Contrast sensitivity and color vision with a yellow intraocular len

OBJECTIVE: To evaluate contrast sensitivity and color vision of yellow ultraviolet (UV) intraocular len (IOL) in cataract patients. DESIGN: Randomized clinical trial. METHODS: Extracapsular cataract extraction was performed in 60 senile cataract patients. The patients were randomly assigned to receive 30 yellow UV IOLs and 30 ordinary UV IOLs. Visual acuity, contrast sensitivity, and color vision were examined up to 6 months postoperatively. RESULTS: The yellow UV IOLs showed statistically significantly higher spatial contrast sensitivity than ordinary UV IOLs in the low and middle frequencies. There was no significant difference between yellow and ordinary UV IOL in color vision. Incidences of photophobia and cyanopsia were less in patients who received the yellow UV IOLs. CONCLUSIONS: Yellow UV IOLs are preferable to ordinary UV IOLs in preserving spatial contrast sensitivity and cause less photophobia and cyanopsia in the early postoperative period.     

Contrast sensitivity function in eyes with diffractive bifocal intraocular lenses

PURPOSE: To evaluate the image quality of asymmetric Acri.Twin bifocal intraocular lenses (IOLs) (Acri.Tec) by comparing distance and near black-white contrast sensitivity function with that of the Pharmacia 811E IOL. SETTING: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. METHODS: Thirty-two eyes of 16 patients were examined after contralateral implantation of 1 Acri.Twin near-weighted 733D IOL and 1 Acri.Twin distance-weighted 737D IOL. Twenty eyes in 10 patients were examined after binocular Pharmacia 811E IOL implantation. Best corrected distance and near visual acuities were determined. Individual reading distance was recorded and corrected to 40 cm for the near contrast test (Holladay Contrast Acuity Test). Distance contrast sensitivity function was evaluated using the Acuity Max (Science 2020) computer program. RESULTS: Best corrected distance visual acuity was significantly better in patients with the 737D IOL than in those with the 733D or 811E IOLs. For distance reading with best distance correction, the 733D IOL performed better than the 737D and the 811E. Individual reading distance with the Acri.Twin IOL and 811E IOL was 33.6 cm and 34.0 cm, respectively. Best distance-corrected near contrast sensitivity function was better in eyes with the near-weighted 733D IOL. Binocular testing showed a significant difference between the 2 groups only at low-contrast values. At distance, contrast sensitivity function was better with the 737D IOL, whereas no difference was found between the 733D and the 811E IOLs. Binocular contrast sensitivity function at distance revealed statistically significantly better results in the Acri.Twin group. CONCLUSION: An asymmetric diffractive bifocal lens system was advantageous in terms of vision quality when implanted binocularly and superior to monocular stronger weighted focus compared with conventional bifocal IOLs.     

Intraindividual comparison of color contrast sensitivity in patients with clear and blue-light-filtering intraocular lenses

PURPOSE: To evaluate the effect of blue-light-filtering intraocular lenses (IOLs) with a yellow chromophore on color contrast sensitivity by intraindividual comparison with an identically designed IOL without a blue-light filter. SETTING: Medical University of Vienna, Department of Ophthalmology, Vienna, Austria. METHODS: Randomized implantation of an AF-1 (UV) IOL (Hoya) in 1 eye and an AF-1 (UY) IOL (Hoya) in the contralateral eye was performed after phacoemulsification and primary posterior curvilinear capsulorhexis. Three months postoperatively, the best distance-corrected visual acuity was evaluated. Before color contrast sensitivity testing, a heterochromatic flicker test was performed in both eyes to avoid error in brightness matching. Central and peripheral tritan color contrast sensitivities were evaluated using the Moorfields Vision System (CH Electronics). RESULTS: Visual acuity did not differ significantly between the 2 IOL groups (P>.05). The central color contrast sensitivity threshold also did not differ significantly between eyes with a clear IOL and eyes with a yellow IOL at any tested spatial frequency. The peripheral color contrast sensitivity test showed slightly higher color contrast sensitivity thresholds in eyes with a yellow IOL, although the differences were not statistically significant. Two patients independently reported subjective changes in color perception in the eye with the yellow IOL. CONCLUSION: In this intraindividual comparison, the implantation of a blue-light-filtering IOL did not lead to a clinically significant change in color contrast sensitivity.     

