Clear Intraocular Lens Research Articles

Decreased visual acuity resulting from glistening and sub-surface nano-glistening formation in intraocular lenses: A retrospective analysis of 5 cases

BackgroundTo report on five patients with decreased visual acuity due to glistening and severe sub-surface nano-glistening (SSNG) formation within their intraocular lenses (IOLs). DesignCase reports and analysis of extracted IOLs. Participants and samplesWe report improved visual acuity when IOLs with severe glistening and SSNG were exchanged for clear IOLs in five patients. MethodsCase reports. Main outcome measuresThe main outcome measure was visual acuity. The secondary outcome measure was light transmission. Explanted IOLs were subjected to investigation. Pre- and postoperative slit lamp images of the anterior eye and microscopic images of the extracted IOLs were taken and compared. Light transmission of the IOL was measured using a double beam type spectrophotometer. An integrated value of the percentage light transmittance in the visible light spectrum was calculated. ResultsWe report on five patients whose visual acuity improved when IOLs were exchanged because of severe glistening and SSNG. All of the affected IOLs were MA60BM (Alcon, Forth Wroth Texas, USA) and the original implantation had occurred over a range of 6–15years prior to the IOL exchange. Light transmission was decreased in all affected lenses compared to a similar control IOL. ConclusionsAlthough only a few reports of cases in which glistening and SSNG have progressed to the level of decreased visual function have been published, the likelihood is that this phenomena will increase as the severity and incidence of these inclusions have been shown to increase with time. Appropriate evaluations of visual function in such patients are needed and consideration should be given to IOL exchange in symptomatic patients.

The effect of blue-blocking intraocular lenses on circadian biological rhythm: protocol for a randomised controlled trial (CLOCK-IOL colour study)

IntroductionBlue light information plays an important role in synchronising internal biological rhythm within the external environment. Circadian misalignment is associated with the increased risk of sleep disturbance, obesity, diabetes mellitus,...

Neutralization method for detecting the incidence of color perception changes after cataract surgery

To evaluate and compare the incidence of cyanopsia using the neutralization method in eyes in which clear or yellow intraocular lenses (IOLs) were implanted. Miyata Eye Clinic, Hiroshima, Japan. Retrospective comparative study. Patients who had cataract surgery with the implantation of a monofocal IOL were enrolled in the study. Group 1 had implantation of a clear IOL (Acrysof SA60AT, Sensar AR40e, N4-18B). Group 2 had implantation of a yellow IOL (AF-1 YA60BB, AN-6). A control group comprised healthy patients. The detection and degree of cyanopsia were evaluated using white gradation cards (1 white [W] and 5 white gradation cards with increasing intensity of yellow tint [Y1, Y2, Y3, Y4, and Y5]) (neutralization method). The study comprised 57 patients in Group 1, 96 in Group 2, and 41 in the control group. All patients in the control group selected the W, Y1, or Y2 cards as white. Cyanopsia was then defined as the perception of Y3, Y4, and Y5 as white. One month postoperatively, cyanopsia occurred significantly more frequently in Group 1 than in Group 2 (14.5% versus 4.9%) (P=.049). There was no significant difference at 3 months (9.1% versus 5.2%) (P > .05). In Group 1, cyanopsia was more frequent in eyes with monocular IOL implantation than in eyes with binocular IOL implantation (22.2% versus 2.7%; P = .035). The incidence of cyanopsia evaluated with the neutralization method was higher with clear IOLs than with yellow IOLs. In monocular implantation, yellow IOLs are recommended to avoid cyanopsia. The author has no financial or proprietary interest in any material or method mentioned.

Attenuating Photostress and Glare Disability in Pseudophakic Patients through the Addition of a Short-Wave Absorbing Filter.

To evaluate the effects of filtering short wavelength light on visual performance under intense light conditions among pseudophakic patients previously implanted with a clear intraocular lens (IOL). This was a patient-masked, randomized crossover study conducted at 6 clinical sites in the United States between September 2013 and January 2014. One hundred fifty-four bilaterally pseudophakic patients were recruited. Photostress recovery time and glare disability thresholds were measured with clip-on blue-light-filtering and placebo (clear; no blue-light filtration) glasses worn over patients' habitual correction. Photostress recovery time was quantified as the time necessary to regain sight of a grating target after intense light exposure. Glare disability threshold was assessed as the intensity of a white-light annulus necessary to obscure a central target. The order of filter used and test eye were randomized across patients. Photostress recovery time and glare disability thresholds were significantly improved (both P < 0.0001) when patients used blue-light-filtering glasses compared with clear, nonfiltering glasses. Compared with a nonfiltering placebo, adding a clip-on blue-absorbing filter to the glasses of pseudophakic patients implanted with clear IOLs significantly increased their ability to cope with glare and to recover normal viewing after an intensive photostress. This result implies that IOL designs with blue-light-filtering characteristics may be beneficial under intense light conditions.

