Associated depression in pseudophakic patients with intraocular lens with and without chromophore

Abstract

BackgroundWith aging, the crystalline lens turns yellowish, which increases the absorption of wavelengths in the blue electromagnetic spectrum, reducing their photoreception in the retina. Since these wavelengths are the main stimulus in the regulation of the circadian rhythm, progressive reduction in their transmission is associated with chronic sleep disturbances and depression in elderly patients. Cataract extraction improves circadian photoreception at any age. However, lenses that block blue waves have 27% to 38% less melatonin suppression than lenses that block only ultraviolet (UV) rays.PurposeTo assess the depression symptoms in subjects who have had bilateral phacoemul-sification and intraocular lens (IOL) implants, one group with yellow chromophore IOLs and the other group with transparent IOLs were compared.SettingAssociation to Prevent Blindness in Mexico (APEC), Hospital “Dr Luis Sánchez Bulnes”.DesignThis was an observational, cross-sectional, and single-center study.Materials and methodsTwenty-six subjects between 60 and 80 years of age, with a history of bilateral phacoemulsification and placement of the same type of IOL in both eyes from 4 to 12 months prior to the study, who attended the follow-up visits and agreed to participate in this study, and provided signed informed consent were included in the study. They were asked to answer the short version of the 15-item Geriatric Depression Scale.ResultsThe average age of the study participants was 72.5±5.94 years. The group without chromophore included 46.1% (n=12) of the patients and the group with chromophore included 53.9% (n=14) of the patients (P=0.088).ConclusionIn the group of patients with IOLs that block the passage of blue light, the depression rate was 21.4%, a rate similar to that observed in the elderly population, whereas no patients in the group with transparent IOLs had depression.

Association between conventional or blue-light-filtering intraocular lenses and survival in bilateral cataract surgery patients

“…In contrast, more recent studies note that the biological effects of cataract surgery may be dependent upon the transmission properties of IOL. Older patients receiving conventional IOL exhibited improved cognitive function and increased slow-wave sleep ( Chellappa et al., 2019 ) and reduced parameters of depression ( Mendoza-Mendieta and Lorenzo-Mejia, 2016 ) and mood disorders ( Zambrowski et al., 2018 ) compared with those implanted with BF-IOL ( Ayaki et al., 2015 ). In a randomized study comparing the long-term effects of type of IOL, the only durable difference was that blue blocking IOLs increased sleep efficiency ( Brondsted et al., 2015 , 2017 ).…”

Protector Role of Intraocular Lenses under Artificial Light Conditions

“…The results of various studies of the use of blue-filtering IOLs suggest that they do not provide protection to the retina, and in addition, they have certain disadvantages in terms of their affecting the quality of vision, especially in mesopic and/or scotopic conditions [46]. In addition, they have been linked with changes to circadian rhythms [26, 47] and depression [25]. However, other authors have demonstrated the protective capacity of blue-filtering IOLs.…”

“…Some authors indicate that using UV/blue-filtering IOLs causes quality of vision impairment [23] or have not detected protective effects after implantation [24]. Conversely, other authors report that the use of UV/blue-filtering IOLs was useful in retinal protection [25]. Here, we show the first in vitro study analyzing a large number of IOL models in a controlled environment to elucidate the erratic effect of the use of UV/blue-filtering IOLs.…”

Clinical Photic Retinopathy: Mechanisms, Manifestations, and Misperceptions

“…Older adults need more light than younger ones for the same ocular transmittance because of age-related pupillary miosis, progressive photoreceptor loss, and the indoor illumination lifestyle of many elderly individuals [29,54,343,354,355]. The potential health benefits of cataract surgery's improvement of blue light-dependent retinal ganglion photoreception were identified over a decade ago [54,354,355] and confirmed in more recent studies on pseudophakic depression [356], longevity [357], cognition [358,359], and sleep [359,360].…”