Effect on contrast sensitivity after clear,yellow and orange intraocular lens implantation

The objective of this study is to evaluate contrast sensitivity function (CSF) after clear, yellow- and orange-tinted intraocular lens (IOL) implantation. This was a prospective randomized study of 98 patients with senile cataract for a period of 6 months from day 1 of August 2014 to day 31 of January 2015. After phacoemulsification, 33 patients were implanted with clear IOLs (AcrySof UV-filtering IOL, SA60AT), 32 patients were implanted with yellow coloured IOLs (AcrySof Natural blue-light-attenuating and UV-filtering IOL, SN60AT with IMPRUV^® filter) and 33 patients were implanted with orange-tinted blue-filtering IOLs (PC440Y Optech). After 1 month, monocular CSF was done under photopic (85 cd/m²) and mesopic (3 cd/m²) illumination condition with CSV-1000 test. The best corrected visual acuity (BCVA) after 1 month was 0.021 ± 0.058 logMAR for clear lens, 0.022 ± 0.059 logMAR for yellow lens and 0.019 ± 0.065 logMAR for orange lens (p = 0.989). Uniocular average photopic contrast sensitivity was 1.36 ± 0.19, 1.43 ± 0.18 and 1.46 ± 0.15 log units for clear lens, yellow lens and orange lens, respectively (statistically not significant; p = 0.076). Average mesopic contrast sensitivity was 1.02 ± 0.21 log units for clear lens, 1.00 ± 0.17 log units for yellow lens and 0.99 ± 0.15 log units for orange lens (statistically not significant; p = 0.771). Yellow or orange coloured blue-filtering IOLs are comparable to clear IOLs in terms of photopic and mesopic contrast sensitivity.     

Visual function in patients with yellow tinted intraocular lenses compared with vision in patients with non-tinted intraocular lenses

AIM: To compare the visual function in patients with short wavelength blue light blocking yellow tinted intraocular lenses (IOLs) with that in patients with non-tinted IOLs. METHODS: 74 patients scheduled for bilateral cataract surgery underwent implantation of either yellow IOLs (HOYA YA60BB) or non-tinted IOLs (VA60BB) in both eyes. Contrast visual acuity with and without a glare source was measured under photopic (100 cd/m2) and mesopic (slightly higher luminance than typically used-5 cd/m2) conditions at 2 weeks and 3 months after surgery using the contrast sensitivity accurate tester. Visual acuity and the incidence of patients who noted cyanopsia were also examined. RESULTS: No significant differences between the yellow tinted and non-tinted IOL groups were observed in mean visual acuity or in photopic or higher luminance mesopic contrast visual acuity with and without glare source at either 2 weeks or 3 months after surgery. Furthermore, there was no significant difference in contrast visual acuity loss as a result of glare. The incidence of patients who noticed cyanopsia was significantly less in the yellow tinted IOL group than in the non-tinted IOL group at 2 weeks after surgery (p = 0.0234), but no patients reported cyanopsia at 3 months. CONCLUSION: Visual function in patients with yellow tinted IOLs is virtually the same as that in patients with non-tinted IOLs.     

Contrast and glare sensitivity after implantation of AcrySof and Human Optics 1CU intraocular lenses

PURPOSE: To evaluate contrast and glare sensitivity of a newly developed, potentially accommodative intraocular lens. METHODS: The clinical interventional prospective randomized study included 20 patients (23 eyes) undergoing standard phacoemulsification with clear cornea incision in topical anesthesia. In the study group (10 eyes), the 1CU Human Optics intraocular lens (optics diameter 5.5 mm) was implanted. The control group (13 eyes) received the monofocal AcrySof intraocular lens (optics diameter: 6.0 mm). Using a newly developed contrast measuring device, contrast and glare sensitivity were tested 4 weeks after surgery. RESULTS: The study group and control group did not vary significantly in contrast (p=0.38) or glare sensitivity (p=0.52). CONCLUSIONS: The results suggest that the newly developed 1CU Human Optics intraocular lens and the standard AcrySof intraocular lens do not vary significantly in glare and contrast sensitivity.     

Comparison of contrast sensitivity and color discrimination after clear and yellow intraocular lens implantation

PURPOSE: To compare contrast sensitivity and color vision in patients in whom blue-light filtering and non-yellow-tinted intraocular lenses (IOLs) were implanted. SETTING: Refractive Surgery Unit, Hospital NISA Valencia al Mar, Valencia, Spain. METHODS: Forty eyes of 20 patients were enrolled in a blue-light filtering fellow-eye control study; patients were implanted with a yellow-tinted IOL (AcrySof Natural, Alcon) in 1 eye and a non-yellow-tinted IOL (AcrySof SA60AT, Alcon) in the fellow eye after cataract surgery. Three months postoperatively, monocular contrast sensitivity function was measured with the CSV 1000-E contrast sensitivity chart at distance and the color discrimination with the Farnsworth-Munsell 100 Hue test. RESULTS: Eyes implanted with blue-light filtering IOLs showed similar contrast sensitivity to that in fellow eyes implanted with non-yellow-tinted IOLs (P>.1). Both types of IOLs showed normal contrast sensitivity values (normalized log-contrast sensitivity about 1.0). There were no statistically significant differences in chromatic discrimination between the 2 types of IOLs (P = .56). CONCLUSION: The use of blue-light filtering IOLs is more advisable because they are capable of protecting the retina against ultraviolet light without disturbance of contrast sensitivity and chromatic vision, which produces subjective impairment in visual function.     

