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Study: Blue light-filtering and UV-filtering lenses should not be combined
Ophthalmology. 2009;116(1):39-45.
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Blue light-filtering IOLs adversely affected contrast sensitivity and blue/yellow foveal threshold more than ultraviolet light-filtering IOLs.
“Our recommendation is to avoid a mixed implantation of a blue light-filtering IOL in one eye and a non-blue light-filtering IOL in the contralateral eye in patients with a high demand in either color or contrast vision,” the study authors said.
The randomized study included 48 eyes of 24 patients with a mean age of 74 years. All patients underwent cataract surgery and IOL implantation into the capsular bag. Patients received a blue light-filtering IOL in one eye and a UV light-filtering IOL in the other eye. Both 6-mm hydrophobic acrylic/polymethylmethacrylate IOLs were manufactured by Hoya Medical Europe.
Data showed that the blue light-filtering IOLs had a significantly worse contrast acuity (P = .0004) and foveal threshold (P = .008) than the UV-filtering IOL. No significant differences were found between outcomes for color vision and high-contrast visual acuity. Differences between the IOLs were larger in low mesopic light conditions.
On a questionnaire, three of 24 patients noted differences between the IOLs. However, questionnaire results were not statistically significant.
This randomized double-blind study evaluates potential differences between blue light and non-blue light filtering IOLs in color vision, contrast sensitivity, foveal threshold and subjective symptoms. Since many previously reported studies using standard testing methods have found no significant differences between blue blocking and non-blue blocking IOLs in color perception, contrast sensitivity and visual acuity, the authors used more sensitive tests such as the Lanthony D-15, Lanthony New Color, Blue/Green Color, Holladay contrast acuity and short wavelength automated perimetry tests. The results show a significant difference in contrast sensitivity and blue/yellow foveal threshold, especially in low mesopic light conditions between the IOLs. The subjective patient questionnaire did not show significant differences between the study groups.
The published literature has conflicting reports of the effects of blue-blocking IOLs. This study supports some of the previous reports that blue-blocking IOLs negatively affect the patient’s vision especially in low mesopic light. Although the actual clinical effects may be small, this article highlights the importance of this ongoing debate and of continued investigation.
– Bonnie An Henderson, MD
OSN Cataract Surgery Board Member