indoor or outdoor light exposures. Nonetheless, the hazard is used for commercial purposes to suggest misleadingly that ambient environmental light can cause acute retinal phototoxicity and increase the risk of AMD. Very large epidemiological studies show that blue-blocking IOLs do not reduce the risk or progression of AMD. Additionally, blue-filtering IOLs or spectacles cannot decrease glare disability, because they decrease image and glare illuminance in the same proportion. Blue light is essential for older adults' scotopic photoreception needed to reduce the risk of nighttime falling and related injuries. It is also critical for circadian photoreception that is essential for good health, sleep and cognitive performance. Unfortunately, age-related pupillary miosis, retinal rod and ganglion cell photoreceptor degeneration and decreased outdoor activity all reduce the amount of healthful blue light available to older adults. Blue-restricting IOLs further reduce the available blue light at a time when older adults need it most. Patients and ophthalmologists are exposed to hypothesis-based advertisements for blue-filtering optical devices that suppress short wavelength light critical for vision in dim lighting and for good physical and mental health. Spectacle and intraocular lens selections should be based on scientific fact, not conjecture. Ideal IOLs should improve photoreception rather than limit it permanently. Practice efficiency, surgical convenience and physician-manufacturer relationships may eliminate a patient's opportunity to choose between colorless blue-transmitting IOLs and yellow-tinted, blue-restricting IOLs. Cataract surgeons ultimately determine whether their patients have the opportunity to make an informed choice about their future photoreception.
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Affiliation(s)
- T Desmettre
- Centre de rétine médicale, 187, rue de Menin, 59520 Marquette-Lez-Lille, France.
| | - S Baillif
- Département d'ophtalmologie, hôpital Pasteur, 30, voie Romaine, 06000 Nice cedex 1, France
| | - T Mathis
- Service d'ophtalmologie, hôpital de la Croix-Rousse, hospices civils de Lyon, 69004 Lyon, France
| | - D Gatinel
- Service d'ophtalmologie, fondation A.-de-Rothschild, 25, rue Manin, 75940 Paris cedex 19, France
| | - M Mainster
- Department of Ophthalmology, University of Kansas School of Medicine, Prairie Village, Kansas, États-Unis
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Wai YZ, Chong YY, Lim LT, Chan JB, Chandrasekaran S. Preferred cataract surgery practices in Malaysia: a survey based study. BMC Res Notes 2023; 16:116. [PMID: 37349840 DOI: 10.1186/s13104-023-06391-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 06/15/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND To describe the preferred cataract surgery practices among Malaysian ophthalmologists and medical officers in comparison with the recommended practices. METHODS An online questionnaire was sent out in April 2021, to Malaysian Ophthalmologists and medical officers who perform cataract surgeries. The questions were focused on the preferred cataract surgery practices of the participants. All data obtained were collected, tabulated and analysed. RESULTS A total of 173 participants responded to the online questionnaire. 55% of the participants were within 31-40 years of age. 56.1% preferred peristaltic pump over venturi system. 91.3% of participants practised povidone iodine instillation to the conjunctival sac. With regards to the main wound incision, more than half of the surgeons (50.3%) preferred fixed superior incision and 72.3% of them preferred 2.75 mm microkeratome blade. Most of the participants (63%) were inclined towards C-Loop clear intraocular lens (IOL) with a single-handed push preloaded system. 78.6% of the surgeons routinely use carbachol in their cataract surgery. CONCLUSIONS This survey provides some insight into the current practices among Malaysian ophthalmologists. Most of the practices are in line with international guidelines for preventing postoperative endophthalmitis. This article could help trainees and ophthalmologists benchmark and observe the common cataract surgery practices among their seniors and peers in Malaysia.
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Affiliation(s)
- Yong Zheng Wai
- Department of Ophthalmology, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
| | | | - Lik Thai Lim
- Faculty of Medicine, Universiti Malaysia Sarawak (UNIMAS), Kota Samarahan, Sarawak, Malaysia.
