Eyeworld

EW CATARACT 89 April 2017 beneficial effect of implanting blue light-blocking IOLs. Many authors have speculated that they may have adverse effects on sleep. In our study, we found that a difference ex- ists in sleep quality between groups with and without blue light-block- ing IOLs and also a marked elevation in the levels of daytime melatonin," she said. The debate about the effects of blue light on the eye is ongoing, and definitive evidence either for or against blue light IOLs is insuf- ficient. A review of the literature from 2010 showed that out of 56 published reports on subjects related to blue-blocking lenses, including sleep disturbance, visual outcomes, cataract surgery, lens transmittance, sunlight exposure, and macular disease from peer-reviewed journals between 1962 and 2009, 11 reports focused on comparing blue-blocking IOLs with conventional IOLs. Only one group of authors reported that the use of blue-blocking IOLs may have had detrimental effects on sco- topic vision and circadian rhythms. Also, the benefits of blocking the transmission of blue light to the macula and the relationship with AMD progression were unclear. 1 In a separate investigation in which 31 patients received con- ventional IOLs and 18 received blue–blocking IOLs, the median postoperative PSQI score was 6, and no statistically significant difference was found between the two IOL groups (P = .65) before and after cataract surgery. Blue light-blocking IOLs had no adverse effect on the quality of sleep in this study group. 2 Another large study that involved 961 patients showed that the overall sleep quality and sleep latency improved after cataract surgery irrespective of whether the patients received an ultraviolet blocking IOL or a blue filtering IOL. 3 In spite of some evidence to the contrary, other investigators insist on the importance of natural blue light for an intact circadian rhythm, saying that inadequate environmen- tal light and/or ganglion photore- ception can cause circadian disrup- tion, increasing the risk of insomnia, depression, and numerous systemic disorders. 4 Yellow chromophores were seen to eliminate up to 57% of blue light entering the eye, thereby adversely affecting circadian pho- toreception. 5 The investigators in this study maintained that yellow chromophores provided no tan- gible clinical benefits in exchange for the photoreception losses they cause and that they were in essence just placebos for AMD prevention that permanently restrict a pseu- dophake's dim light and circadian perception at ages when they were needed most. EW References 1. Henderson BA and Grimes KJ. Blue-block- ing IOLs: a complete review of the literature. Surv Ophthalmol. 2010;55:284–9. 2. Landers J, et al. Effect of a blue blocking intraocular lens on the quality of sleep. J Cataract Refract Surg. 2009;35:83–8. 3. Iona A, et al. Impact of cataract surgery on sleep in patients receiving either ultra- violet blocking or blue filtering intraocular lens implants. Invest Ophthalmol Vis Sci. 2014;55:4999– 5004. 4. Turner PL and Mainster MA. Circadian pho- toreception; ageing and the eye's important role in systemic health. Br J Ophthalmol. 2008;92:1439–44. 5. Mainster MA and Turner P. Blue–block- ing IOLs decrease photoreception without providing significant photoprotection. Surv Ophthalmol. 2010;55:272–89. Editors' note: Dr. Rojas-Rosario has no financial interests related to her comments. Contact information Rojas-Rosario: contacto@hospitaldelaluz.org The doctor gave me six months… OMG! …to my ne xt visit! Parasol® BVI, BVI Logo and all other trademarks (unless noted otherwise) are property of a Beaver-Visitec International ("BVI") company © 2017 BVI Six Full Months of Effective Dry Eye Relief Featuring • Simple insertion technique • No foreign body sensation • Exceptionally reliable retention Coming Soon! Extend 180 4 sizes! The Extend 180® Long-Term Dissolvable Implant Indications • Post-ocular surgery or seasonal dry eye • Contact lens intolerance • Dry eye associated with digital eye strain For pre-order introductory pricing 866-906-8080 customersupport@beaver-visitec.com Visit us at ASCRS 2017 in booth 2613 Shedding light continued from page 86

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