Yellow-tinted Intraocular Lenses Research Articles

Evaluation of visual performance and eye movements in patients with blue light-filtering intraocular lenses versus ultraviolet light-filtering intraocular lenses.

Eye movement plays an important role in visual perception and provides essential visual information for everyday tasks. Our previous study indicated that the visual performance and eye movement pattern were impaired in age-related cataract patients and could be improved after cataract surgery, but the impact of different intraocular lens (IOL) types was obscure. Previous studies found that blue light might affect the eye movement pattern and cognitive function. In this study, we explored the visual performance and eye movement pattern in post-cataract surgery patients implanted with blue light-filtering IOLs or ultraviolet (UV) light-filtering IOLs to further understand the impact of different types of IOLs on and daily visual performance and eye movement pattern and to help ophthalmologists and patients make the personalized option of IOL types in future. Patients after both-eye cataract surgeries were included in this study. Eye movement behaviors were automatically recorded by an eye tracker while performing three performance-based everyday tasks (non-social object search, face recognition, and reading). Visual performance and eye movement parameters were compared between participants with blue light-filtering IOLs and UV light-filtering IOLs. The correlation between visual performance and eye movement parameters was explored to determine which eye movement parameters had a significant influence on visual performance outcomes. A total of 30 patients (16 with blue light-filtering IOLs and 14 with UV light-filtering IOLs) were included. In this study, we found that the eye movement pattern was slightly different with these two IOLs: during non-social object visual search task, time to first fixation and fixation counts before first fixation were notably increased in yellow-tinted blue light-filtering IOL patients. During reading task, a higher total fixation count was also found in blue light-filtering IOL patients. However, the visual performance of these two IOLs was close, except for a quicker search of the target object with clear UV light-filtering IOLs. Both blue light-filtering and UV light-filtering IOLs were able to successfully restore visual function and yield satisfactory outcomes after cataract surgery. Although subtle, yellow-tinted IOLs did have a slight but significant impact on visual performance and the eye movement pattern of elderly patients when handling everyday tasks.

Comparative Spectrophotometer Analysis of Ultraviolet-light Filtering, Blue-light Filtering, and Violet-light Filtering Intraocular Lenses.

PurposeTo compare the light transmittance property of seven currently used intraocular lens (IOL) models by spectrophotometer data.MethodsLight transmission spectra of seven IOL models were assessed with a spectrophotometer. The transmittance properties were analyzed in 1 nm units from 350 nm wavelength to 800 nm.ResultsThree ultraviolet filtering IOL models (ZCB00, XC1-SP, and AT LISA 809M) showed nearly full transmittance of the light from 400 to 500 nm, while steeply attenuating light with shorter wavelengths in various degrees. Three blue-light filtering IOLs (yellow-tinted IOLs; XY1, SN60WF, and TNFT00) showed a slow-sloped increase of light transmission between 400 to 500nm. Among the three, XY1 showed different degree of inclination, showing a steeper slope than SN60WF and TNFT00. The violet-light filtering IOL (ZFR00V) showed a rapid increase of the transmission at around 435 nm wavelength, which is similar to ultraviolet filtering IOLs.ConclusionsThe seven different IOLs measured showed different characteristics of light transmission depending on the properties of each material and color. Blue-light filtering IOLs tend to blocked a wide range of wavelength up to 500 nm, but rather were not effective at the range of 400 to 430 nm. Violet-light filtering IOL showed advantages in filtering the high-energy wavelength, around 430 nm, having a potential risk to retina and allowing the transmission of useful blue and green wavelength which is necessary for a better scotopic contrast sensitivity.

X-ray radiation affects the protection filter of yellow-tinted acrylic hydrophobic intraocular lenses against harmful UV-A and blue light

Purpose: This study aims to investigate whether x-ray irradiation at doses delivered to the eye in plain radiography, CT and fluoroscopically guided procedures can affect the optical properties of yellow-tinted intraocular lenses (IOLs) implants in the near-Ultraviolet (UV-A) and visible (VIS) region. Material and Methods: 5 yellow azodye doped IOL of different models and diopters were irradiated with x-rays ranging from 1.1 to 22.6 mGy. The transmission spectra of each IOL were recorded pre-irradiation and post-irradiation by using a light source for IOL illumination, a spectraflect-coated integration sphere for the spectrum collection and a UV/VIS spectrometer for the spectrum record. Results: According to the recorded spectra, the transmittance of all the yellow-tinted IOLs increases systematically in the UV-A and blue light region as the irradiation dose increases. A linear dependence is recorded between the percentage increase of the transmittance and the increase in the irradiation dose at 380 nm.

