Influence of blue-light-filtering intraocular lenses on color perception and contrast acuity.
OBJECTIVE
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).


METHODS
Randomized, controlled, double-masked, and bilateral study with intraindividual comparison.


METHODS
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.


METHODS
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.


BACKGROUND
The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Wirtitsch
Matthias G
MG
Department of Ophthalmology, Hietzing Hospital, Vienna, Austria. matthias.wirtitsch@wienkav.at
Schmidinger
Gerald
G
Prskavec
Martin
M
Rubey
Martin
M
Skorpik
Florian
F
Heinze
Georg
G
Findl
Oliver
O
Karnik
Nadja
N
D000368:Aged; D000369:Aged, 80 and over; D003118:Color Perception / Q000502:physiology*; D003119:Color Perception Tests; D015350:Contrast Sensitivity / Q000502:physiology*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008027:Light; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D018918:Phacoemulsification; D011446:Prospective Studies; D011474:Prosthesis Design; D011795:Surveys and Questionnaires; D014792:Visual Acuity / Q000502:physiology*