Contrast sensitivity: determining the visual quality and function of cataract, intraocular lenses and refractive surgery

PURPOSE OF REVIEW: This review provides an update of recent advances in understanding the quality and functional significance of contrast sensitivity for the clinician regarding cataract, intraocular lenses and refractive surgery that goes beyond the measurement of visual acuity. RECENT FINDINGS: New American National Standards Institute standards for contrast sensitivity based on linear sine-wave gratings are discussed that promise rapid advances of understanding and quantifying visual quality and function by unifying clinical results reported using contrast sensitivity. Increased sensitivity of linear sine-wave gratings over proposed bull's-eye radial gratings is discussed. Digital-image-processing software uses contrast sensitivity data to process images to help understand the quality of what the patient sees. Contrast sensitivity measurement is compared with wavefront aberrometry. Contrast sensitivity measures the total visual system quality in terms of contrast, whereas wavefront aberrometry measures the optical quality in terms of spatial distortion. Both measurements are needed to more fully understand the quality of vision. SUMMARY: Recent advances provide the clinician with an awareness of why the new contrast-sensitivity standards are based on linear sine-wave gratings and how image-processing software can be used to better understand the quality of functional vision of the patient.     

非球面人工晶状体植入术后对比敏感度观察

目的:评价白内障超声乳化吸除联合非球面人工晶状体(intraocularlens,IOL)植入术后对比敏感度(contrast sensitivity,CS)的变化。方法:对45例(48眼)老年性白内障患者实施超声乳化吸除联合IOL植入术,24例(25眼)植入Z9001非球面IOL(AIOL);21例(23眼)植入AR40e单焦球面IOL(SI-OL)。术后3mo应用美国Stereo Optical公司产的OPTEC 6500P视功能测试系统的对比敏感度测试包分别在空间频率为1.5,3,6,12,18cpd的昼及夜照明条件下对手术眼进行有眩光和无眩光的对比敏感度检查。所得数据进行t检验。结果:术后3mo,AIOL组在大部分空间频率下CS普遍优于SIOL组,差异有统计学意义(P<0.05),在1.5cpd有眩光昼及夜照明条件,AIOL组的CS与SIOL组无统计学差异。结论:植入Z9001非球面IOL后,提高了患者的对比敏感度,明显改善患者的视觉质量.     

Effect of a yellow intraocular lens on scotopic vision, glare disability, and blue color perception

PURPOSE: To compare the photopic and scotopic contrast sensitivity with and without glare as well as blue color perception between eyes with an AcrySof SN60AT Natural intraocular lens (IOL) (Alcon Laboratories Inc.) and eyes with a conventional AcrySof SA60AT IOL. SETTING: Ankara University School of Medicine, Department of Ophthalmology, Ankara, Turkey. METHODS: Right eyes of 38 patients with an AcrySof Natural IOL and right eyes of 38 age-matched patients with a conventional AcrySof SA60AT IOL were included in a study. Contrast sensitivity was measured with the Functional Acuity Contrast Test under photopic conditions. Scotopic contrast sensitivity in the presence or absence of glare was measured using the Mesotest II (Oculus GmbH). Blue-green color vision was evaluated with the Moreland equation of the HMC Anomaloskop MR (Oculus GmbH). RESULTS: The mean age of patients was 66.6 years +/- 8.2 (SD) in the Natural IOL group and 66.4 +/- 8.0 years in the conventional IOL group. There was no statistically significant difference in photopic contrast sensitivity, scotopic contrast sensitivity with and without glare, or disability glare between the 2 groups (P>.05). Photopic and scotopic contrast sensitivity with and without glare significantly decreased with age in both groups (P<.01). There was no statistically significant difference in anomaloscope scores between the 2 groups (P>.05). The Moreland middle match point showed a significant shift toward blue with age in both groups (P<.01). CONCLUSIONS: The AcrySof SN60AT Natural IOL provided contrast sensitivity under photopic and scotopic conditions (with and without glare) and blue color perception comparable that obtained with the AcrySof SA60AT IOL. Scotopic vision and blue color discrimination decreased with age with both IOLs.     