- Universiti Malaysia Sarawak (UNIMAS), Kota Samarahan, Sarawak, Malaysia.
| | - Jan Bond Chan
- International Specialist Eye Center, Kuala Lumpur, Malaysia
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Mainster MA, Findl O, Dick HB, Desmettre T, Ledesma-Gil G, Curcio CA, Turner PL. The Blue Light Hazard Versus Blue Light Hype. Am J Ophthalmol 2022; 240:51-57. [PMID: 35227699 PMCID: PMC10243475 DOI: 10.1016/j.ajo.2022.02.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 02/14/2022] [Accepted: 02/16/2022] [Indexed: 11/01/2022]
Abstract
PURPOSE The blue light hazard is the experimental finding that blue light is highly toxic to the retina (photic retinopathy), in brief abnormally intense exposures, including sungazing or vitreoretinal endoillumination. This term has been misused commercially to suggest, falsely, that ambient environmental light exposure causes phototoxicity to the retina, leading to age-related macular degeneration (AMD). We analyze clinical, epidemiologic, and biophysical data regarding blue-filtering optical chromophores. DESIGN Perspective. METHODS Analysis and integration of data regarding the blue light hazard and blue-blocking filters in ophthalmology and related disciplines. RESULTS Large epidemiologic studies show that blue-blocking intraocular lenses (IOLs) do not decrease AMD risk or progression. Blue-filtering lenses cannot reduce disability glare because image and glare illumination are decreased in the same proportion. Blue light essential for optimal rod and retinal ganglion photoreception is decreased by progressive age-related crystalline lens yellowing, pupillary miosis, and rod and retinal ganglion photoreceptor degeneration. Healthful daily environmental blue light exposure decreases in older adults, especially women. Blue light is important in dim environments where inadequate illumination increases risk of falls and associated morbidities. CONCLUSIONS The blue light hazard is misused as a marketing stratagem to alarm people into using spectacles and IOLs that restrict blue light. Blue light loss is permanent for pseudophakes with blue-blocking IOLs. Blue light hazard misrepresentation flourishes despite absence of proof that environmental light exposure or cataract surgery causes AMD or that IOL chromophores provide clinical protection. Blue-filtering chromophores suppress blue light critical for good mental and physical health and for optimal scotopic and mesopic vision.
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Affiliation(s)
- Martin A Mainster
- Department of Ophthalmology, University of Kansas School of Medicine, Prairie Village, Kansas, USA.
| | - Oliver Findl
- Vienna Institute for Research in Ocular Surgery, A Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria
| | - H Burkhard Dick
- Department of Ophthalmology, Ruhr University Eye Hospital, Science, Bochum, Germany
| | | | - Gerardo Ledesma-Gil
- Retina Department, Institute of Ophthalmology, Fundación Conde de Valenciana, Mexico City, Mexico
| | - Christine A Curcio
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Patricia L Turner
- Department of Ophthalmology, University of Kansas School of Medicine, Prairie Village, Kansas, USA
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Lian Y, Lu W, Huang H, Wu G, Xu A, Jin W. The Long-Term Effect of Blue-Light Blocking Spectacle Lenses on Adults’ Contrast Perception. Front Neurosci 2022; 16:898489. [PMID: 35911990 PMCID: PMC9334884 DOI: 10.3389/fnins.2022.898489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 06/24/2022] [Indexed: 11/21/2022] Open
Abstract
Purpose To evaluate the long-term effect of two different degrees of blue-light blocking (BB) spectacle lenses on adults’ contrast perception under various lighting conditions. Methods In total, 144 healthy adults aged 24.70 (±4.32 years) were recruited to this randomized controlled trial. The participants were randomly divided into three groups and used three different spectacle lenses (15% BB: 15% blue-blocking spectacle lenses; 30% BB: 30% blue-blocking spectacle lenses; RC: regular clear lenses serving as control). Contrast sensitivity under four light conditions (scotopic and photopic, both with/without glare) was measured using standard clinical tests at baseline, 1 month, 3 months and 6 months of use. The area under the log contrast sensitivity function (AULCSF) was also computed as an index for their overall contrast sensitivity across spatial frequencies. Results There was no significant difference in AULCSFs among the three types of spectacle lenses under any light condition (all P > 0.81). No statistical difference was found in the AULSCF among the four time points (all P > 0.39), with no interaction between the effects of group and time (all P > 0.42). Conclusion Wearing blue-light blocking lens had no clinically significant effect on adults’ long-term contrast perception under scotopic or photopic conditions, or with glare.
