Department of OphthalmologyRudolf Foundation Clinic ViennaHead: Prof. Dr. Susanne Binder

YEWHI-Study - A Comparison Between Blue Light Filtering and Ultraviolet Light Filtering Intraocular lenses

B. Neumaier-Ammerer, S. Felke, F. Zeiler, S. Hagen, P. Haas, S. Binder

No financial interest-all authorsThe Ludwig Boltzmann

Institute of Retinology and Biomicroscopic

Lasersurgery

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 CSV-1000E 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:

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 .

BCVA - 8 weeks postop

0,6

0,7

0,8

0,9

1

Hoya AF-1 UV 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

10 Lux 100 Lux 1000 Lux

measu

red

in

S

nellen

Reading acuity - 8 weeks postop

0

0,1

0,2

0,3

0,4

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

10 Lux 100 Lux 1000 Lux

log

RA

Dlo

g R

AD

Results II - contrast sensitivity tests

8 weeks postop:

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 contrast- sensitivity-values at different spatial frequences (Vector-vision-1000-Test) were within the normal ranges in all four groups.

Pelli Robsen Charts (mean)

0,8

1,3

Hoya AF-1 UV 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

10 Lux 100 Lux 1000 Lux

Vector vision test without glare

0,1

1

10 HoyaAF-1 UV

HoyaAF-1 UY

AlconSA60AT

AlconSN60At

standardvalue 50-75a

Vector vision test with glare

0,1

1

10

3c

/d

6c

/d

12

c/d

18

c/d

HoyaAF-1 UV

HoyaAF-1 UY

AlconSA60AT

AlconSN60At

standardvalue 50-75a

Results III – colour perception

8 weeks postop:

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.

Mistakes in the blue spectrum at the 28 Roth-Hue-Test

0

1

2

3

4

5

Hoya AF-1 UV Hoya AF-1 UY AlconSA60AT

AlconSN60AT

1000 Lux

10 Lux

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.