Effect of a blue-light-blocking intraocular lens on the quality of sleep
ABSTRACT To evaluate whether implantation of a blue-light-blocking intraocular lens (IOL) affects sleep quality.
Repatriation General Hospital, Adelaide, Australia.
This study comprised patients who had bilateral cataract surgery during the preceding 12 months with implantation of a conventional SI40NB IOL or an AcrySof Natural SN60WF blue-light-blocking IOL. Patients were contacted by telephone at least 6 months after second-eye surgery, and the Pittsburgh Sleep Quality Index (PSQI) questionnaire was administered. Results were compared between groups.
Of the 49 patients, 31 received conventional IOLs and 18, blue-light-blocking IOLs. The mean age of the patients was 80 years +/- 8.1 (SD). The median PSQI score was 6 (interquartile range 3 to 8). There were no statistically significant differences in PSQI scores between the 2 IOL groups (P = .65). This remained true after adjustment for sex, age, medication, and time since surgery.
The blue-light-blocking IOL had no effect on the sleep quality of patients, indicating that these IOLs might serve as an alternative to conventional IOLs without a detrimental effect on circadian rhythm.
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ABSTRACT: Light is the signal that entrains the biological clock in humans to the 24-hour external time. Recently, it has been shown that short wavelengths play a key role in this process. In the present study, we describe a procedure to measure, objectively and in a quick way, the spectral composition of the light reaching the retina in vivo. The instruments involved are the foveal reflection analyzer (FRA) and the macular pigment reflectometer (MPR). By making use of these reflectometers, we show quantitatively that in subjects with cataracts, the light input is especially reduced in the short wavelength range. After cataract surgery during which the crystalline lens is replaced by a transparent artificial lens, the transmittance of the short wavelengths (between 420-500 nm) improved on average by a factor of 4. We conclude that this technique holds great promises for the chronobiological field because it allows for quantification of the spectral composition and light levels reaching the retina in vivo.Journal of Biological Rhythms 04/2010; 25(2):123-31. DOI:10.1177/0748730409360888 · 3.32 Impact Factor
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ABSTRACT: Intraocular lenses (IOLs) that block both ultraviolet and blue wavelength light (<500 nm)were introduced in the 1990s. Since then, the potential benefits and harm from blocking blue light has been debated. We report the results of a complete review of all peer-reviewed published studies regarding the impact of blocking the transmission of blue light. Fifty-six published reports on subjects related to blue-blocking lenses including sleep disturbance, visual outcomes, cataract surgery, lens transmittance, sunlight exposure, and macular disease were found in peer reviewed journals from 1962 to 2009. Eleven reports specifically compared visual outcomes between blue-blocking IOLs and nonblue-locking IOLs. Of these, 10 independent studies (10/11, 91%) concluded that there are no significant effects of blue-blocking IOLs on various meters of visual performance including visual acuity, contrast sensitivity, color perception, and photopic, mesopic, and scotopic sensitivities. Only one group of authors reported that the use of blue-blocking IOLs may have detrimental effects on scotopic vision and circadian rhythms. However, the actual clinical significance of these potential negative effects on scotopic vision and on sleep patterns is uncertain. The benefits of blocking the transmission of blue light to the macula and the relationship between progression of age-related macular degeneration remain unclear. However, the published studies clearly state that the use of blue-blocking IOLs is not detrimental in visual acuity, color perception, and contrast sensitivity. The reported potential negative effects on scotopic vision and sleep disturbance appear to be minimal and may not be clinically relevant. (Surv Ophthalmol 55:284--289, 2010. 2010 Elsevier Inc. All rights reserved.)Survey of Ophthalmology 05/2010; 55(3):284-9. DOI:10.1016/j.survophthal.2009.07.007 · 3.51 Impact Factor
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ABSTRACT: Background Blue-light-filtering intraocular lenses have been developed to avoid the “blue-light-hazard,” which is thought to induce age-related macular degeneration. However, the intrinsically photosensitive retinal ganglion cells have their peak sensitivity at 480 nm, and their sent information influences melatonin production in the pineal gland. Material and Methods To analyze the effect of these blue-light-filtering intraocular lenses we compared the change in melatonin daytime levels after implantation of blue-light-filtering or white intraocular lenses. Eight subjects with cataract were randomized to receive either blue-light-filtering or white intraocular lenses. Melatonin analysis, visual acuity, complete slit lamp analysis, and questionnaire about sleeping habits and quality were performed before and 1 month after cataract surgery. Results Five subjects received a blue-light-filtering and three a white intraocular lens. The average amounts of wakes during the night increased postoperatively in three out of the five subjects who received the blue-light-filtering lens. Subjects with the white lens only had 1.0 pg/ml increase of melatonin after surgery. Conclusion We found that subjects who received blue-light-filtering intraocular lenses had an increase in uneasy sleep and more wakes during the night. Since melatonin secretion is not blocked by the blue-light-filtering lenses, which leads to elevated levels of melatonin during day time, and can increase retinal damage in light, the effectiveness of the blue-light-filtering intraocular lenses has to be questioned and needs to be further investigated.Spektrum der Augenheilkunde 08/2013; 27(4):176-180. DOI:10.1007/s00717-013-0174-5 · 0.18 Impact Factor