Comparison of post-op quality of vision of spheric IOL and aspheric hydrophilic acrylic yellow tinted intraocular lens implantation following phacoemulsification cataract surgery

Purpose: To compare the post-op visual quality of spheric and aspheric acrylic yellow tinted intraocular lens following phacoemulsification cataract surgery. Place of study: Al-Majeed Laser Eye Hospital. Methods: Total 60 subjects (aged 40-65years) with age related mature cataracts were included. Data was assembled by non-probability convenient sampling technique at Al-Majeed Laser Eye Hospital. All patients presenting with mature cataract were include in this study without any other pathology and fundus abnormality. Pre and post-operative visual acuity was measured by using standard snellen visual acuity testing chart. For the purpose of accuracy repetitive values were taken for each patient. Post-operative vision was recorded one month followed by phacoemulsification. Comparisons was made between spheric and asphereic acrylic yellow tinted intraocular lens by applying (descriptive) statistics and paired sample t test for the analysis of results. Results: Quality of vision was compared post-operatively after implantation of aspheric hydrophilic acrylic IOL and spheric IOL in posterior chamber under the same phaco surgeon. All subjects after intra ocular implantation had better corrected visual acuity of 6/9 and more improved 6/6. There were found statistically differences in recorded visual acuity with aspheric yellow tinted iol implanation and spheric iol (p = 0.15) between the two types of intra-ocular lens. The mean, standard deviation, t-value found with spheric IOL were.1867, .18889, 2.517 respectively. However, of aspheric hydrophilic acrylic intra-ocular lens mean, standard deviation and t values found .800, .13493 and 2.5493 respectively. There was significant variance in statistics and quality of vision between the two types of lenses. Conclusions: This study concludes that post –operative improvement in quality of vision was better with aspheric hydrophilic yellow tinted lenses than spheric iol implantation. Implanting a foldable aspheric acrylic IOL gave much advantage in visual outcome to pseudophakes by protecting retina from light of shorter wavelength and decrease of chromatic aberration under the photopic circumstances particularly in subjects at hazard of age-related macular degeneration (AMD).

Macular pigment changes after cataract surgery with yellow-tinted intraocular lens implantation.

We previously reported that macular pigment optical density (MPOD) levels decreased during a long follow-up period after clear intraocular lens (IOL) implant surgery presumably due to excessive light exposure. We examined changes in MPOD levels in the eyes that received yellow-tinted IOL implant surgery. This was a prospective, observational study. Fifty-five eyes of 35 patients were studied. MPOD levels were measured with a dual-wavelength autofluorescence technique on day 4; months 1, 3, and 6; and years 1 and 2 postoperatively. The average optical densities at 0°- 2° eccentricities (local MPODs) and total volumes of MPOD (MPOVs) in the area within 1.5° and 9° eccentricities were analyzed. The mean local MPOD at baseline (on day 4) was 0.79 at 0°, 0.71 at 0.5°, 0.68 at 0.9°, and 0.32 at 2°. The mean MPOV within 1.5° and 9° at baseline was 2950 and 18,897, respectively. Local MPOD at 0.9° and 2° and MPOVs were slightly decreased at month 1 and increased after that. The increase reached statistical significance in local MPOD at 0.5° and 2° and MPOVs (Tukey-Kramer test). The changes in MPOV within 9° at year 2 [(MPOV on year 2 - MPOV on day 4) / MPOV on day 4] were from -0.21 to 1.18 (mean and standard deviation: 1.14 ± 0.28). The MPOV of 15 eyes increased more than 10% from the initial value, was maintained within 10% in 21 eyes, and deteriorated more than 10% in only 3 eyes. Local MPOD and MPOV tended to slightly decrease month 1 postoperatively and gradually increased after that, but the rates of increases in MPOD levels were small. Yellow-tinted IOLs that have a lower transmittance of blue light might be preferable for preserving MPOD levels after surgery.

Evaluating the Biostability of Yellow and Clear Intraocular Lenses with a System Simulating Natural Intraocular Environment.