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Popov I, Jurenova D, Valaskova J, Sanchez-Chicharro D, Stefanickova J, Waczulikova I, Krasnik V. Effect of Blue Light Filtering Intraocular Lenses on Visual Perception. ACTA ACUST UNITED AC 2021; 57:medicina57060559. [PMID: 34206059 PMCID: PMC8226562 DOI: 10.3390/medicina57060559] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 05/26/2021] [Indexed: 12/24/2022]
Abstract
Background and Objectives: This retrospective consecutive case control study compares best-corrected visual acuity (BCVA), mesopic contrast sensitivity (CS), color vision, and glare between a group of eyes with blue-light-filtering intraocular lenses and another with UV-light-filtering intraocular lenses. Materials and Methods: We used Early Treatment Diabetic Retinopathy Study charts to compare BCVA, Rabin charts for mesopic CS testing, Oculus HMC Anomaloscope MR to test for chromatic discrimination, and Oculus Mesotest II to measure scotopic CS with glare. For analysis, we used descriptive statistics and compared means with parametric and non-parametric tests. The level of significance was set as α = 0.05. Results: For the group with the blue-light-filtering intraocular lens, the average results were BCVA = 0.96 (SD ± 0.09), CS = 1.78 log (SD ± 0.12), chromatic discrimination results M = 63.91 (SD ± 11.88), R = 60.07 (SD ± 7.89). For mesopic CS with glare, the group achieved on average 2.54 (SD ± 1.50) points out of 4. For the group with the UV-light-filtering intraocular lens, the average results were BCVA = 0.93 (SD ± 0.14), CS = 1.79 log (SD ± 0.13), chromatic discrimination results M = 65.38 (SD ± 17.14), R = 60.79 (SD ± 10.39). For mesopic CS with glare, this group achieved an average of 2.79 (SD ± 1.53) points out of 4. Conclusion: No significant differences (p > 0.05) were found in any of the tested parameters between the analyzed groups. Slight shift in color vision was observed, although not statistically significant.
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Affiliation(s)
- Ivajlo Popov
- Department of Ophthalmology, Faculty of Medicine, Comenius University, 82101 Bratislava, Slovakia; (I.P.); (D.J.); (J.V.); (J.S.)
| | - Denisa Jurenova
- Department of Ophthalmology, Faculty of Medicine, Comenius University, 82101 Bratislava, Slovakia; (I.P.); (D.J.); (J.V.); (J.S.)
| | - Jela Valaskova
- Department of Ophthalmology, Faculty of Medicine, Comenius University, 82101 Bratislava, Slovakia; (I.P.); (D.J.); (J.V.); (J.S.)
| | | | - Jana Stefanickova
- Department of Ophthalmology, Faculty of Medicine, Comenius University, 82101 Bratislava, Slovakia; (I.P.); (D.J.); (J.V.); (J.S.)
| | - Iveta Waczulikova
- Faculty of Mathematics, Physics and Informatics, Comenius University, 84248 Bratislava, Slovakia;
| | - Vladimir Krasnik
- Department of Ophthalmology, Faculty of Medicine, Comenius University, 82101 Bratislava, Slovakia; (I.P.); (D.J.); (J.V.); (J.S.)
- Correspondence: ; Tel.: +421-0248234-157
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Psychophysical Measurements of Luminance Contrast Sensitivity and Color Discrimination with Transparent and Blue-Light Filter Intraocular Lenses. Ophthalmol Ther 2017; 6:301-312. [PMID: 28795358 PMCID: PMC5693818 DOI: 10.1007/s40123-017-0101-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Indexed: 12/03/2022] Open
Abstract
Introduction The purpose of this study was to measure luminance contrast sensitivity and color vision thresholdfs in normal subjects using a blue light filter lens and transparent intraocular lens material. Methods Monocular luminance grating contrast sensitivity was measured with Psycho for Windows (version 2.36; Cambridge Research Systems) at 3.0, 6.0, 12.0, 20.0, and 30.0 cycles per degree of visual angle (cpd) in 15 normal subjects (eight female), with a mean age of 21.6 years (SD = 3.8 years). Chromatic discrimination was assessed with the Cambridge colour test (CCT) along the protan, deutan, and tritan color confusion axes. Both tests were performed in a darkened room under two situations: with a transparent lens and with blue light filter lens. Subjective impressions were taken by subjects regarding their visual experience under both conditions. Results No difference was found between the luminance contrast sensitivity measured with transparent and blue light filter. However, 13/15 (87%) of the subjects reported more comfortable vision with the blue filter. In the color vision test, tritan thresholds were significantly higher for the blue filter compared with the transparent filter (p = 0.003). For protan and deutan thresholds no differences were found. Conclusion Blue-yellow color vision is impaired with the blue light filter, and no impairment occurs with the transparent filter. No significant differences in thresholds were found in the luminance contrast sensitivity comparing the blue light and transparent filters. The impact of short wavelength light filtering on intrinsically photosensitive retinal ganglion cells is also discussed.
