The effect of blue-blocking and neutral intraocular lenses on circadian photoentrainment and sleep one year after cataract surgery

Adam Elias Brøndsted; Birgitte Haargaard; Birgit Sander; Henrik Lund-Andersen; Poul Jennum; Line Kessel

doi:10.1111/aos.13323

The effect of blue-blocking and neutral intraocular lenses on circadian photoentrainment and sleep one year after cataract surgery

Adam Elias Brøndsted, Birgitte Haargaard, Birgit Sander, Henrik Lund-Andersen, Poul Jennum, Line Kessel

Department of Clinical Medicine

14 Citations (Scopus)

Abstract

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.

Original language	English
Journal	Acta Ophthalmologica
Volume	95
Issue number	4
Pages (from-to)	344-351
ISSN	1755-375X
DOIs	https://doi.org/10.1111/aos.13323
Publication status	Published - Jun 2017

Keywords

Aged
Cataract Extraction
Circadian Rhythm/physiology
Double-Blind Method
Female
Follow-Up Studies
Humans
Lenses, Intraocular
Light
Male
Middle Aged
Postoperative Period
Prosthesis Design
Pseudophakia/physiopathology
Sleep/physiology

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title = "The effect of blue-blocking and neutral intraocular lenses on circadian photoentrainment and sleep one year after cataract surgery",

abstract = "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.",

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author = "Br{\o}ndsted, {Adam Elias} and Birgitte Haargaard and Birgit Sander and Henrik Lund-Andersen and Poul Jennum and Line Kessel",

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language = "English",

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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

PY - 2017/6

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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.

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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

SN - 1755-375X

VL - 95

SP - 344

EP - 351

JO - Acta Ophthalmologica

JF - Acta Ophthalmologica

IS - 4

ER -

The effect of blue-blocking and neutral intraocular lenses on circadian photoentrainment and sleep one year after cataract surgery

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Keywords

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