PurposeBlue light–filtering intraocular lenses (IOLs) are thought to protect the retina from blue light damage after cataract surgery, and the implantation of yellow-tinted IOLs has been commonly used in cataract surgery. To our knowledge, this is the first investigation measuring the long-term biostability of yellow-tinted IOLs using an in vitro system simulating natural intraocular environment.MethodsSix hydrophobic acrylic IOLs, three clear IOLs, and three yellow-tinted IOLs were included in the study. Each yellow-tinted IOL was a matching counterpart of a clear IOL, with the only difference being the lens color. The IOLs were kept in conditions replicating the intraocular environment using a perfusion culture system for 7 months. Resolution, light transmittance rate, and the modulation transfer function (MTF) were measured before and after culturing. Surface roughness of the anterior and posterior surfaces was also measured.ResultsAfter culturing for 7 months, there were no changes in the resolution, the light transmittance rate, and MTF. The surface roughness of the anterior and posterior surfaces increased after culturing; however, this increase was clinically insignificant. There were no differences in surface roughness between the clear and yellow-tinted IOLs, either before or after culturing.ConclusionsA novel in vitro system replicating intraocular environment was used to investigate the biostability of yellow-tinted IOLs. The surface roughness showed no clinically significant increase after culturing for 7 months.Translational RelevanceThis system is useful for evaluating the biostability of IOLs.

Prevention of increased abnormal fundus autofluorescence with blue light–filtering intraocular lenses

To observe changes in fundus autofluorescence 2 years after implantation of blue light-filtering (yellow-tinted) and ultraviolet light-filtering (colorless) intraocular lenses (IOLs). Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan, and the Department of Ophthalmology, University of Bern, Bern, Switzerland. Prospective comparative observational study. Patients were enrolled who had cataract surgery with implantation of a yellow-tinted or colorless IOL and for whom images were obtained on which the fundus autofluorescence was measurable using the Heidelberg Retina Angiogram 2 postoperatively. The fundus autofluorescence in the images was classified into 8 abnormal patterns based on the classification of the International Fundus Autofluorescence Classification Group, The presence of normal fundus autofluorescence, geographic atrophy, and wet age-related macular degeneration (AMD) also was recorded. The fundus findings at baseline and 2 years postoperatively were compared. Fifty-two eyes with a yellow-tinted IOL and 79 eyes with a colorless IOL were included. Abnormal fundus autofluorescence did not develop or increase in the yellow-tinted IOL group; however, progressive abnormal fundus autofluorescence developed or increased in 12 eyes (15.2%) in the colorless IOL group (P = .0016). New drusen, geographic atrophy, and choroidal neovascularization were observed mainly in the colorless IOL group. The incidence of AMD was statistically significantly higher in the colorless IOL group (P = .042). Two years after cataract surgery, significant differences were seen in the progression of abnormal fundus autofluorescence between the 2 groups. The incidence of AMD was lower in eyes with a yellow-tinted IOL. No author has a financial or proprietary interest in any material or method mentioned.

Influence of light filters in intraocular lenses on color perception and contrast acuity

To compare contrast acuity at different illumination levels, color vision, and the subjective visual impression in patients after bilateral cataract surgery with mixed implantation of a yellow-tinted intraocular lens (IOL) and an orange-tinted IOL. Department of Ophthalmology, Hietzing Hospital, Vienna, Austria. Prospective case series. Consecutive patients with age-related cataract had standardized small-incision cataract surgery with IOL implantation in the capsular bag. Patients were randomly assigned to receive a yellow Polylens Y30 in 1 eye and an Orange Series model PC 440Y in the contralateral eye. The main outcome measures were contrast acuity, color vision, and subjective visual impression. Contrast acuity was measured at illumination levels of 5.0 lux and 0.5 lux and contrast levels of 50.0%, 25.0%, and 12.5%. Color vision was assessed using the Heidelberg-multicolor anomaloscope, and the subjective visual impression was evaluated using a questionnaire. This study included 64 eyes of 32 patients. The intraindividual comparison showed no significant difference in contrast sensitivity at different contrast and illumination levels or in color vision. On questioning, 3 patients reported a difference in subjective color perception between the 2 IOL types. There were no differences in contrast sensitivity or color vision between yellow-tinted IOLs and orange-tinted IOLs. No author has a financial or proprietary interest in any material or method mentioned.