Scotopic sensitivity and color vision with a blue-light-absorbing intraocular lens

PURPOSE: To investigate possible adverse effects of a yellow-tinted intraocular lens (IOL) on scotopic sensitivity and hue discrimination. SETTING: Departments of Ophthalmology, Columbia University and New York University School of Medicine, New York, New York, USA. METHODS: Nine patients with a yellow-tinted IOL in 1 eye and a colorless ultraviolet IOL in the fellow eye and 9 young phakic subjects with and without a yellow-tinted clip-on lens were tested. Hue discrimination was measured with the Farnsworth-Munsell (FM) 100-hue test. Dark-adapted thresholds to 440 nm, 500 nm, and 650 nm lights were measured at 23 locations using a modified Humphrey perimeter, and dark-adapted thresholds to white light were measured at 15 degrees temporal retina. RESULTS: In the 9 patients, there were no significant differences in dark-adapted sensitivities to 440, 500, 650 nm, or white-light stimuli and no differences in FM 100-hue error scores between eyes with yellow-tinted IOLs and those with colorless IOLs. Similarly, in young phakic subjects, there were no significant differences in FM 100-hue error scores or dark-adapted sensitivity to the white light with and without the yellow-tinted clip-on lens. However, with the clip-on lens, mean sensitivities to the 440 nm, 500 nm, and 650 nm stimuli were significantly decreased by 2.7 to 2.8 dB, 0.7 to 1.0 dB, and 0 to 1.2 dB, respectively. CONCLUSION: Results suggest that implantation of a yellow-tinted IOL has non-significant effect on scotopic sensitivity and hue discrimination.     

Contrast sensitivity in patients with posterior chamber intraocular lens implants

Divergent contrast sensitivity findings have been reported in patients with intraocular lens implants. In this study, contrast sensitivity to stationary sine-wave gratings of six spatial frequencies from 0.5 to 22.8 cycles/degree was measured psychophysically in 13 patients with posterior chamber intraocular lens implants and in 10 controls. Corrected visual acuity was 0.7 to 1.0 in the intraocular lens group and 0.9 to 1.0 in the reference group. The age, the pupil diameter and the rate of subtle age-related macular changes were equal in the two groups. No statistically significant difference in mean contrast sensitivity between the patients and the controls was observed at any spatial frequency examined.     

Contrast sensitivity and higher order aberrations in eyes implanted with AcrySof IQ SN60WF and AcrySof SN60AT intraocular lenses

PURPOSE: To evaluate the efficacy of the aspheric optic of the AcrySof IQ SN60WF intraocular lens (IOL) in decreasing spherical and total higher order aberrations and improving contrast sensitivity after cataract surgery compared to the spheric AcrySof SN60AT. METHODS: Fifty-two eyes of 36 patients were evaluated at the University of Texas Southwestern Medical Center at Dallas 3 to 6 months after phacoemulsification with implantation of the AcrySof IQ SN60WF (27 eyes) or AcrySof SN60AT (25 eyes) IOL. Eyes with previous surgery or ocular pathology were excluded. RESULTS: Eyes implanted with the AcrySof IQ SN60WF had less total higher order and spherical aberrations than AcrySof SN60AT-implanted eyes at pupils of 4 mm (0.14+/-60.06 vs 0.18+/-0.04 microm and -0.01+/-0.03 vs 0.09+/-0.03 microm, respectively), 5 mm (0.24+/-0.07 vs 0.34+/-0.08 microm and 0.03+/-0.02 vs 0.23+/-0.08 microm, respectively), and 6 mm (0.42+/-0.13 vs 0.67+/-0.12 microm and 0.08+/-0.04 and 0.46+/-0.09 microm, respectively), (P<.05 for all), with similar mean coma, trefoil, and 5th order aberrations. AcrySof SN60WF eyes showed better contrast sensitivity than AcrySof SN60AT eyes at 12 and 18 cycles per degree (cpd) under mesopic conditions (1.65+/-0.23 vs 1.51+/-0.25 and 1.22+/-0.21 vs 1.01+/-0.19, respectively), and at 18 cpd under glare (1.12+/-0.30 vs 0.87+/-0.31, respectively) (P<.05). Photopic contrast sensitivity was similar in both groups. The two groups had comparable mean age, axial length, IOL power, and postoperative mesopic and photopic pupil sizes. CONCLUSIONS: Compared to a spheric optic, the aspheric design of the AcrySof IQ SN60WF reduces spherical aberration, especially under larger pupil sizes, and improves mesopic contrast sensitivity at higher frequencies with and without glare.     

