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J. M. Nolan, P. O'Reilly, J. Loughman, E. Loane, E. E. Connolly, J. Stack, S. Beatty; Macular Pigment Levels Increase Following Blue-Light Filtering Intraocular Lens Implantation. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1721.
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Photo-oxidative stress is believed to play a role in AMD pathogenesis. Macular pigment (MP), consisting of lutein (L), zeaxanthin (Z) and meso-Z, has a max absorption at 460nm and protects the retina from photo-oxidative injury. We investigated whether the blue light filtering properties of the Alcon AcrySof Natural intraocular lens (ANIOL) implanted during cataract surgery impacts on MP optical density (MPOD).
44 patients scheduled for cataract surgery were recruited. All patients had pre-op best corrected visual acuity (BCVA) of at least 0.5logMAR in the study eye. Patients were randomised to have either the standard Alcon AcrySof 3-piece acrylic intraocular lens (AIOL) or the ANIOL. Spatial profile of MPOD was measured by customised heterochromatic flicker photometry (cHFP) 1 week pre-op and 1 week post-op, and at 3, 6 and 12 months post-op. Serum concentrations of L and Z were measured at each visit.
There was a significant positive correlation between MPOD values at 0.25deg recorded 1 week pre- and post-op in eyes implanted with an AIOL (r=0.915,p<0.01;paired samples t-test:p=0.631) and in those implanted with an ANIOL (r=0.868,p<0.05;paired samples t-test:p=0.719). MPOD increased significantly after 3 months in the ANIOL group (p<0.05). There was a significant time effect for serum Z over the study period (p<0.05).
cHFP can reliably measure MPOD spatial profile in the presence of cataract, and cataract surgery does not artefactually alter MPOD readings. This study provides evidence that implanting a blue-light filtering IOL is associated with augmentation of MPOD in the absence of raised serum L and Z concentrations, consistent with the view that filtering blue light limits photo-oxidative retinal injury, and a consequential depletion of MP. However, further study is required to assess whether these findings are associated with a reduced risk of AMD.
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