April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
The effect of neutral and blue-blocking intraocular lenses on circadian photoentrainment
Author Affiliations & Notes
  • Adam Elias Brondsted
    Dept. of Ophthalmology, Glostrup Hospital, Glostrup, Denmark
    Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
  • Birgitte Haargaard
    Dept. of Ophthalmology, Glostrup Hospital, Glostrup, Denmark
    Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
  • Birgit A Sander
    Dept. of Ophthalmology, Glostrup Hospital, Glostrup, Denmark
  • Henrik Lund-Andersen
    Dept. of Ophthalmology, Glostrup Hospital, Glostrup, Denmark
    Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
  • Poul Jennum
    Danish Center for Sleep Medicine, Dept. of Clinical Neurophysiology, Glostrup Hospital, Glostrup, Denmark
    Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
  • Steen Gammeltoft
    Dept. for Clinical Biochemistry, Glostrup Hospital, Glostrup, Denmark
  • Line Kessel
    Dept. of Ophthalmology, Glostrup Hospital, Glostrup, Denmark
    Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
  • Footnotes
    Commercial Relationships Adam Elias Brondsted, None; Birgitte Haargaard, None; Birgit Sander, None; Henrik Lund-Andersen, None; Poul Jennum, None; Steen Gammeltoft, None; Line Kessel, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 4184. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Adam Elias Brondsted, Birgitte Haargaard, Birgit A Sander, Henrik Lund-Andersen, Poul Jennum, Steen Gammeltoft, Line Kessel; The effect of neutral and blue-blocking intraocular lenses on circadian photoentrainment. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4184.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose: The intrinsically photosensitive retinal ganglion cells (ipRGCs) require blue light for the photoentrainment of the circadian rhythm. Blue light is absorbed by the cataractous lens and, to a lesser degree, by blue-blocking intraocular lenses (IOLs). The CIRCAT study is a randomized clinical trial aimed at evaluating the effect of cataract surgery and comparing the effect of blue-blocking and neutral IOLs on circadian photoentrainment. Data is presented from the interim analysis including 42 patients.

Methods: Patients with cataract and no other significant diseases were included and randomized to neutral or blue-blocking IOL implant. Examinations were performed before 2 days 3 weeks and 1 year after cataract surgery. Stimulation of ipRGC was determined by short wavelength chromatic pupillometry using the consensual postillumination pupil reaction (PIPR). The circadian rhythm was assessed by direct activity measurements (actigraphy) and by questionnaires (Pittsburg Sleep Quality Index & and Morningness Eveningness Questionnaire).

Results: The PIPR increased significantly at 2 days (P=0.031) and 3 weeks (P=0.001) after surgery, but returned to baseline 1 year after (P=0.21). No effect of IOL type was found (P=0.53) Sleep efficiency measured with actigraphy did not change significantly in the neutral IOL group (P=0.13) but increased by 6.16 percentage points 1 year after surgery in the blue-blocking IOL group (P=0.012). The questionnaires revealed that IOL type affected the outcome at 1 year significantly (P=0.003 / P=0.021) leading to an increase in self-evaluated sleep quality (1.83 PSQI points) in the blue-blocking group and to a slight shift from “evening” to “morning type”.

Conclusions: We found that cataract surgery increased the PIPR to blue light suggesting an increased potential for circadian photoentrainment. However, 1 year after surgery the PIPR was back to preoperative levels. Adaptation in the circadian photoentrainment system may explain why the pupil reaction returns to baseline. Surprisingly, we also found an improvement in sleep quality associated with a relative shift in circadian type in the blue-blocking IOL treatment group. This suggests, that the adaptational mechanism is optimized for physiological lens yellowing and that the blue-blocking IOLs may protect the circadian photoetrianment system from inappropriately timed blue light (eg. television etc).

Keywords: 458 circadian rhythms • 445 cataract • 668 pupillary reflex  
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×