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The effect of blue‐blocking and neutral intraocular lenses on circadian photoentrainment and sleep one year after cataract surgery
Author(s) -
Brøndsted Adam Elias,
Haargaard Birgitte,
Sander Birgit,
LundAndersen Henrik,
Jennum Poul,
Kessel Line
Publication year - 2017
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.13323
Subject(s) - medicine , cataract surgery , actigraphy , circadian rhythm , intraocular lens , ophthalmology , melatonin , pittsburgh sleep quality index , anesthesia , sleep quality , pharmacology , insomnia
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 (ip RGC ) 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 IOL s compared with participants allocated to neutral IOL s. Compared with preoperative levels, the ip RGC 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 IOL s. Conclusion Blue‐blocking IOL s increased sleep efficiency but lowered nocturnal melatonin secretion compared with neutral IOL s. Cataract surgery improved the response of ip RGC s and sleep quality. However, the effect of cataract surgery on sleep quality may be unrelated to circadian photoentrainment.