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.

Changes in blood pressure and sleep duration in patients with blue light-blocking/yellow-tinted intraocular lens (CHUKYO study)

Blood pressure and sleep duration may be influenced by retinal light exposure. Cataracts may exert such an influence by decreasing the transparency of the crystalline lens. A large-scale clinical study was conducted to examine changes in blood pressure and sleep duration after intraocular lens (IOL) implantation during cataract surgery and to investigate how different types of IOL influence the degree of these effects. Using a questionnaire, we collected information, including blood pressure measurement and sleep duration, from 1367 patients (1367 eyes) before IOL implantation, 1 week after IOL implantation and 1 month after IOL implantation. Systolic and diastolic blood pressures were significantly decreased in the total patient group after implantation. The decrease in systolic blood pressure 1 month after implantation was significantly more in patients who received a yellow-tinted IOL than it was in those who received an ultraviolet (UV) light-filtering IOL. The post-implantation sleep duration, including naps, became shorter in patients who had slept too much and became longer in those who had slept too little before IOL implantation. Our observations suggest that a yellow-tinted IOL is better for patients with high blood pressure than a UV light-filtering IOL. Furthermore, the yellow-tinted IOL is as good as the UV light-filtering IOL for improving sleep duration. A pale yellow-tinted IOL is likely to be superior to a moderate yellow-tinted IOL in terms of allowing patients to discriminate different colors. Thus, the pale yellow-tinted IOL appears to be better for patients than the UV light-filtering IOL and the moderate yellow-tinted IOL.

The yellow intraocular lens and the natural ageing lens

The purpose of this study is to review and evaluate the advantages and disadvantages of blue light (400-480 nm) filtering intraocular lenses (IOLs) when compared with the ultraviolet (UV)-blocking IOLs. Theories that blue light could be related to the pathogenesis of age-related macular degeneration (AMD) have led to the use of yellow tinted IOLs in cataract surgery to filter short wavelength light. In spite of the potential benefits, some concerns have been raised. The potential advantages of the blue light filtering IOLs are that they could better mimic the conditions of phakia and therefore be more protective for the retina in decreasing the incidence of AMD. However, the potential disadvantages are that blue light filtering could negatively affect scotopic vision and circadian rhythms in older patients. These advantages and disadvantages of blue light filtering IOLs have not been proven clinically and thus many questions remain. Studies have shown that each type of IOL may have its own benefits and the type of IOL should be picked on the basis of patients' specific situations. In cataract surgery, considerations such as preexisting AMD, night vision problems or sleep problems may be considered with the choice of IOL.

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.

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

Effects of blue light–filtering intraocular lenses on the macula, contrast sensitivity, and color vision after a long-term follow-up

To evaluate the possible side effects and potential protection 5 years after implantation of an intraocular lens (IOL) with a blue-light filter (yellow tinted). Ophthalmology Department, University of São Paulo, São Paulo, Brazil. Prospective randomized clinical study. Patients with bilateral visually significant cataract randomly received an ultraviolet (UV) and blue light-filtering IOL (Acrysof Natural SN60AT) in 1 eye and an acrylic UV light-filtering only IOL (Acrysof SA60AT) in the fellow eye. The primary outcome measures were contrast sensitivity, color vision, and macular findings 5 years after surgery. The study enrolled 60 eyes of 30 patients. There were no significant clinical or optical coherence tomography findings in terms of age-related macular degeneration in any eye. There were no statistically significant differences in central macular thickness between the 2 IOL groups (P=.712). There were also no significant between-group differences under photopic or scotopic conditions at any spatial frequency studied. No statistically significant differences in the color discrimination test were found between the 2 IOL groups (P=.674). After 5 years, there were no significant differences in color perception, scotopic contrast sensitivity, or photopic contrast sensitivity between the blue light-filtering (yellow-tinted) IOL and the IOL with a UV-light filter only (untinted). The potential advantage of the tinted IOL in providing protection to macular cells remains unclear.

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.

