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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(1): 39-45.
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Autor/innen der Med Uni Graz:
Wirtitsch Matthias
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Abstract:
PURPOSE: To compare contrast acuity at different illumination levels and color vision and the subjective impression in patients after bilateral cataract surgery with a mixed implantation of a blue-light-filtering and an ultraviolet (UV)-filtering intraocular lens (IOL). DESIGN: Randomized, controlled, double-masked, and bilateral study with intraindividual comparison. PARTICIPANTS: This study included 48 eyes of 24 consecutive patients with age-related cataract. METHODS: Each patient had standardized small incision cataract surgery with IOL implantation into the capsular bag. Patients were randomly assigned to receive a blue-light-filtering Hoya AF-1 (UY) YA-60BB IOL in one eye and a UV-filtering Hoya AF-1 (UV) VA-60BB IOL (Hoya Medical Europe, Frankfurt/Main, Germany) in the contralateral eye. Contrast acuity was measured at illumination levels of 500, 5, and 0.5 lux and contrast levels of 100%, 50%, 25%, 12.5%, and 6.25%. Color vision was assessed using the Lanthony desaturated D-15 test, the Lanthony new color test (Munsell chroma 2 and 4), and an anomaloscope. Blue/yellow foveal threshold was tested applying short-wave automated perimetry. The subjective visual impression of patients was evaluated using a questionnaire. MAIN OUTCOME MEASURES: Contrast acuity, color vision, and foveal threshold. RESULTS: The blue-light-filtering IOLs had worse contrast acuity (P = 0.0004) and foveal threshold (P = 0.008) compared with the UV-filtering IOLs. Color vision tests and high-contrast visual acuity did not show any statistically significant differences between IOLs (P>0.05). On questioning, 3 of 24 patients noticed a difference between the implanted IOLs concerning visual impression. CONCLUSIONS: This study shows that blue-light-filtering IOLs negatively affect contrast acuity and blue/yellow foveal threshold when compared with UV-filtering IOLs. Although the differences were small, the results suggest bilateral implantation of the same IOL type and avoidance of a mixed implantation of a blue-light-filtering IOL in one and a non-blue-light-filtering IOL in the contralateral eye in patients with high demands in color vision. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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