Zusammenfassung
Hintergrund: Intraokularlinsen (IOL) mit Blaulichtfilter könnten die Wahrscheinlichkeit des Auftretens
oder der Progression einer Makuladegeneration nach Kataraktoperation reduzieren. Zusätzlich
könnte es durch die Reduktion der longitudinalen chromatischen Aberration zu einer
verbesserten visuellen Funktion nach Kataraktoperation kommen. Ziel dieser Studie
war der Vergleich der visuellen Funktion nach Implantation einer IOL mit und ohne
Blaulichtfilter. Patienten und Methoden: Einundzwanzig Patienten erhielten während der Kataraktoperation eine IOL mit Blaulichtfilter
(AF-1 UY, Hoya, Japan), 22 Patienten eine IOL ohne diesen Filter (AF-1 UV, Hoya, Japan).
Drei Monate postoperativ wurden unkorrigierter und bestkorrigierter Visus, mesopische
und photopische Kontrastsensitivität, Farbensehen und die subjektive Sehqualität mittels
eines standardisierten Fragebogens untersucht. Ergebnisse: Sowohl hinsichtlich des Visus als auch des mesopischen und photopischen Kontrastsehens
beziehungsweise Farbensehens konnte kein signifikanter Unterschied zwischen den beiden
Patientengruppen beobachtet werden. Die subjektive Sehqualität wurde von allen Patienten
als sehr hoch bewertet, auch diesbezüglich konnte kein signifikanter Unterschied zwischen
beiden Gruppen gefunden werden. Schlussfolgerung: Die visuelle Funktion von Patienten mit Blaulichtfilter-IOL ist mit jener ohne Blaulichtfilter
sowohl hinsichtlich Visus als auch hinsichtlich Kontrast- und Farbensehen vergleichbar.
Da Blaulichtfilter-IOLs diesbezüglich keinen Nachteil aufweisen, aber einen eventueller
Schutz für die Makula bieten, kann die Implantation dieser IOL bei Kataraktoperationen
empfohlen werden, vor allem bei Patienten mit einem erhöhten Risiko für Makuladegeneration.
Abstract
Background: Recently, intraocular lenses (IOLs) with a blue light filter have been introduced
to protect the retina from age-related macular degeneration (AMD) after cataract extraction.
A reduction of longitudinal chromatic aberration by filtering blue light may enhance
patient’s visual function. In this study we compared subjective and objective parameters
of visual function following implantation of blue light filter (yellow) IOLs and IOLs
of the same design without filter. Patients and Methods: 21 patients (21 eyes) underwent implantation of an IOL with a blue light filter (AF-1
UY, Hoya, Japan), 22 patients (22 eyes) received an IOL without blue light filter
(AF-1 UV, Hoya, Japan). Patients were examined three months postoperatively for uncorrected
and best corrected spectacle visual acuity, mesopic and photopic contrast sensitivity,
colour vision and subjective quality of vision by a standard questionnaire. Results: Eyes with blue light filter IOLs did not show any significant difference in any parameter
analysed when compared to eyes without the blue light filter IOL. Subjective quality
of vision was considered to be high by all patients and no significant difference
was observed between the two IOL groups. Conclusion: The visual function of patients with blue filter IOLs is not significantly different
to those without blue light filter IOLs. Since blue light filter IOLs did not show
any functional disadvantage, but potentially protect the macula from AMD, blue light
filter IOLs may be considered as a reasonable alternative to traditional IOLs, especially
in eyes with a high risk for the development of macular degeneration.
Schlüsselwörter
Katarakt - Sehqualität - Blaulichtfilter - Kontrastsehen - Farbensehen
Key words
cataract - quality of vision - blue light filter - contrast - colour vision
Literatur
- 1
Braunstein R E, Sparrow J R.
A blue-blocking intraocular lens should be used in cataract surgery.
Arch Ophthalmol.
2005;
123
547-549
- 2
Cristobal J A, Sierra J, Martin J. et al .
Intraocular lenses with blue light filter.
Arch Soc Esp Oftalmol.
2005;
80
245-249
- 3
Boer M R, Moll A C, Vet de H C. et al .
Psychometric properties of vision-related quality of life questionnaires: a systematic
review.
Ophthalmic Physiol Opt.
2004;
24
257-273
- 4
Elliott D B, Situ de P.
Visual acuity versus letter contrast sensitivity in early cataract.
Vision Res.
1998;
38
2047-2052
- 5
Freeman E E, Munoz B, West S K. et al .
Is there an association between cataract surgery and age-related macular degeneration?
Data from three population-based studies.
Am J Ophthalmol.
2003;
135
849-856
- 6
Fristrom B, Lundh B L.
Colour contrast sensitivity in cataract and pseudophakia.
Acta Ophthalmol Scand.
2000;
78
506-511
- 7
Ham W T Jr, Mueller H A, Sliney D H.
Retinal sensitivity to damage from short wavelength light.
Nature.
1976;
260
153-155
- 8
Holladay J T.
Visual acuity measurements.
J Cataract Refract Surg.
2004;
30
287-290
- 9
Kim Y Y, Kim J S, Shin D H. et al .
Effect of cataract extraction on blue-on-yellow visual field.
Am J Ophthalmol.
2001;
132
217-220
- 10
Klein R, Klein B E, Jensen S C. et al .
The relationship of ocular factors to the incidence and progression of age-related
maculopathy.
Arch Ophthalmol.
1998;
116
506-513
- 11
Mainster M A.
Intraocular lenses should block UV radiation and violet but not blue light.
Arch Ophthalmol.
2005;
123
550-555
- 12
Mainster M A.