Comparison of color perception after tinted blue light–filtering and clear ultraviolet-filtering intraocular lens implantation

To compare color perception after implantation of clear and yellow-tinted intraocular lenses (IOLs). Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. Comparative case series. This study evaluated eyes that had implantation of an Acrysof IQ SN60WF yellow-tinted IOL or an Acrysof SA60AT clear IOL. All eyes were evaluated postoperatively at 1 month and 3 months. The uncorrected distance visual acuity, intraocular pressure, and color vision (Ishihara pseudoisochromatic test, Edridge-Green lantern test, Heidelberg anomaloscope, and Farnsworth-Munsell (FM) 100-hue test) were evaluated. Both IOL groups comprised 50 eyes. There were no significant differences between the 2 groups in color vision on any of the 4 tests (P≥.05). Plotting the error scores on the polarity graph of the FM 100-hue test showed that eyes with a yellow-tinted IOL did not have a specific axis of confusion. There was no difference in color perception between the 2 IOLs irrespective of the color vision test used.

Macular Pigment Changes in Pseudophakic Eyes Quantified with Resonance Raman Spectroscopy

We examined changes in macular pigment optical density (MPOD) levels after cataract surgery and compared the MPOD between eyes with clear intraocular lenses (IOLs) and yellow-tinted IOLs. Prospective, comparative case series. The MPOD levels were measured in 480 eyes of 337 patients after cataract surgery. Among them, the data from 259 eyes (clear IOL group, 121 eyes; yellow-tinted IOL group, 138 eyes) of 259 Japanese patients were selected for statistical analyses on the basis of the inclusion criteria: a postoperative visual acuity (VA) of ≥0.8 and no fundus diseases. Only 1 eye of each patient was enrolled. Patients provided informed consent to participate in this study on the basis of the approval of the institutional review board before surgery. The patients selected the type of IOL to be implanted. The MPOD levels were measured using resonance Raman spectroscopy on day 1 (baseline value); months 1, 3, and 6; and years 1 and 2 postoperatively. The difference in MPOD levels between the IOL groups was analyzed by unpaired t tests. The following parameters were analyzed by multiple regression analysis: age, gender, body mass index (BMI), smoking history, glaucoma, diabetes, preoperative VA, preoperative refractive error, and IOL power and type. We found no significant differences in the baseline characteristics between the 2 groups. Until 6 months postoperatively, the MPOD levels did not differ significantly between the groups. However, from 1 year onward, the levels were significantly higher in the yellow-tinted IOL group compared with the clear IOL group. By multiple regression analysis, 1 day postoperatively, older age and diabetes were correlated with lower MPOD levels; 1 year postoperatively and thereafter, however, lower MPOD levels were correlated with clear IOLs. Cataract surgery with clear IOLs induced a greater decrease in macular pigment levels compared with yellow-tinted IOLs during a longer follow-up period. These findings agreed with observations that excessive light exposure is associated inversely with MPOD, because clear IOLs transmit higher intensities of blue light than yellow-tinted IOLs.

The Effect of Yellow Tinted Intraocular Lenses on the Result of Frequency Doubling Perimetry after Cataract Surgery

PurposeTo investigate the effect of yellow tinted intraocular lenses (IOLs), implanted in the bag after phacoemulsification, on the result of frequency doubling technique (FDT) perimetry.MethodsFor 68 eyes of 52 patients, an IOL was implanted in the bag after phacoemulsification. The patients were categorized into three groups according to the type of implanted IOLs used. IOLs were selected randomly among two types of yellow IOLs (Acrysof SN60WF IOL, Hoya YA60BBR IOL) and a clear IOL was used as a control. A FDT Humphrey matrix was performed 2 months after the surgery. The mean deviation (MD) and pattern standard deviation (PSD) among these three groups was analyzed using Mann-Whitney U-test.ResultsTwo months after the procedure, there was no significant difference between each of the three groups: the clear IOL and Hoya YA60BBR IOL (MD, p = 0.21; PSD, p = 0.27), the clear IOL and Alcon SN60WF IOL (MD, p = 0.11; PSD, p = 0.22), and the Hoya YA60BBR IOL and Alcon SN60WF IOL (MD, p = 0.33; PSD, p = 0.56).ConclusionsWhen interpreting the result of the FDT after cataract surgery, the color and type of IOLs used should not be considered.

Comparison of visual performance with blue light–filtering and ultraviolet light–filtering intraocular lenses

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. Ludwig Boltzmann Institute of Retinology and Biomicroscopic Laser-Surgery, Department of Ophthalmology, Rudolf Foundation Clinic, Vienna, Austria. Comparative case series. 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). 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). 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.