Rejuvenation Effects of Cataract Surgery with Ultraviolet Blocking Intra-Ocular Lens on Circadian Rhythm and Gait Speed

Previously, we reported improvements in sleep quality and gait speed after implantation of a yellow-colored, blue light-blocking intra-ocular lens (IOL). This study evaluated systemic health parameters for 7 months after cataract surgery with implantation of a clear, ultraviolet (UV)-blocking IOL. A total of consecutive 71 patients (average age 74.1 years) underwent cataract surgery with the implantation of a clear, UV-blocking IOL. Participants were evaluated using the Pittsburgh Sleep Quality Index (PSQI) and the National Eye Institute Visual Function Questionnaire (VFQ-25) before and at 2 and 7 months after surgery. Four-meter gait speed was also determined. The metabolic parameters of serum glycated hemoglobin (HbA1c), triglycerides (TGs), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were tested. The pre-operative and post-operative (2 and 7 months after surgery) results were 66.4±16.5, 79.5±12.6, and 81.0±13.0 for VFQ-25 score, 5.7±3.5, 5.1±3.1, and 4.8±2.9 for PSQI, and 0.90±0.22, 0.91±0.22, and 0.92±0.22 meters/sec for gait speed. Significant improvements following surgery were noted in the VFQ-25 score for all cases and in the PSQI for poor sleepers (preoperative PSQI >5.5) (P<0.05, paired t-test). The gait speed and metabolic parameters showed no significant changes. Cataract surgery with implantation of an UV-blocking clear IOL has the potential for improving circadian rhythm and systemic health parameters.

Impact of cataract surgery on sleep in patients receiving either ultraviolet-blocking or blue-filtering intraocular lens implants.

Although visual impairment is a well-recognized consequence of cataract development, little is known about the ability of the melanopsin-based photosensitive retinal ganglion cells (pRGCs) to regulate sleep-wake timing in the presence of cataract. In this study, we replaced a cataractous natural crystalline lens with two different types of artificial intraocular lenses, a UV-blocking lens or a blue-filtering lens. We investigated the level of sleep disturbance before cataract surgery and any change in sleep due to improved light transmission following surgery and compared this in both types of intraocular lens. Quality of sleep in 961 patients undergoing cataract surgery was assessed by administering the validated self-reported Pittsburgh Sleep Quality Index (PSQI) questionnaire. The PSQI distinguishes good sleepers from poor sleepers by scoring seven different sleep components over the last month, which are combined to produce an overall score for sleep quality. Patients received either an ultraviolet-blocking (UVB) clear intraocular lens (IOL) or a blue-filtering (BF) IOL. Questionnaires were completed four times: 1 month preoperatively and again 1, 6 (UVB-IOL only), and 12 months postoperatively. Half of the patients reported poor sleep in the presence of cataract in both the UVB-IOL (mean PSQI = 6.35; SD = 3.82) and BF-IOL (mean PSQI = 6.39; SD = 4.04) groups. Cataract removal improved overall sleep quality significantly 1 month postoperatively in the UVB-IOL (mean PSQI = 5.89; SD = 3.71) and BF-IOL (mean PSQI = 6.08; SD = 3.88) groups. Sleep latency also improved for the UVB-IOL (preoperative mean = 1.16; SD = 1.003) and BF-IOL (preoperative mean = 1.17; SD = 1.03) groups at 1 month (UVB-IOL group mean = 1.01; SD = 0.923 and BF-IOL group mean = 1.00; SD = 0.95), which was sustained at 6 months for the UVB-IOL group (mean = 1.02; SD = 0.93) and 12 months for both the UVB-IOL and BF-IOL groups (6 months: UVB-IOL group mean = 0.96; SD = 0.92 and for the BF-IOL group mean = 0.99; SD = 0.96). Overall sleep quality and sleep latency improves after removal of cataract irrespective of the type of IOL implanted. These data show that implantation of BF-IOL does not have a negative impact on the sleep-wake cycle.