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van Os A, Stassen MJC, Tassignon MJ, Rozema JJ. Influence of yellow filters on straylight measurements. J Cataract Refract Surg 2017; 43:1077-1080. [PMID: 28917410 DOI: 10.1016/j.jcrs.2017.06.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 05/31/2017] [Accepted: 06/05/2017] [Indexed: 11/18/2022]
Abstract
PURPOSE To determine whether the yellow filters often used for glare reduction influence retinal straylight measured in healthy eyes. SETTING Department of Ophthalmology, Antwerp University Hospital, Edegem, Belgium. DESIGN Prospective case series. METHODS For each eye, the spherical equivalent (SE) was determined using an autorefractometer, followed by 5 straylight measurements taken with the compensation-comparison method. The first measurement was taken with a colorless plano lens placed in front of the eye, followed by 4 other measurements with yellow filters with cutoff wavelengths at 450 nm, 511 nm, 527 nm, and 550 nm. Ametropic volunteers were corrected using an additional lens in all measurements. Age, sex, and eye color were listed. In addition to the basic measurements, base- and age-corrected and base-, age-, and SE-corrected values were calculated. RESULTS The data from 56 right eyes of 56 healthy volunteers aged 28.7 years ± 10.3 (SD) were assessed. The straylight of the 4 yellow filters was significantly higher than that of the plano lens (P < .001, analysis of variance [ANOVA]). The straylight also increased with higher cutoff frequencies, albeit insignificantly (P > .05, ANOVA). No significant difference was found between sexes (P = .909) or between eye colors (P > .05). CONCLUSIONS The use of yellow filters increased retinal straylight by a small but significant amount compared with the use of unfiltered light. This suggests that the visual comfort often experienced while wearing these filters is not associated with reduced straylight.
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Affiliation(s)
- Anne van Os
- From the Department of Medicine and Health Sciences (van Os, Stassen, Tassignon, Rozema), Antwerp University, Wilrijk, and the Department of Ophthalmology (Tassignon, Rozema), Antwerp University Hospital, Edegem, Belgium
| | - Mark J C Stassen
- From the Department of Medicine and Health Sciences (van Os, Stassen, Tassignon, Rozema), Antwerp University, Wilrijk, and the Department of Ophthalmology (Tassignon, Rozema), Antwerp University Hospital, Edegem, Belgium
| | - Marie-José Tassignon
- From the Department of Medicine and Health Sciences (van Os, Stassen, Tassignon, Rozema), Antwerp University, Wilrijk, and the Department of Ophthalmology (Tassignon, Rozema), Antwerp University Hospital, Edegem, Belgium
| | - Jos J Rozema
- From the Department of Medicine and Health Sciences (van Os, Stassen, Tassignon, Rozema), Antwerp University, Wilrijk, and the Department of Ophthalmology (Tassignon, Rozema), Antwerp University Hospital, Edegem, Belgium.
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Teh BL, Megaw R, Borooah S, Dhillon B. Optimizing cataract surgery in patients with age-related macular degeneration. Surv Ophthalmol 2016; 62:346-356. [PMID: 28012877 DOI: 10.1016/j.survophthal.2016.12.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 12/12/2016] [Indexed: 10/20/2022]
Abstract
Age-related macular degeneration (AMD) is one of the leading causes of visual impairment. The development of cataract in AMD patients poses challenges in assessing timing of surgery, predicting potential benefit to the patient of surgery, and predicting short- and long-term effects of surgery on progression of their AMD. Although traditional cataract surgery remains the mainstay of treatment, recently several devices have been developed to address the specific needs of AMD patients with cataract. We look at the associations between cataract and AMD and outline the treatment approaches to cataract surgery in AMD, looking at the potential benefits and risks of both traditional approaches and newer devices. We provide clinicians treating patients with AMD and cataract with a framework for choosing the appropriate management.