Violet and blue light blocking intraocular lenses: photoprotection versus photoreception.
Br J Ophthalmol.
2006;
90
784-792
- 13
Margrain T H, Boulton M, Marshall J. et al .
Do blue light filters confer protection against age-related macular degeneration?.
Prog Retin Eye Res.
2004;
23
523-531
- 14
Marshall J, Cionni R J, Davison J. et al .
Clinical results of the blue-light filtering AcryS of Natural foldable acrylic intraocular
lens.
J Cataract Refract Surg.
2005;
31
2319-2323
- 15
Mayer S, Wirbelauer C, Pham D T.
Functional results after intraocular lens implantation with or without blue light
filter: an intraindividual comparison.
Klin Monatsbl Augenheilkd.
2006;
223
142-146
- 16
Mendes F, Schaumberg D A, Navon S. et al .
Assessment of visual function after corneal transplantation: the quality of life and
psychometric assessment after corneal transplantation (Q-PACT) study.
Am J Ophthalmol.
2003;
135
785-793
- 17
Meyers S M, Ostrovsky M A, Bonner R F.
A model of spectral filtering to reduce photochemical damage in age-related macular
degeneration.
Trans Am Ophthalmol Soc.
2004;
102
83-93; discussion 93 - 85
- 18
Negishi K, Ohnuma K, Hirayama N. et al .
Effect of chromatic aberration on contrast sensitivity in pseudophakic eyes.
Arch Ophthalmol.
2001;
119
1154-1158
- 19
Nijkamp M D, Dolders M G, Brabander de J. et al .
Effectiveness of multifocal intraocular lenses to correct presbyopia after cataract
surgery: a randomized controlled trial.
Ophthalmology.
2004;
111
1832-1839
- 20
Nilsson S E.
Are there advantages in implanting a yellow IOL to reduce the risk of AMD?.
Acta Ophthalmol Scand.
2004;
82
123-125
- 21
Nilsson S E, Textorius O, Andersson B E. et al .
Clear PMMA versus yellow intraocular lens material. An electrophysiologic study on
pigmented rabbits regarding „the blue light hazard”.
Prog Clin Biol Res.
1989;
314
539-553
- 22
Oliphant D, Hovis J K.
Comparison of the D-15 and City University (second) color vision tests.
Vision Res.
1998;
38
3461-3465
- 23
Packer M, Fine I H, Hoffman R S.
Wavefront technology in cataract surgery.
Curr Opin Ophthalmol.
2004;
15
56-60
- 24
Packer M, Fine I H, Hoffman R S. et al .
Improved functional vision with a modified prolate intraocular lens.
J Cataract Refract Surg.
2004;
30
986-992
- 25
Petersen H, Seiler T.
Laser in situ keratomileusis (LASIK). Intraoperative and postoperative complications.
Ophthalmologe.
1999;
96
240-247
- 26
Rodriguez-Galietero A, Montes-Mico R, Munoz G. et al .
Comparison of contrast sensitivity and color discrimination after clear and yellow
intraocular lens implantation.
J Cataract Refract Surg.
2005;
31
1736-1740
- 27
Rodriguez-Galietero A, Montes-Mico R, Munoz G. et al .
Comparison of contrast sensitivity and color discrimination after clear and yellow
intraocular lens implantation.
J Cataract Refract Surg.
2005;
31
1736-1740
- 28
Rosen P N, Twa M D.
Improved functional vision with a modified prolate IOL.
J Cataract Refract Surg.
2004;
30
2247-2248; author reply 2248 - 2250
- 29
Seiler T.
Change of paradigms in refractive surgery.
Ophthalmologe.
2001;
98
701-702
- 30
Shah S A, Miller K M.
Explantation of an AcrySof Natural intraocular lens because of a color vision disturbance.
Am J Ophthalmol.
2005;
140
941-942
- 31
Sparrow J M, Hill A R, Ayliffe W. et al .
Human lens nuclear colour matching and brunescence grading in vivo.
Int Ophthalmol.
1988;
11
139-149
- 32
Sparrow J R, Miller A S, Zhou J.
Blue light-absorbing intraocular lens and retinal pigment epithelium protection in
vitro.
J Cataract Refract Surg.
2004;
30
873-878
- 33
Sperduto R D, Hiller R, Seigel D.
Lens opacities and senile maculopathy.
Arch Ophthalmol.
1981;
99
1004-1008
- 34
Hoeve van der J.
Eye lesions produced by light rich in ultraviolet rays: senile cataract senile degeneration
of the macula.
Am J Ophthalmol.
1920;
3
178-194
- 35
Wang J J, Klein R, Smith W. et al .
Cataract surgery and the 5-year incidence of late-stage age-related maculopathy: pooled
findings from the Beaver Dam and Blue Mountains eye studies.
Ophthalmology.
2003;
110
1960-1967
- 36
Werner J S.
Night vision in the elderly: consequences for seeing through a „blue filtering” intraocular
lens.
Br J Ophthalmol.
2005;
89
1518-1521
- 37
Yuan Z, Reinach P, Yuan J.
Contrast sensitivity and color vision with a yellow intraocular len.
Am J Ophthalmol.
2004;
138
138-140
- 38
Zigman S.
Tinting of intraocular lens implants.
Arch Ophthalmol.
1982;
100
998
Dr. Christina Wohlfart
Universitäts-Augenklinik, Medizinische Universität Graz
Auenbruggerplatz 4
8036 Graz, Österreich
Phone: ++43/3 16/3 85 38 17
Fax: ++43/3 16/3 85 32 61
Email: christinawohlfart@gmx.at