Aurium变色人工晶状体植入术后对比敏感度和眩光对比敏感度的研究

目的 研究Aurium变色人工晶状体对术后对比敏感度和眩光对比敏感度的影响.方法 临床病例系列对比研究.选取2010年8月至2011年4月在南昌大学第二附属医院眼科就诊的白内障超声乳化联合人工晶状体植入术后患者,且随访资料完整的病例70例(眼),其中37例为Aurium (model400)变色人工晶状体组,33例为黄色蓝光滤过型IQ (SN60WF)人工晶状体组.观察患者术后3个月时的裸眼视力(UCVA),最佳矫正视力(BCVA),对比敏感度(CS)和眩光对比敏感度(GS).结果 二组患者术后3个月时的裸眼视力和最佳矫正视力差异均无统计学意义(P＞0.05).Aurium组和IQ组在明适应、明适应眩光、暗适应条件下,两组之间的对比敏感度和眩光对比敏感度差异无统计学意义(P＞0.05),在暗适应眩光条件下Aurium组的眩光对比敏感度(空间频率3 cpd、6 cpd)要优于黄色蓝光滤过型IQ组,差异有统计学意义(P＜0.05).结论 植入Aurium变色人工晶状体术后患者的视力与黄色蓝光滤过型IQ人工晶状体的视力差异无统计学意义.Aurium变色人工晶状体在暗适应眩光条件下,空间频率(3 cpd、6 cpd)的眩光对比敏感度要优于黄色蓝光滤过型IQ人工晶状体.     

白内障超声乳化人工晶状体植入术后对比敏感度与眩光对比敏感度变化分析

目的 分析白内障超声乳化人工晶状体植入术后对比敏感度与眩光对比敏感度变化.方法 选取我院2009年1月至2010年6月行超声乳化人工晶状体植入术的白内障患者45例(60眼),术后随访1～6个月,平均3.5个月.观察患者术前及术后随访末期BCVA,并于术前及术后1个月检测患者对比敏感度和眩光对比敏感度.结果 患者术后BCVA较术前显著提高,差异有统计学意义(P＜0.05).明视无眩光及明视眩光条件下,患者术后各空间频率下的对比敏感度及眩光对比敏感度较术前均明显提高,差异均有显著统计学意义(均为P＜0.01).暗视无眩光及暗视眩光条件下,除高空间频率(18.0c·d-1)外,患者术后其他空间频率下的对比敏感度及眩光对比敏感度较术前均明显提高,差异均有显著统计学意义(均为P ＜0.01).明视及暗视条件下,眩光对于患者术前、术后高空间频率(12.0 c·d-1、18.0c·d-1)下的对比敏感度均无明显影响(P＞0.05),但对术前、术后其他空间频率下的对比敏感度均有明显影响(P＜0.01).与暗视眩光条件相比,明视眩光条件下的患者术前、术后各空间频率对眩光比敏感度均较高,差异均有统计学意义(均为P ＜0.05).结论 对比敏感度及眩光对比敏感度检查可以作为白内障患者更客观有效的视功能检查方法.     

Contrast transfer ratio in normal,cataractous, and intraocular implant lenses

In order to clinically evaluate the optical performance of the crystalline lens as well as that of intraocular implant lenses, measurements were made of the brightness of two markedly different and easily sited landmarks on the retina (the papilla and the macula) using the photopapillometer. The contrast transfer ratio (CTR) thus generated permitted investigation of three groups of subjects: 1. Normal persons (n = 53) with visual acuity of 1.0 (20/20) from each mature decade of life provided values indicating the age-related changes in eyes not necessarily tending toward lens opacification. Relatively constant CTR values (approximately 2:1) were observed up to 60 years, after which the ratio fell significantly to about 1.5:1 (ranging from 1.41:1 to 1.68:1, depending on the site measured on the papilla). Such a finding in subjects with normal vision was considered to demonstrate the tendency for older lenses to become yellow, which would reduce the CTR.2. Patients (n = 33) who were being followed clinically for developing lens opacification had their CTRs measured for correlation with their visual acuities. Here, strong correlation (P < 0.001) was observed.3. Evaluation of the improvement wrought by the implantation of an intraocular lens in yet another group of patients (n = 38) revealed an increase in the CTR to a virtually normal level (1.97:1). This method provides information about the actual optical efficiency of the lens when the other ocular media are clear, supplementing other methods for evaluating lens density and clarity, and thus further facilitating critical assessment of the progress of lens opacification.