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Affiliation(s)
| | - Roly Megaw
- Princess Alexandra Eye Pavilion, Edinburgh, UK
| | | | - Baljean Dhillon
- Princess Alexandra Eye Pavilion, Edinburgh, UK; Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
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Wissiak E, Ardjomand N, Steinwender G, Prskavec M, Baradaran-Dilmaghani R, Kohl M, Wirtitsch MG. Influence of light filters in intraocular lenses on color perception and contrast acuity. J Cataract Refract Surg 2015; 41:1217-23. [DOI: 10.1016/j.jcrs.2014.09.048] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 08/27/2014] [Accepted: 09/01/2014] [Indexed: 10/23/2022]
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Miyata A. Neutralization method for detecting the incidence of color perception changes after cataract surgery. J Cataract Refract Surg 2015; 41:764-70. [DOI: 10.1016/j.jcrs.2014.07.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 07/18/2014] [Accepted: 07/30/2014] [Indexed: 11/27/2022]
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Ho JCH. Reduction in mean deviation values in automated perimetry in eyes with multifocal compared to monofocal intraocular lens implants. Am J Ophthalmol 2014; 158:1100-1. [PMID: 25437833 DOI: 10.1016/j.ajo.2014.08.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 08/13/2014] [Accepted: 08/26/2014] [Indexed: 10/24/2022]
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Nilforushan N, Parsamanesh M, Yu F, Nassiri N, Miraftabi A, Coleman AL. Effect of yellow-tinted intraocular lens on standard automated perimetry and short wavelength automated perimetry in patients with glaucoma. Middle East Afr J Ophthalmol 2014; 21:216-9. [PMID: 25100904 PMCID: PMC4123272 DOI: 10.4103/0974-9233.134671] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Purpose: To investigate the effect of cataract surgery and yellow-tinted intraocular lens (IOLs) implantation on perimetry indices of short-wavelength automated perimetry (SWAP) and standard automated perimetry (SAP) testing in patients with coexisting cataract and glaucoma. Materials and Methods: In this prospective comparative case series, phacoemulsification with implantation of yellow-tinted Acrysof Natural IOL was performed in 16 eyes of 16 patients with visually significant cataract (best-corrected visual acuity (VA) better than 20/120) and mild to moderate glaucoma. Pre- and postoperative values for VA and for perimetry indices including mean deviation (MD), pattern standard deviation (PSD), and foveal threshold (FT) from both SAP and SWAP testing were compared. Results: Postoperative VA improved significantly after cataract surgery and yellow-tinted IOL implantation (P < 0.001). After cataract extraction and IOL implantation, MD and FT on SWAP testing improved significantly (P = 0.001); however, there was no statistically significant change with SAP testing between the pre- and postoperative perimetry indices. There was no statistically significant change in PSD with either SAP or SWAP testing postoperatively. The differences between pre- and postoperative values for all perimetry indices under study were not significant when comparing SAP with SWAP tests, except for MD which had improved statistically significantly in SWAP testing (P = 0.03). Conclusions: In mild to moderate glaucoma patients with cataracts, the perimetry indices of SWAP testing improved after phacoemulsification and yellow-tinted IOL implantation. This suggests that the yellow-tinted IOLs have less effect on SWAP testing than visually significant cataracts.
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Affiliation(s)
- Naveed Nilforushan
- Department of Ophthalmology, Ophthalmic Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Parsamanesh
- Department of Ophthalmology, Ophthalmic Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Fei Yu
- Glaucoma Division, Jules Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, USA
| | - Nariman Nassiri
- Glaucoma Division, Jules Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, USA
| | - Arezoo Miraftabi
- Department of Ophthalmology, Ophthalmic Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Anne L Coleman
- Glaucoma Division, Jules Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, USA
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To L, Woods RL, Goldstein RB, Peli E. Psychophysical contrast calibration. Vision Res 2013; 90:15-24. [PMID: 23643843 PMCID: PMC3744609 DOI: 10.1016/j.visres.2013.04.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Revised: 02/13/2013] [Accepted: 04/12/2013] [Indexed: 11/23/2022]
Abstract
Electronic displays and computer systems offer numerous advantages for clinical vision testing. Laboratory and clinical measurements of various functions and in particular of (letter) contrast sensitivity require accurately calibrated display contrast. In the laboratory this is achieved using expensive light meters. We developed and evaluated a novel method that uses only psychophysical responses of a person with normal vision to calibrate the luminance contrast of displays for experimental and clinical applications. Our method combines psychophysical techniques (1) for detection (and thus elimination or reduction) of display saturating non-linearities; (2) for luminance (gamma function) estimation and linearization without use of a photometer; and (3) to measure without a photometer the luminance ratios of the display's three color channels that are used in a bit-stealing procedure to expand the luminance resolution of the display. Using a photometer we verified that the calibration achieved with this procedure is accurate for both LCD and CRT displays enabling testing of letter contrast sensitivity to 0.5%. Our visual calibration procedure enables clinical, internet and home implementation and calibration verification of electronic contrast testing.
