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Yellow Intraocular Lenses – To Block or Not to Block
There are no studies showing a statistically significant influence of night to transmit as much blue light as possible to the retina for
yellow IOLs on colour discrimination using the Farnsworth-Munsell optimal scotopic vision. However, a study with inter-individual
D-15, Farnsworth Munsel 100-hue and Lanthony desaturated D-15 comparison from the authors’ group comparing patients with
test. However, Mester et al. reported some colour disturbance in the phototropic IOLs versus those with clear or yellow Hoya IOLs did not
early, but not in the late, clinical follow-up period.
29
Some patients do show any clinically or statistically significant difference between the
notice a difference if a yellow IOL is implanted in one eye and a clear patients in terms of best corrected spectacle visual acuity, photopic
IOL in the other,
28,33
but the difference between the patient groups and mesopic contrast sensitivity or colour discrimination.
37
was not statistically significant. Kara-Junior et al. also studied the
effect of yellow IOLs on blue–yellow perimetry and did not find any Conclusion
statistically significant difference in a study with intra-individual Published data on yellow-tinted IOLs do not provide any clear clinical
comparison. There is only one report of a patient’s intolerance for evidence at the moment that implantation of these IOLs is superior to
mixed implantation of yellow and clear IOLs requiring an IOL clear UV-blocking IOLs in reducing the incidence of AMD in
exchange.
34,35
A statistically significant difference in terms of colour pseudophakic patients, but this might be a potential advantage.
discrimination has therefore not yet been shown in the literature; Clinical data do not show any clear disadvantage on visual
however, a mixed implantation in patients should be avoided, performance with these IOLs. Therefore, even though there are few
especially in patients with colour-sensitive professions, e.g. studies showing some loss of contrast sensitivity under mesopic
photographer, flower seller, painter, etc. condition, it is questionable whether this is of clinical relevance. n
The literature is not conclusive in terms of mesopic and scotopic
Elfriede Wenzl is a Resident in the Department of
contrast sensitivity. However, clinical trials in general do not show any
Ophthalmology at Medical University Graz. Her
clinically significant differnce in terms of mesopic contrast sensitivity research focus lies in the anterior segment of the eye,
between clear and yellow-tinted IOLs. Whereas few studies with intra-
especially cataract and refractive surgery. She is a
member of the Austrian and German Society of
and inter-individual analysis showed a trend towards better mesopic
Ophthalmology and the European Society of Cataract
contrast sensitivity with clear IOLs,
28,29,36
other studies did not show and Refractive Surgery (ESCRS).
any statistically significant difference at all,
27,30
which is also the
experience of the authors.
27
However, these studies are poorly
comparable, since different tests were used to examine contrast
Matthias G Wirtitsch is a Resident in the Department
of Ophthalmology at Hietzing Hospital in Vienna. He is
sensitivity. Illumination was 85cd/m
2
, 3cd/m
2
and <1cd/m
2
in most of also conducting research in the Department of
the studies. A second problem in comparing the published studies lies
Ophthalmology at Medical University Graz, where his
in the IOL power implanted. Whereas Rodriguez-Galietero et al.
interests are focused on light filters in intraocular
lenses and their influence on colour perception and
included patients in the study only if they had an IOL power of +21.00 contrast vision.
to +22.5D,
30,32
other studies report on IOLs implanted between +10 and
+ 30D.
29
However, the transmittance capacity of the IOLs also depends
Navid Ardjomand is a Consultant Ophthalmic Surgeon
on the IOL power, and the published data are given for a +21D IOL.
23
at the University Hospital Graz and an Associate
Professor of Ophthalmology at Medical University
To overcome the eventual mesopic and scotopic problem with yellow
Graz. He is a member of several societies, including
the European Society of Cataract and Refractive
IOLs, Medennium Company in the US developed a phototropic IOL
Surgery (ESCRS) and the Association for Research in
that is clear in the absence of UV radiation and turns yellow in the Vision and Ophthalmology (ARVO).
presence of UV light. This system should provide optimal protection
from short-wavelength blue light during the day and turns clear at
1. Ham WT, Jr., Mueller HA, Ruffolo JJ, Jr., et al., Photochem 2004;30:873–8. 26. Boettner E, Wolter J, Invest Ophthalmol, 1962;1:776–83.
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Ophthalmol Vis Sci, 1978;17:1029–35. Ophthalmol, 2008;246:671–6. Ophthalmology, 2009;116:39–45.
4. Heinermann PH, Exp Biol, 1984;43:127–47. 16. Klein R, Klein BE, Jensen SC, et al., Arch Ophthalmol, 29. Mester U, Holz F, Kohnen T, et al., J Cataract Refract Surg,
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6. Sivak JG, Bobier WR, Am J Optom Physiol Opt, 1978;55:813–17. 17. Mitchell P, Wang JJ, Foran S, et al., Ophthalmology, 30. Rodríguez-Galietero A, Montés-Micó R, Muñoz G, et al.,
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EUROPEAN OPHTHALMIC REVIEW 79
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