Images created in a model eye during simulated cataract surgery can be the basis for images perceived by patients during cataract surgery.

To evaluate the images created in a model eye during simulated cataract surgery. This study was conducted as a laboratory investigation and interventional case series. An artificial opaque lens, a clear intraocular lens (IOL), or an irrigation/aspiration (I/A) tip was inserted into the 'anterior chamber' of a model eye with the frosted posterior surface corresponding to the retina. Video images were recorded of the posterior surface of the model eye from the rear during simulated cataract surgery. The video clips were shown to 20 patients before cataract surgery, and the similarity of their visual perceptions to these images was evaluated postoperatively. The images of the moving lens fragments and I/A tip and the insertion of the IOL were seen from the rear. The image through the opaque lens and the IOL without moving objects was the light of the surgical microscope from the rear. However, when the microscope light was turned off after IOL insertion, the images of the microscope and operating room were observed by the room illumination from the rear. Seventy percent of the patients answered that the visual perceptions of moving lens fragments were similar to the video clips and 55% reported similarity with the IOL insertion. Eighty percent of the patients recommended that patients watch the video clip before their scheduled cataract surgery. The patients' visual perceptions during cataract surgery can be reproduced in the model eye. Watching the video images preoperatively may help relax the patients during surgery.

Estimation of the melatonin suppression index through clear and yellow-tinted intraocular lenses.

To estimate the melatonin suppression index (MSI), which may reflect the nonvisual photoreception function, through commercially available foldable, clear and yellow-tinted intraocular lenses (IOLs). The MSIs for 13 IOL models (6 clear IOLs, 7 yellow-tinted IOLs) with three lens powers were calculated based on previously reported data about the melatonin suppression spectrum, spectral intensity of a 20-W white fluorescent lamp and spectral transmission of IOLs in wavelengths from 300 to 800nm. The models tested were the SA60AT and SN60AT (Alcon Japan); the VA-60BBR, YA-60BBR, and NM-1 (Hoya); the AU6K and AN6K (Kowa); the N4-18B and N4-18YG (Nidek); the X-60 and NX-60 (Santen); and the KS-3Ai and KS-AiN (Staar Japan). The MSIs of the clear IOLs ranged from 1.12 to 1.18mWcm(-2)sr(-1) and those of the yellow-tinted IOLs from 0.74 to 1.01mWcm(-2)sr(-1). All yellow-tinted IOLs had significantly lower MSIs (P<0.0001-0.0021) than the clear IOLs; the %MSI cutoff values for yellow-tinted IOLs compared to the clear IOLs were 11.4-36.2%. The MSIs of the six clear IOLs did not differ based on lens powers (P=0.2159-0.6144). Except for one IOL model, all yellow-tinted IOLs had a lower MSI with higher lens powers compared to those with lower lens powers (P<0.0001-0.0055). Compared to phakic eyes (MSI, 1.03mWcm(-2)sr(-1)), the MSIs of the clear IOLs were higher (%MSI cutoff, -14.6 to -8.4%), whereas those of the yellow-tinted IOLs were lower (2.6-28.1%). Compared to aphakic eyes (MSI, 1.21mWcm(-2)sr(-1)), the MSIs of the clear (2.1-7.4%) and yellow-tinted (16.7-38.6%) IOLs were lower. Yellow-tinted IOLs absorb more circadian rhythm-associated light than clear IOLs. The difference in the lens power is significantly related to the MSI value in some yellow-tinted IOLs. To correlate the current data with the clinical relevance of these findings, the percent loss of the MSI leading to a circadian rhythm disorder needs to be clarified.