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Affiliation(s)
- Long To
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
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Schmack I, Schimpf M, Stolzenberg A, Conrad-Hengerer I, Hengerer FH, Dick BH. Visual quality assessment in patients with orange-tinted blue light–filtering and clear ultraviolet light–filtering intraocular lenses. J Cataract Refract Surg 2012; 38:823-32. [DOI: 10.1016/j.jcrs.2011.12.028] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2011] [Revised: 11/30/2011] [Accepted: 12/01/2011] [Indexed: 11/15/2022]
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Zhu XF, Zou HD, Yu YF, Sun Q, Zhao NQ. Comparison of blue light-filtering IOLs and UV light-filtering IOLs for cataract surgery: a meta-analysis. PLoS One 2012; 7:e33013. [PMID: 22412976 PMCID: PMC3296774 DOI: 10.1371/journal.pone.0033013] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Accepted: 02/03/2012] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND A number of published randomized controlled trials have been conducted to evaluate visual performance of blue light-filtering intraocular lenses (IOL) and UV light-filtering intraocular lenses (IOL) after cataract phacoemulsification surgery. However, results have not always been consistent. Therefore, we carried out a meta-analysis to compare the effectiveness of blue light-filtering IOLs versus UV light-filtering IOLs in cataract surgery. METHODS AND FINDINGS Comprehensive searches of PubMed, Embase, Cochrane Library and the Chinese BioMedical literature databases were performed using web-based search engines. Fifteen trials (1690 eyes) were included for systematic review, and 11 of 15 studies were included in this meta-analysis. The results showed that there were no significant differences in postoperative mean best corrected visual acuity, contrast sensitivity, overall color vision, or in the blue light spectrum under photopic light conditions between blue light-filtering IOLs and UV light-filtering IOLs [WMD = -0.01, 95%CI (-0.03, 0.01), P = 0.46; WMD = 0.07, 95%CI (-0.04, 0.19), P = 0.20; SMD = 0.14, 95%CI (-0.33, 0.60), P = 0.566; SMD = 0.20, 95%CI (-0.04, 0.43), P = 0.099]. However, color vision with blue light-filtering IOLs was significantly reduced in the blue light spectrum under mesopic light conditions [SMD = 0.74, 95%CI (0.29, 1.18), P = 0.001]. CONCLUSION This meta-analysis demonstrates that postoperative visual performance with blue light-filtering IOLs is approximately equal to that of UV light-filtering IOLs after cataract surgery, but color vision with blue light-filtering IOLs demonstrated some compromise in the blue light spectrum under mesopic light conditions.
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Affiliation(s)
- Xiao-feng Zhu
- Department of Ophthalmology, Shanghai First People's Hospital Affiliated Shanghai Jiao Tong University, Shanghai, China
| | - Hai-dong Zou
- Department of Ophthalmology, Shanghai First People's Hospital Affiliated Shanghai Jiao Tong University, Shanghai, China
- * E-mail:
| | - Yong-fu Yu
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
| | - Qian Sun
- Department of Ophthalmology, Shanghai First People's Hospital Affiliated Shanghai Jiao Tong University, Shanghai, China
| | - Nai-qing Zhao
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
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Kontadakis GA, Plainis S, Moschandreas J, Tsika C, Pallikaris IG, Tsilimbaris MK. In vivo evaluation of blue-light attenuation with tinted and untinted intraocular lenses. J Cataract Refract Surg 2011; 37:1031-7. [DOI: 10.1016/j.jcrs.2010.12.047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2010] [Revised: 12/10/2010] [Accepted: 12/10/2010] [Indexed: 12/01/2022]
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Wang H, Wang J, Fan W, Wang W. Comparison of photochromic, yellow, and clear intraocular lenses in human eyes under photopic and mesopic lighting conditions. J Cataract Refract Surg 2011; 36:2080-6. [PMID: 21111310 DOI: 10.1016/j.jcrs.2010.07.024] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2010] [Revised: 07/08/2010] [Accepted: 07/09/2010] [Indexed: 10/18/2022]
Abstract
PURPOSE To evaluate the results of the first blue light-filtering photochromic intraocular lens (IOL) and compare them with those of a regular yellow blue light-filtering IOL and a clear ultraviolet-filtering IOL in human eyes under various lighting conditions. SETTING Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China. DESIGN Prospective comparative clinical study. METHODS This study evaluated eyes that had implantation of 1 of the following 3 IOLs: photochromic Aurium Matrix acrylic, model 400; yellow AF-1 (UY); or clear MC611MI. All eyes were followed for 3 months. The uncorrected (UDVA) and corrected (CDVA) distance visual acuities, contrast vision (lighting 400 lux, 30 lux, 5 lux), contrast sensitivity, color vision (Farnsworth-Munsell 100-hue test under 400 lux, 30 lux), and patient questionnaire responses were evaluated. RESULTS The photochromic IOL group comprised 39 eyes; the yellow IOL group, 41 eyes; and the clear IOL group, 38 eyes. There were no significant differences between the 3 IOLs in UDVA, CDVA, contrast sensitivity, or questionnaire responses. The photochromic group had significantly better color vision than the yellow IOL group at 30 lux and better contrast vision at 5% contrast (P < .05); however, there were no significant differences between the photochromic IOL group and the clear IOL group (P > .05). CONCLUSION The photochromic blue light-filtering IOL performed as well as the yellow and clear IOLs under photopic conditions. Under mesopic conditions, the yellow IOL gave poor color vision and contrast sensitivity.
