The effect of blue-blocking and neutral intraocular lenses on circadian photoentrainment and sleep one year after cataract surgery
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The effect of blue-blocking and neutral intraocular lenses on circadian photoentrainment and sleep one year after cataract surgery. / Brøndsted, Adam Elias; Haargaard, Birgitte; Sander, Birgit; Lund-Andersen, Henrik; Jennum, Poul; Kessel, Line.
In: Acta Ophthalmologica, Vol. 95, No. 4, 2017, p. 344-351.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - The effect of blue-blocking and neutral intraocular lenses on circadian photoentrainment and sleep one year after cataract surgery
AU - Brøndsted, Adam Elias
AU - Haargaard, Birgitte
AU - Sander, Birgit
AU - Lund-Andersen, Henrik
AU - Jennum, Poul
AU - Kessel, Line
N1 - © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
PY - 2017
Y1 - 2017
N2 - PURPOSE: To compare the long-term effect on circadian photoentrainment and sleep in patients implanted with neutral and blue-blocking intraocular lenses 1 year after cataract surgery.METHODS: Randomized, controlled trial involving 67 patients with age-related cataract. Intervention was cataract surgery with implantation of either a neutral or a blue-blocking intraocular lens (IOL). Main outcome was activation of the intrinsically photosensitive retinal ganglion cells (ipRGC) measured by chromatic pupillometry. The circadian rhythm was analysed by 24-hr melatonin profiles and actigraphy; the latter was also used to determine objective sleep quality. The Pittsburgh Sleep Quality Index determined subjective sleep quality.RESULTS: One year after surgery, peak melatonin concentration was 3.3 pg/ml (95% CI, 2-5.5) corresponding to 50% lower for the participants allocated to blue-blocking IOLs compared with participants allocated to neutral IOLs. Compared with preoperative levels, the ipRGC response had increased by 13.7% (95% confidence interval [CI], 3.2-22.6) 1 year after surgery. Objective sleep quality was also improved as the time of wakefulness after sleep onset had improved by 5 min (95% CI, 1-10) for the entire population while sleep efficiency had increased by two percentage points (95% CI, 0.42-3.65) although exclusively, for the participants allocated to blue-blocking IOLs.CONCLUSION: Blue-blocking IOLs increased sleep efficiency but lowered nocturnal melatonin secretion compared with neutral IOLs. Cataract surgery improved the response of ipRGCs and sleep quality. However, the effect of cataract surgery on sleep quality may be unrelated to circadian photoentrainment.
AB - PURPOSE: To compare the long-term effect on circadian photoentrainment and sleep in patients implanted with neutral and blue-blocking intraocular lenses 1 year after cataract surgery.METHODS: Randomized, controlled trial involving 67 patients with age-related cataract. Intervention was cataract surgery with implantation of either a neutral or a blue-blocking intraocular lens (IOL). Main outcome was activation of the intrinsically photosensitive retinal ganglion cells (ipRGC) measured by chromatic pupillometry. The circadian rhythm was analysed by 24-hr melatonin profiles and actigraphy; the latter was also used to determine objective sleep quality. The Pittsburgh Sleep Quality Index determined subjective sleep quality.RESULTS: One year after surgery, peak melatonin concentration was 3.3 pg/ml (95% CI, 2-5.5) corresponding to 50% lower for the participants allocated to blue-blocking IOLs compared with participants allocated to neutral IOLs. Compared with preoperative levels, the ipRGC response had increased by 13.7% (95% confidence interval [CI], 3.2-22.6) 1 year after surgery. Objective sleep quality was also improved as the time of wakefulness after sleep onset had improved by 5 min (95% CI, 1-10) for the entire population while sleep efficiency had increased by two percentage points (95% CI, 0.42-3.65) although exclusively, for the participants allocated to blue-blocking IOLs.CONCLUSION: Blue-blocking IOLs increased sleep efficiency but lowered nocturnal melatonin secretion compared with neutral IOLs. Cataract surgery improved the response of ipRGCs and sleep quality. However, the effect of cataract surgery on sleep quality may be unrelated to circadian photoentrainment.
KW - Aged
KW - Cataract Extraction
KW - Circadian Rhythm/physiology
KW - Double-Blind Method
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Lenses, Intraocular
KW - Light
KW - Male
KW - Middle Aged
KW - Postoperative Period
KW - Prosthesis Design
KW - Pseudophakia/physiopathology
KW - Sleep/physiology
U2 - 10.1111/aos.13323
DO - 10.1111/aos.13323
M3 - Journal article
C2 - 27966269
VL - 95
SP - 344
EP - 351
JO - Acta Ophthalmologica
JF - Acta Ophthalmologica
SN - 1755-375X
IS - 4
ER -
ID: 194041631