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白内障手术中紫外线吸收及额外蓝光滤过人工晶状体在不同光照条件下的视觉舒适度和心理负荷评估

Evaluation of Visual Comfort and Mental Effort Under Different Light Conditions for Ultraviolet-Absorbing and Additional Blue-Filtering Intraocular Lenses for Cataract Surgery.

作者信息

Steinemann Alexandra, Bromundt Vivien, Chellappa Sarah L, Frey Sylvia, Schmidt Christina, Schlote Torsten, Goldblum David, Cajochen Christian

机构信息

Augenklinik, Universitätsspital Basel, Basel, Switzerland.

Chronobiologie, Inselspital Universitätsspital Bern, Bern, Switzerland.

出版信息

Klin Monbl Augenheilkd. 2019 Apr;236(4):398-404. doi: 10.1055/a-0810-0302. Epub 2019 Jan 7.

Abstract

PATIENTS AND METHODS

Patients with an ultraviolet blocking lens (UV) (n = 5) or blue filter lens (BB) (n = 8) after intraocular lens (IOL) replacement for cataract and age-adjusted controls (AACs) (n = 16) underwent a balanced crossover within-subject design. After 1.5 h of dark adaptation, they were exposed to polychromatic light at 6500 K (blue-enriched) and 2500 K and 3000 K (non-blue-enriched) for 2 hours in the evening. Visual comfort and mental effort were repeatedly assessed by the Visual Analogue Scale (0 - 100) and the Visual Comfort and Mental Effort Rating Scale (0 - 100) for each light condition. The results were compared using mixed model analysis.

RESULTS

The mean (± SD) age for AAC and patients with UV or BB was 69.8 ± 6.2 y, 70.8 ± 4 y, and 63.6 ± 5.6 y, respectively. Irrespective of the light condition, patients with UV and BB felt mentally more tired during the experiments compared to AACs (F = 6.15, p = 0.003). However, patients with BB were mentally more motivated to perform the exercises compared to patients with UV and AACs (F = 8.1, p < 0.001). Patients with BB perceived ambient light as less glary (F = 4.71, p = 0.01) than patients with UV. Blue ambient light was felt less intensely in patients with BB (F = 2.51, p = 0.042) compared to those with UV and the AACs.

CONCLUSION

Lens replacement in older cataract patients may increase visual comfort and minimize mental effort. While subtle, the magnitude of these effects may depend on the type of intraocular lens. BB intraocular lenses may have potential benefits, as ambient light is perceived as having less glare and less visual tension.

摘要

患者与方法

白内障人工晶状体(IOL)置换术后佩戴紫外线阻挡镜片(UV)(n = 5)或蓝光滤过镜片(BB)(n = 8)的患者以及年龄匹配的对照组(AACs)(n = 16)接受了平衡交叉的受试者内设计。在进行1.5小时的暗适应后,他们于傍晚时分暴露于6500K(富含蓝光)、2500K和3000K(非富含蓝光)的多色光下2小时。针对每种光照条件,通过视觉模拟量表(0 - 100)和视觉舒适度与精神努力程度评定量表(0 - 100)反复评估视觉舒适度和精神努力程度。使用混合模型分析对结果进行比较。

结果

AAC组以及佩戴UV或BB镜片的患者的平均(±标准差)年龄分别为69.8 ± 6.2岁、70.8 ± 4岁和63.6 ± 5.6岁。无论光照条件如何,与AACs相比,佩戴UV和BB镜片的患者在实验过程中感觉精神上更疲惫(F = 6.15,p = 0.003)。然而,与佩戴UV镜片的患者和AACs相比,佩戴BB镜片的患者在精神上更有动力进行这些活动(F = 8.1,p < 0.001)。与佩戴UV镜片的患者相比,佩戴BB镜片的患者感觉环境光的眩光更少(F = 4.71,p = 0.01)。与佩戴UV镜片的患者和AACs相比,佩戴BB镜片的患者对蓝色环境光的感受没那么强烈(F = 2.51,p = 0.042)。

结论

老年白内障患者更换晶状体可能会提高视觉舒适度并使精神努力程度降至最低。虽然这些影响很细微,但其程度可能取决于人工晶状体的类型。BB人工晶状体可能具有潜在益处,因为环境光被认为眩光更少且视觉张力更小。

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