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Affiliation(s)
- Haiwei Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Bejing, China
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Neumaier-Ammerer B, Felke S, Hagen S, Haas P, Zeiler F, Mauler H, Binder S. Comparison of visual performance with blue light-filtering and ultraviolet light-filtering intraocular lenses. J Cataract Refract Surg 2011; 36:2073-9. [PMID: 21111309 DOI: 10.1016/j.jcrs.2010.06.069] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2010] [Revised: 06/16/2010] [Accepted: 06/28/2010] [Indexed: 11/18/2022]
Abstract
PURPOSE To compare the contrast sensitivity, glare, color perception, and visual acuity at different light intensities with yellow-tinted and clear intraocular lenses (IOLs) by different manufacturers. SETTING Ludwig Boltzmann Institute of Retinology and Biomicroscopic Laser-Surgery, Department of Ophthalmology, Rudolf Foundation Clinic, Vienna, Austria. DESIGN Comparative case series. METHODS Eyes were randomized to 1 of the following IOLs: AF-1 (UY) (yellow tinted), AcrySof SN60AT (yellow tinted), AF-1 (UV) (clear), or AcrySof SA60AT (clear). One week and 2 months postoperatively, monocular contrast sensitivity function and color discrimination were tested and the corrected distance and near visual acuities were evaluated. All tests were performed under different light intensities (10 to 1000 lux). RESULTS Of the 80 patients enrolled, 76 completed the study; there were 37 eyes in the yellow-tinted IOL group and 39 in the clear IOL group. There were no significant differences between yellow-tinted IOLs and clear IOLs except in color vision under mesopic conditions (10 lux). Patients with a yellow-tinted IOL made significantly more mistakes in the blue-light spectrum than patients with clear IOLs (P = .00015). There was no significant difference under photopic conditions (1000 lux). CONCLUSIONS The yellow-tinted IOLs were equivalent to the clear IOLs in postoperative contrast sensitivity, visual acuity, and color perception under photopic conditions. Patients with yellow-tinted IOLs made statistically significantly more mistakes in the blue range under dim light than patients with clear IOLs.
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Affiliation(s)
- Beatrix Neumaier-Ammerer
- Ludwig Boltzmann Institute of Retinology and Biomicroscopic Lasersurgery, Department of Ophthalmology, Rudolf Foundation Clinic Vienna, Vienna, Austria.
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Artigas JM, Felipe A, Navea A, Artigas C, García-Domene MC. Spectral transmittance of intraocular lenses under natural and artificial illumination: criteria analysis for choosing a suitable filter. Ophthalmology 2011; 118:3-8. [PMID: 20801517 DOI: 10.1016/j.ophtha.2010.06.023] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2009] [Revised: 06/14/2010] [Accepted: 06/17/2010] [Indexed: 11/17/2022] Open
Abstract
PURPOSE To compare the spectral transmission of different intraocular lenses (IOLs) with either ultraviolet (UV) or blue-light filters, and to analyze the performance of these filters with artificial light sources as well as sunlight. DESIGN Experimental study. METHODS The spectral transmission curve of 10 IOLs was measured using a PerkinElmer Lambda 800 UV/VIS spectrometer (Waltham, MA). Different filtering simulations were performed using the D65 standard illuminant as daylight and standard incandescent lamp and fluorescent bulb illuminants. MAIN OUTCOMES MEASURES Spectral transmittance of the IOLs. RESULTS All the IOLs studied provide good UVC (200-280 nm) and UVB (280-315 nm) protection, except for one that presented an appreciable window at 270 nm. Nevertheless, both natural and artificial sources have practically no emission under 300 nm. In the UVA (315-380 nm) range the curves of the different IOLs manifested different degrees of absorption. CONCLUSIONS Not all the UV filters incorporated in different IOLs protect equally. The filters that provide greater photoprotection against UV radiation, even blue light, are yellow and orange. Then, yellow and orange IOL filters may be best suited for cases requiring special retinal protection. The filters that favor better photoreception of visible light (380-780 nm) are those that transmit this radiation close to 100%. Artificial illumination practically does not emit in the UV range, but its levels of illumination are very low when compared with solar light. A possible balance between photoprotection and photoreception could be a sharp cutoff filter with the cutoff wavelength near 400 nm and a maximum transmittance around 100%.
