Mainster M A, Sparrow J R
Department of Ophthalmology, University of Kansas Medical School, Kansas City, KS 66160-7379, USA.
Br J Ophthalmol. 2003 Dec;87(12):1523-9. doi: 10.1136/bjo.87.12.1523.
Older, and even some modern, intraocular lenses (IOLs) transmit potentially hazardous ultraviolet radiation (UVR) to the retina. In addition, IOLs transmit more blue and green light to the retina for scotopic vision than the crystalline lenses they replace, light that is also potentially hazardous. The severity of UVR-blue type phototoxicity increases with decreasing wavelength, unlike the action spectrum of blue-green type retinal phototoxicity and the luminous efficiency of scotopic vision which both peak in the blue-green part of the optical spectrum around 500 nm. Theoretically, UVR+blue absorbing IOLs provide better retinal protection but worse scotopic sensitivity than UVR-only absorbing IOLs, but further study is needed to test this analysis. UVR is potentially hazardous and not useful for vision, so it is prudent to protect the retina from it with chromophores in IOLs. Determining authoritatively how much blue light an optimal IOL should block requires definitive studies to determine (1) the action spectrum of the retinal phototoxicity potentially involved in human retinal ageing, and (2) the amount of shorter wavelength blue light required for older adults to perform essential activities in dimly lit environments.
较老式的甚至一些现代的人工晶状体(IOL)会将潜在有害的紫外线(UVR)传输至视网膜。此外,与它们所替代的晶状体相比,人工晶状体在暗视觉时会向视网膜传输更多的蓝光和绿光,而这些光也具有潜在危害。UVR - 蓝光型光毒性的严重程度随波长减小而增加,这与蓝绿光型视网膜光毒性的作用光谱以及暗视觉的发光效率不同,后两者在光谱的蓝绿部分约500纳米处达到峰值。从理论上讲,与仅吸收UVR的人工晶状体相比,吸收UVR + 蓝光的人工晶状体能提供更好的视网膜保护,但暗视觉敏感度更差,不过还需要进一步研究来验证这一分析。UVR具有潜在危害且对视力无用,所以在人工晶状体中使用发色团来保护视网膜是谨慎之举。要权威地确定最佳人工晶状体应阻挡多少蓝光,需要进行确定性研究以确定:(1)可能与人类视网膜衰老相关的视网膜光毒性的作用光谱;(2)老年人在昏暗环境中进行基本活动所需的较短波长蓝光量。