JKOS Journal of the Korean Ophthalmological Society J Korean Ophthalmol Soc 0378-6471 2092-9374 Korean Ophthalmological Society 10.3341/jkos.2017.58.1.34 jkos-58-34 Original Article Intraindividual Comparison of Visual Outcomes between Blue Light-filtering and Ultraviolet Light-filtering Intraocular Lens LeeGeun Young M.D KimIm Gyu M.D YuSung M.D LeeGwang Ja M.D LeeKyoo Won MD, PhD ParkYoung Jeung MD, PhD Cheil Eye Hospital, Daegu, Korea ￭ Address reprint requests to Young Jeung Park, MD, PhD Cheil Eye Hospital, #1 Ayang-ro, Dong-gu, Daegu 41196, Korea Tel: 82-53-959-1751, Fax: 82-53-959-1758 E-mail: eyepark9@naver.com 08 2017 30 8 2017 58 1 34 42 13 9 2016 1 11 2016 19 12 2016 Copyright © 2017 Korean Ophthalmological Society 2017 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Purpose

To compare the clinical results of short-term visual acuity and quality of vision after implantation of a yellow-tinted blue light-filtering intraocular lens (IOL) (Acrysof IQ® SN60WF) and an clear ultraviolet (UV) light filtering IOL (enVista TM MX60) in the same patient.

 Methods

44 patients with bilateral cataract received an SN60WF in one eye and an MX60 in the other eye. All eyes were eval-uated for refraction power and uncorrected visual acuity (UCVA) at preoperative and 1, 3 months postoperatively. At post-operative 3 months, corrected visual acuity, quality of vision (OQASⅡ®), contrast sensitivity (CGT 2000®) and visual field (Humphrey Field Analyzer®), and subjective patients' response to the degree of brightness were evaluated. Furthermore, glisten-ing degree, intraocular stability, and posterior capsular opacification were examined.

 Results

There were no significant differences in average refractive power or UCVA at 1 and 3 months ( p > 0.05) between the two groups. At 3 months after cataract surgery, the quality of vision according to OQASⅡ®, the contrast sensitivity according to CGT 2000® with the glare either on or off, and visual field; showed no difference between the two groups ( p > 0.05). Both IOLs had no glistening and posterior capsular opacity. The patients' response to the degree of brightness shows that MX60 (48.3%) has a higher degree of satisfaction.

 Conclusions

Yellow-tinted blue light-filtering IOL and clear UV light-filtering IOL had no difference in short-term visual acuity and quality of vision. Subjective brightness perception, however, was better with clear UV light-filtering IOL.