Macular thickness measured by optical coherence tomography in pseudophakic eyes with clear vs yellow implant

ObjectiveTo study the use of optical coherence tomography (OCT), for measuring the macular thickness variations produced over time in elderly pseudophakic subjects implanted with a clear intraocular lens (IOL) in one eye, and a yellow IOL in the other eye. MethodsMacular thickness measurements were obtained in the 36 eyes of 18 subjects over 65 years, with cataracts surgically removed from both eyes and implanted with different absorbance (clear and yellow) IOLs in two separate surgeries. Stratus-OCT was used to determine the macular thickness in two sessions with 5 years of difference. ResultsAfter 5 years of follow-up, the eyes implanted with clear IOLs revealed a significant decrease in macular thickness. However, in eyes implanted with yellow IOLs the macular thickness remained stable. The mean overall decrease in macular thickness in eyes implanted with clear IOLs was 5±8μm (p=0.02), and foveal thickness reduction was 10±17μm (p=0.02). ConclusionsThe macular thickness changes produced in eyes implanted with a yellow IOL differ from those with a clear IOL. These observations point to a possible protective effect of yellow IOL against the harmful effects of light in elderly pseudophakic subjects. However, studies with a longer follow-up are still needed to confirm that the protection provided by this IOL model is clinically significant.

Espesor macular medido con tomografía de coherencia óptica en ojos pseudoafáquicos con implante amarillo vs. transparente

ObjectiveTo study the use of optical coherence tomography (OCT), for measuring the macular thickness variations produced over time in elderly pseudophakic subjects implanted with a clear intraocular lens (IOL) in one eye, and a yellow IOL in the other eye. MethodsMacular thickness measurements were obtained in the 36 eyes of 18 subjects over 65 years, with cataracts surgically removed from both eyes and implanted with different absorbance (clear and yellow) IOLs in 2 separate surgeries. Stratus-OCT was used to determine the macular thickness in 2 sessions with 5 years of difference. ResultsAfter 5 years of follow-up, the eyes implanted with clear IOLs revealed a significant decrease in macular thickness. However, in eyes implanted with yellow IOLs the macular thickness remained stable. The mean overall decrease in macular thickness in eyes implanted with clear IOLs was 5±8μm (P=.02), and foveal thickness reduction was 10±17μm (P=.02). ConclusionsThe macular thickness changes produced in eyes implanted with a yellow IOL differ from those with a clear IOL. These observation point to a possible protective effect of yellow IOL against the harmful effects of light in elderly pseudophakic subjects. However, studies with a longer follow-up are still needed to confirm that the protection provided by this IOL model is clinically significant.

Comparison of Intraocular Straylight in Patients with Clear and Photochromic Intraocular Lenses

Comparison of Intraocular Straylight in Patients with Clear and Photochromic Intraocular Lenses

Anterior segment optical coherence tomography in black‐on‐clear polypseudophakia

Anterior segment optical coherence tomography in black‐on‐clear polypseudophakia

Effect of aspherical and yellow tinted intraocular lens on blue-on-yellow perimetry

To investigate the possible effect of aspherical or yellow tinted intraocular lens (IOL) on contrast sensitivity and blue-on-yellow perimetry. This prospective randomized bilateral double-masked clinical study included 52 patients with visually significant bilateral cataracts divided in two groups; 25 patients (50 eyes) received aspherical intraocular lens in one eye and spherical intraocular lens in the fellow eye; and 27 patients (54 eyes) received ultraviolet and blue light filter (yellow tinted) IOL implantation in one eye and acrylic ultraviolet filter IOL in the fellow eye. The primary outcome measures were contrast sensitivity and blue-on-yellow perimetry values (mean deviation [MD] and pattern standard deviation [PSD]) investigated two years after surgery. The results were compared intra-individually. There was a statistically significant between-group (aspherical and spherical intraocular lens) difference in contrast sensitivity under photopic conditions at 12 cycles per degree and under mesopic conditions at all spatial frequencies. There were no between-group significant differences (yellow tinted and clear intraocular lens) under photopic or mesopic conditions. There was no statistically significant difference between all intraocular lens in MD or PSD. Contrast sensitivity was better under mesopic conditions with aspherical intraocular lens. Blue-on-yellow perimetry did not appear to be affected by aspherical or yellow tinted intraocular lens. Further studies with a larger sample should be carried out to confirm or not that hypotheses.