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Affiliation(s)
- Jose M Artigas
- Fundación Oftalmológica del Mediterráneo (FOM), Bifurcación Pío Baroja-General Avilés, Valencia, Spain.
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Mainster MA, Turner PL. Effect of yellow-tinted intraocular lenses on short-wavelength automated perimetry. Am J Ophthalmol 2010; 150:589-90; author reply 590-1. [PMID: 20863923 DOI: 10.1016/j.ajo.2010.06.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2010] [Accepted: 06/29/2010] [Indexed: 10/19/2022]
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Mainster MA, Turner PL. Blue-blocking IOLs decrease photoreception without providing significant photoprotection. Surv Ophthalmol 2009; 55:272-89. [PMID: 19883931 DOI: 10.1016/j.survophthal.2009.07.006] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2009] [Revised: 07/16/2009] [Accepted: 07/31/2009] [Indexed: 12/22/2022]
Abstract
Violet and blue light are responsible for 45% of scotopic, 67% of melanopsin, 83% of human circadian (melatonin suppression) and 94% of S-cone photoreception in pseudophakic eyes (isoilluminance source). Yellow chromophores in blue-blocking intraocular lenses (IOLs) eliminate between 43 and 57% of violet and blue light between 400 and 500 nm, depending on their dioptric power. This restriction adversely affects pseudophakic photopic luminance contrast, photopic S-cone foveal threshold, mesopic contrast acuity, scotopic short-wavelength sensitivity and circadian photoreception. Yellow IOL chromophores provide no tangible clinical benefits in exchange for the photoreception losses they cause. They fail to decrease disability glare or improve contrast sensitivity. Most epidemiological evidence shows that environmental light exposure and cataract surgery are not significant risk factors for the progression of age-related macular degeneration (AMD). Thus, the use of blue-blocking IOLs is not evidence-based medicine. Most AMD occurs in phakic adults over 60 years of age, despite crystalline lens photoprotection far greater than that of blue-blocking IOLs. Therefore, if light does play some role in the pathogenesis of AMD, then 1) senescent crystalline lenses do not prevent it, so neither can blue-blocking IOLs that offer far less photoprotection, and 2) all pseudophakes should wear sunglasses in bright environments. Pseudophakes have the freedom to remove their sunglasses for optimal photoreception whenever they choose to do so, provided that they are not encumbered permanently by yellow IOL chromophores. In essence, yellow chromophores are placebos for prevention of AMD that permanently restrict a pseudophake's dim light and circadian photoreception at ages when they are needed most. If yellow IOLs had been the standard of care, then colorless UV-blocking IOLs could be advocated now as "premium" IOLs because they offer dim light and circadian photoreception roughly 15-20 years more youthful than blue-blocking IOLs.
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Affiliation(s)
- Martin A Mainster
- Department of Ophthalmology, University of Kansas School of Medicine, Prairie Village, Kansas, USA.
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Wirtitsch MG, Schmidinger G, Prskavec M, Rubey M, Skorpik F, Heinze G, Findl O, Karnik N. Influence of Blue-Light-Filtering Intraocular Lenses on Color Perception and Contrast Acuity. Ophthalmology 2009; 116:39-45. [DOI: 10.1016/j.ophtha.2008.08.035] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2008] [Revised: 08/14/2008] [Accepted: 08/14/2008] [Indexed: 10/21/2022] Open
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Mainster MA, Turner PL. Blue-blocking intraocular lenses: myth or reality? Am J Ophthalmol 2009; 147:8-10. [PMID: 19100352 DOI: 10.1016/j.ajo.2008.08.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2008] [Revised: 08/12/2008] [Accepted: 08/13/2008] [Indexed: 10/21/2022]
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Current world literature. Curr Opin Ophthalmol 2008; 20:69-72. [PMID: 19077831 DOI: 10.1097/icu.0b013e32831fd89f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Schmidinger G, Menapace R, Pieh S. Intraindividual comparison of color contrast sensitivity in patients with clear and blue-light-filtering intraocular lenses. J Cataract Refract Surg 2008; 34:769-73. [DOI: 10.1016/j.jcrs.2007.12.034] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2007] [Accepted: 12/18/2007] [Indexed: 11/28/2022]
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