 Blue light-filtering intraocular lens (IOL) Clear ultraviolet (UV) light-filtering IOL Glistening Quality of vision References YoonKCMunGHKimSDPrevalence of eye diseases in South Korea: data from the Korea National Health and Nutrition Examination Survey 2008-2009Korean J Ophthalmol20112542133 PuttingBJvanBest JAZweypfenningRCSpectral sensi-tivity of the blood-retinal barrier at the pigment epithelium for blue light in the 400-500 nm rangeGraefes Arch Clin Exp Ophthalmol19616611124 SparrowJRMillerASZhouJBlue light-absorbing intraocular lens and retinal pigment epithelium protection in vitroJ Cataract Refract Surg19616611124 HamWTJrMuellerHASlineyDHRetinal sensitivity to damage from short wavelength lightNature19616611124 PollackAMarcovichABukelmanAOliverMAge-related mac-ular degeneration after extracapsular cataract extraction with intra-ocular lens implantationOphthalmology19616611124 KleinRKleinBEWongTYThe association of cataract and cataract surgery with the long-term incidence of age-related macul-opathy: the Beaver Dam eye studyArch Ophthalmol200212015518 WangJJKleinRSmithWCataract surgery and the 5-year incidence of late-stage age-related maculopathy: pooled findings from the Beaver Dam and Blue Mountains eye studiesOphthalmology19616611124 MesterUHolzFKohnenTIntraindividual comparison of a blue-light filter on visual function: AF-1 (UY) versus AF-1 (UV) intraocular lensJ Cataract Refract Surg19616611124 SchmackISchimpfMStolzenbergAVisual quality assess-ment in patients with orange-tinted blue light-filtering and clear ul-traviolet light-filtering intraocular lensesJ Cataract Refract Surg19616611124 ZhuXFZouHDYuYFComparison of blue light-filtering IOLs and UV light-filtering IOLs for cataract surgery: a meta-analysisPLoS One20127e33013 WernerLGlistenings and surface light scattering in intraocular lensesJ Cataract Refract Surg19616611124 ColinJPraudDTouboulDSchweitzerCIncidence of glisten-ings with the latest generation of yellow-tinted hydrophobic acryl-ic intraocular lensesJ Cataract Refract Surg19616611124 OshikaTShiokawaYAmanoSMitomoKInfluence of glisten-ings on the optical quality of acrylic foldable intraocular lensBr J Ophthalmol19616611124 ColinJOrignacIGlistenings on intraocular lenses in healthy eyes: effects and associationsJ Refract Surg19616611124 DhaliwalDKMamalisNOlsonRJVisual significance of glistenings seen in the AcrySof intraocular lensJ Cataract Refract Surg19616611124 BaeHWKimEKKimTISpherical aberration, contrast sensi-tivity and depth of focus with three aspherical intraocular lensesJ Korean Ophthalmol Soc19616611124 KangISYouICParkYGYoonKCComparison of visual func-tion among aspheric intraocular lensesJ Korean Ophthalmol Soc19616611124 MunGHImSKParkHYYoonKCComparison of visual func-tion between two aspheric intraocular lenses after microcoaxial cataract surgeryJ Korean Ophthalmol Soc19616611124 LeeKHYoonMHSeoKYComparisons of clinical results after implantation of three aspheric intraocular lensesJ Korean Ophthalmol Soc19616611124 KangMJHwangHBChungSKEffect of glistening-free intra-ocular lens on intraocular straylightJ Korean Ophthalmol Soc19616611124 ParkYSJiYSYoonKCComparison of clinical long-term out-comes with two types of one-piece aspheric intraocular lenses after cataract surgeryJ Korean Ophthalmol Soc19616611124 ColinJOrignacITouboulDGlistenings in a large series of hy-drophobic acrylic intraocular lensesJ Cataract Refract Surg19616611124 ChewEYSperdutoRDMiltonRCRisk of advanced age-re-lated macular degeneration after cataract surgery in the Age-Related Eye Disease Study: AREDS report 25Ophthalmology2009116297303 MainsterMATurnerPLBlue-blocking IOLs decrease photo-reception without providing significant photoprotectionSurv Ophthalmol19616611124 AppleDJMamalisNOlsonRJKincaidMCIntraocular lenses: evolution, designs, complications, and pathology1st ed.BaltimoreWilliams & Wilkins19891141 PackerMRajanMLigabueEHeinerPClinical properties of a novel, glistening-free, single-piece, hydrophobic acrylic IOLClin Ophthalmol19616611124 PackerMFryLLaveryKTSafety and effectiveness of a glistening-free single-piece hydrophobic acrylic intraocular lens (enVista)Clin Ophthalmol19616611124 HeinerPLigabueEFanALamDSafety and effectiveness of a single-piece hydrophobic acrylic intraocular lens (enVista[R]) - re-sults of a European and Asian-Pacific studyClin Ophthalmol19616611124 TurnerPLMainsterMACircadian photoreception: ageing and the eye’s important role in systemic healthBr J Ophthalmol19616611124 Tables