Contrast sensitivity and color perception with orange and yellow intraocular lenses

To evaluate contrast sensitivity function (CSF) and color vision after implantation of either orange or yellow-tinted intraocular lenses (IOLs). Fifty-six eyes of 28 cataract patients who had bilateral implantation of orange-tinted (PC440Y Orange, Ophtec), yellow-tinted (AcrySof Natural SN60AT, Alcon), or clear (AcrySof SA60AT, Alcon) IOLs were examined. Six months postoperatively, monocular CSF under photopic and mesopic (with and without glare) conditions were measured using the Functional Visual Analyzer. Color discrimination was determined with the Farnsworth-Munsell 100-Hue test. Patients implanted with orange-tinted, yellow-tinted, or clear IOLs displayed similar CSF values, with no statistically significant differences at any spatial frequency (p>0.05). There were no statistically significant differences in chromatic discrimination among the 3 groups of patients (p>0.05). Orange or yellow blue-filtering IOL implantation is comparable to a clear IOL in terms of photopic and mesopic contrast sensitivity or color discrimination.

Visual quality assessment in patients with orange-tinted blue light–filtering and clear ultraviolet light–filtering intraocular lenses

To evaluate potential differences in the quality of vision after implantation of a blue light-filtering intraocular lens (IOL) and an ultraviolet (UV) light-filtering IOL. Department of Ophthalmology, Ruhr-University, Bochum, Germany. Prospective randomized cohort study. Patients with age-related cataract had bilateral standardized small-incision Kelman phacoemulsification-based cataract surgery with implantation of a blue light-filtering IOL (Oculaid PC 440Y Orange Series) in 1 eye and a UV light-filtering IOL (Oculaid PC 430 Elite Series) in the other eye. Outcome measures included scotopic and photopic corrected distance visual acuity (CDVA) and photopic uncorrected distance visual acuity (UDVA), color discrimination, and contrast sensitivity with and without glare. A questionnaire was used to assess patient satisfaction. Postoperative follow-up visits were scheduled at 1, 3, and 6 months. Twenty-two patients (44 eyes) completed the study. There were no statistically significant differences in UDVA, CDVA, or contrast sensitivity with or without glare between the 2IOL groups. Color discrimination was significantly decreased in eyes with blue light-filtering IOLs compared with UV light-filtering IOLs, except along the red-green axis (P=.118). No subjective differences in color or light perception were found. Both IOL types provided similar postoperative visual function except color perception, which was slightly better in eyes with a clear IOL. Although differences were not clinically significant, information about potential disturbances in color vision might be provided before implanting an orange blue light-filtering IOL. No author has a financial or proprietary interest in any material or method mentioned.

Contrast Sensitivity and Color Vision Comparison Between Clear and Yellow-Tinted Intraocular Lens in Diabetic Retinopathy

Contrast Sensitivity and Color Vision Comparison Between Clear and Yellow-Tinted Intraocular Lens in Diabetic Retinopathy

Measurements of transmission spectrums and estimation of retinal blue-light irradiance values of currently available clear and yellow-tinted intraocular lenses

To compare the spectral transmission characteristics of currently available, foldable, clear and yellow-tinted intraocular lenses (IOLs), and evaluate the protective effects they provide against retinal damage by sunlight. We measured the spectral transmittance in the wavelength range of 300-800 nm using a spectrophotometer for 63 IOLs including three clear IOLs (N4-18B, Nidek; X-60, Santen; KS-3Ai, Staar Japan) and four yellow-tinted IOLs (N4-18YG, Nidek; NX-60, Santen; KS-AiN, Staar Japan; NM-1, Hoya) with three different lens powers. The blue-light irradiance (BLI) values through the IOLs were calculated as the retinal hazard index for sungazing. The data from three clear IOLs (SA60AT, Alcon Japan; VA-60BBR, Hoya; AU6K, Kowa) and three yellow-tinted IOLs (SN60AT, Alcon Japan; YA-60BBR, Hoya; AU6N, Kowa) reported previously were also discussed. Except for the X-60, the clear IOLs completely absorbed ultraviolet (UV) light and nearly completely transmitted visible light at wavelengths longer than 440 nm. Yellow-tinted IOLs absorbed more in the blue-light range (400-500 nm) than clear IOLs. All IOLs had lower BLI values than aphakic eyes, and all yellow-tinted IOLs had lower BLI values than phakic eyes. The BLI values of the NX-60, KS-AiN, NM-1, SN60AT and YA-60BBR IOLs decreased with the increase in lens power. Compared to aphakic eyes, currently available UV-blocking clear and yellow-tinted IOLs reduce the BLI values by 43-82%. However, the data presented in this study are not directly applicable to humans implanted with IOLs or for the use of IOLs in a clinical situation, since in those cases the balance between photoprotection and photoreception must be taken into account.

