Transcript Folie 1 - ASCRS/ASOA 2008

YEWHI-Study - A Comparison Between Blue Light Filtering
and Ultraviolet Light Filtering Intraocular lenses
The Ludwig Boltzmann
Institute of Retinology and
Biomicroscopic
Lasersurgery
B. Neumaier-Ammerer, S. Felke, F. Zeiler, S. Hagen, P. Haas,
S. Binder
Department of Ophthalmology
No financial interest-all authors
Rudolf Foundation Clinic Vienna
Head: Prof. Dr. Susanne Binder
Purpose: To evaluate the difference between yellow tinted and non-tinted
intraocular lenses (IOL) relative to contrast sensitivity, glare, colour perception and
visual acuity at different light intensities.
Study design: Prospective randomised study
Method: 80 eyes of 80 patients were included. 20 IOLs of each of the following
lens types were implanted: HOYA AF-1 UY (yellow), HOYA AF-1 UV, Alcon Acrysof
SN60AC (yellow), Alcon Acrysof SA60AC.
Parameters of interest were: reading acuity tested with Radner charts; Snellen
BCVA (far distance) ; contrast sensitivity tests with Pelli Robsen Charts and CSV1000E Vector Vision Test with and without glare; colour perception with Ishihara
Charts and the Roth 28 Hue Test
All tests were performed under standardized light conditions and different light
intensities ranging form 10 to 1000 lux.
Study follow ups: 1 and 8 weeks after surgery
Results I:
Reading acuity - 8 weeks postop
1
0,4
0,9
0,3
log RAD
measured in Snellen
BCVA - 8 weeks postop
0,8
0,7
0,6
0,1
10 Lux
100 Lux
1000 Lux
0,95
0,89
0,84
Hoya AF-1 UY
0,9
0,87
0,8
Alcon SA60AT
0,93
0,9
0,83
Alcon SN60AT
0,84
0,76
0,7
Hoya AF-1 UV
0,2
0
10 Lux
100 Lux
1000 Lux
Hoya AF-1 UV
0,27
0,12
0,07
Hoya AF-1 UY
0,35
0,22
0,12
Alcon SA60AT
0,28
0,15
0,06
Alcon SN60AT
0,34
0,22
0,12
There was no significant difference in far or near distance visual acuity at
any light intensity (10,100, 1000 lux) between the yellow tinted and the clear
IOLs .
Results II - contrast sensitivity tests
8 weeks postop:
Vector vision test without glare
Pelli Robsen Charts (mean)
10
Hoya
AF-1 UV
Hoya
AF-1 UY
1,3
1
1,15
1,33
1,4
Hoya AF-1 UY
1,14
1,37
1,43
Alcon SA60AT
1,14
1,33
1,4
Alcon SN60AT
1,08
1,29
1,3
At the 8 weeks follow up there was no
significant difference in the mean contrast
sensitivity quotient (Pelli Robsen chart)
between yellow and clear intraocular lenses
at 10, 100 and 100 lux.
Even when tested with glare, the contrastsensitivity-values
at
different
spatial
frequences (Vector-vision-1000-Test) were
within the normal ranges in all four groups.
Alcon
SN60At
0,1
standard
value 5075a
Vector vision test with glare
Hoya
AF-1 UV
10
Hoya
AF-1 UY
Alcon
SA60AT
1
Alcon
SN60At
0,1
18c/d
Hoya AF-1 UV
12c/d
1000 Lux
6c/d
100 Lux
3c/d
10 Lux
3c
/d
6c
/d
12
c/
d
18
c/
d
0,8
Alcon
SA60AT
standard
value 5075a
Results III – colour perception
8 weeks postop:
Mistakes in the blue spectrum at the 28 Roth-Hue-Test
5
4
3
1000 Lux
10 Lux
2
1
0
Hoya AF-1 UV Hoya AF-1 UY
Alcon
SA60AT
Alcon
SN60AT
Patients with blue light filtering IOLs made significant more mistakes in the blue
light spectrum when tested under mesopic conditions at 10 lux (p= 0,0015).
Under photopic conditions (1000 lux) there was no significant difference
between yellow and clear IOLs (p=0,8) in the blue light spectrum.
Conclusion:
We could not find any difference between yellow (blue light filtering) and
clear intraocular lenses, except colour perception in the blue light spectrum
under mesopic conditions. How far this reduced blue perception is
disturbing the patient is uncertain at the moment.
In a quality of life questionnaire our patients did not quote any impairment,
i.e. the postoperative patient satisfaction was not due to the implanted lens
type.
If the implantation of yellow tinted IOLs could prevent the development of
macular degeneration this would compensate the reduced blue colour
perception in mesopic light conditions. But this macular protection of yellow
lenses has to be confirmed in long term studies.