Patient demographics

Intraocular lens type
 p-value*
enVista TM MX60 AcrySof IQ® SN60WF
Number of eyes 44 44
OD:OS 24:20 20:24
Sex (male:female) 14:30 14:30
Mean age (years) 70.0 ± 8.6 70.0 ± 8.6
Pre OP S.E. (D) 0.55 ± 1.34 0.20 ± 1.94 0.370
UCVA (Snellen) 0.42 ± 0.17 0.46 ± 0.19 0.314
Axial length (mm) 23.23 ± 0.70 23.22 ± 0.66 0.954
Intraocular lens power (D) 21.30 ± 1.80 21.16 ± 1.70 0.716
Foveal thickness measured by OCT (μ m) 228.65 ± 24.73 229.29 ± 18.22 0.916

Values are presented as mean ± standard deviation unless otherwise indicated. Pre OP = preoperative; S.E. = spherical equivalent; D = diopter; UCVA = uncorrected distant visual acuity; OCT = optical coherence tomography.

p-value: paired sample t-test.

Refractive and visual outcomes at postoperative 1 month and 3 months

Intraocular lens type
 p-value*
enVista TM MX60 AcrySof IQ® SN60WF
Postop 1 month UCVA 0.79 ± 0.17 0.77 ± 0.15 0.427
S.E. (D) 0.00 ± 0.49 0.09 ± 0.45 0.365
Postop 3 months UCVA 0.80 ± 0.16 0.78 ± 0.17 0.696
BCVA 0.96 ± 0.08 0.94 ± 0.09 0.434
S.E. (D) -0.02 ± 0.53 0.07 ± 0.41 0.372

Values are presented as mean ± standard deviation unless otherwise indicated. Postop = postoperative; UCVA= uncorrected visual acuity (Snellen); S.E. = spherical equivalent; D = diopter; BCVA= best corrected visu-al acuity.

p-value: paired sample t-test.

Optical quality parameters measured by optical quality analysis system II® (OQAS II®) at postoperative 3 months

Intraocular lens type
 p-value*
enVista TM MX60 AcrySof IQ® SN60WF
OSI 1.28 ± 0.84 1.35 ± 1.04 0.727
MTF cut-off value 32.15 ± 9.08 31.98 ± 10.68 0.936
Strehl ratio 0.17 ± 0.05 0.16 ± 0.05 0.507
VA100 1.08 ± 0.31 1.07 ± 0.36 0.322
VA20 0.75 ± 0.25 0.74 ± 0.28 0.869
VA9 0.44 ± 0.15 0.42 ± 0.15 0.539

Values are presented as mean ± standard deviation unless otherwise indicated. OSI = objective scatter index; MTF = modulation transfer function; VA100 = optical quality of the eye for 100% contrast conditions; VA20 = optical quality of the eye for 20% contrast conditions; VA9 = optical quality of the eye for 9% contrast conditions.

p-value: paired sample t-test.

Visual field parameters measured by Humphrey field analyzer®: 24-2 SITA-Fast at postoperative 3 months

Intraocular lens type
 p-value*
enVista TM MX60 AcrySof IQ® SN60WF
MD -1.69 ± 0.89 -1.67 ± 1.08 0.945
PSD 2.16 ± 0.86 2.41 ± 1.29 0.458
Fovea threshold 35.43 ± 1.96 35.09 ± 2.07 0.596

Values are presented as mean ± standard deviation unless otherwise indicated. MD = mean deviation; PSD = pattern standard deviation.

p value: paired sample t-test.

 Figures

Blue light-filtering intraocular lens and ultraviolet (UV) light-filtering intraocular lens. The left lens is enVista TM MX60 and the right lens is AcrySof IQ® SN60WF.

Contrast sensitivity test. The contrast sensitivity measurement using CGT-2000® was compared at (A) day, (B) twilight, and (C) night. Superior column tested when glare off, inferior column tested when glare on ( p < 0.05).

Questionnaire about brightness perception at post-operative 3 months. 29 out of 44 (66%) patients answered the questionnaire.

Slit lamp examination at postoperative 3 months. Posterior capsular opacity and glistening did not develop in the (A) enVista TM MX60 (B) AcrySof IQ® SN60WF.