Effect of blue-light filtering on multifocal visual-evoked potentials

To perform an objective functional assessment of the impact of blue-light filters on cortical processing to evaluate the potential side effects of the filters on higher tier visual function at the neural level. Department of Ophthalmology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany. Cohort study. Multifocal pattern-reversal visual-evoked potentials (multifocal VEPs) were recorded monocularly in pseudophakic patients with a clear intraocular lens (IOL) under 2 conditions: (1) stimulus perception through a yellow filter with the filter characteristics of an AF-1 YA-60BB IOL (blue filtering); (2) stimulus perception through a neutral filter that homogeneously attenuates the effective stimulus intensity as under the blue-light filtering condition but independent of the wavelength (neutral filtering). Second-order kernel multifocal VEPs were extracted for 60 visual field locations, and amplitude and latency effects were determined for 6 stimulus eccentricities. The study evaluated 20 patients. Typical multifocal VEPs were obtained for the blue-light and neutral filtering conditions at all eccentricities. No significant effects on amplitudes were obtained, and a subtle latency effect (<0.5 millisecond delay for neutral filtering; P<.02) did not reach significance in an eccentricity-specific analysis. The induced short-term change in the spectral composition of the visual stimulus left neural activity at the level of the primary visual cortex largely unaffected, providing an objective account of the integrity of visual processing under this condition.

Influence of Blue Light-filtering Intraocular Lenses on Retinal Nerve Fiber Layer Measurements by Spectral-domain Optical Coherence Tomography

Purpose: The purpose of this study was to assess the influence of blue light-filtering intraocular lenses (IOL) on peripapillary retinal nerve fiber layer (RNFL) thickness measurements by spectral-domain (SD) optical coherence tomography (OCT).Methods: This prospective study included 50 eyes of 50 patients. Patients were randomly assigned to receive either a blue light-filtering IOL (acrysof IQ (SN60WF) [Alcon]) or a clear IOL (Tecnis (Z9003) [AMO]). The peripapillary RNFL thickness was measured using a Cirrus SD OCT before and 8 weeks after cataract surgery. Perioperative differences in RNFL thickness measurements and signal strengths (SS) were evaluated and compared in both IOL groups.Results: Thirty-nine eyes of 39 patients were included in the final analysis. There was a significant increase in average RNFL thickness and SS after cataract surgery in both IOL groups. No significant difference in perioperative changes of RNFL measurements was noted between yellow and clear IOL groups. In the multivariable analysis, the factor affecting perioperative differences of RNFL measurements was not IOL type but SS.Conclusions: Our data suggests that blue-light filtering IOL does not influence RNFL thickness measurements by Cirrus SD-OCT.

Effect of 1-year lutein supplementation on macular pigment optical density and visual function

Although it is known that antioxidants including lutein can affect macular pigment optical density (MPOD) and visual function, we still have much to learn about their effect. Our aim was to assess the 1-year changes in MPOD and visual function in response to supplementation containing lutein. We prospectively measured the MPOD level of those who received a supplement containing 6mg of lutein daily for 1year. MPOD level was measured every 3months by using autofluorescence spectrometry with the two-wavelength method. Other examinations, including contrast sensitivity and retinal sensitivity were also measured every 3 or 6months. Stepwise regression analysis was performed to determine the factors that correlated with the changes observed in those examinations. Forty-three eyes of 43 Japanese subjects, including five normal eyes, five fellow eyes with central serous chorioretinopathy (CSC), and 33 fellow eyes with age-related macular degeneration (AMD) were enrolled. The higher baseline MPOD level was correlated with the eye with a clear intraocular lens (IOL). Although no time-dependent changes in the MPOD level were obtained in any area, subjects without cardiovascular diseases showed higher increase in the MPOD level. We observed significant increases in the contrast sensitivity at 1year (p = 0.0124) and in the retinal sensitivity at 6months (p < 0.0001) and 1year (p < 0.0001). Stepwise regression analysis showed that nonsmokers had increased contrast sensitivity (p = 0.0173), and the fellow eye of those with CSC had less of an increase in retinal sensitivity (p = 0.0491). Daily supplementation with 6mg of lutein did not affect the MPOD level for 1year, suggesting that 6mg of lutein may be insufficient to increase the MPOD level. However, supplementation seems to improve visual functions such as contrast sensitivity and retinal sensitivity.