Griepentrog John E, Zhang Xianghong, Marroquin Oscar C, Garver Michael B, Rosengart AnnaElaine L, Chung-Chou Chang Joyce, Esfandiari Hamed, Loewen Nils A, Rosengart Matthew R
Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA.
Department of Clinical Analytics, University of Pittsburgh Medical Center Health Services Division, Pittsburgh, PA 15213, USA.
iScience. 2020 Dec 29;24(1):102009. doi: 10.1016/j.isci.2020.102009. eCollection 2021 Jan 22.
Circadian rhythms regulate adaptive alterations in mammalian physiology and are maximally entrained by the short wavelength blue spectrum; cataracts block the transmission of light, particularly blue light. Cataract surgery is performed with two types of intraocular lenses (IOL): (1) conventional IOL that transmit the entire visible spectrum and (2) blue-light-filtering (BF) IOL that block the short wavelength blue spectrum. We hypothesized that the transmission properties of IOL are associated with long-term survival. This retrospective cohort study of a 15-hospital healthcare system identified 9,108 participants who underwent bilateral cataract surgery; 3,087 were implanted with conventional IOL and 6,021 received BF-IOL. Multivariable Cox proportional hazards models that included several determined subgroup and sensitivity analyses yielded estimates supporting that conventional IOL compared with BF-IOL may be associated with significantly reduced risk of long-term death. Confirming these differences and identifying any potential causal mechanisms await the conduct of appropriately controlled prospective translational trials.
昼夜节律调节哺乳动物生理的适应性变化，并在短波长蓝光光谱的作用下达到最大程度的同步；白内障会阻碍光线的传播，尤其是蓝光。白内障手术使用两种类型的人工晶状体（IOL）：（1）能透过整个可见光谱的传统IOL，以及（2）能阻挡短波长蓝光光谱的蓝光滤过（BF）IOL。我们假设IOL的透射特性与长期生存率有关。这项对一个拥有15家医院的医疗系统进行的回顾性队列研究，确定了9108名接受双侧白内障手术的参与者；其中3087人植入了传统IOL，6021人接受了BF-IOL。多变量Cox比例风险模型纳入了几个已确定的亚组并进行了敏感性分析，结果显示与BF-IOL相比，传统IOL可能与长期死亡风险显著降低有关。要证实这些差异并确定任何潜在的因果机制，还需进行适当对照的前瞻性转化试验。
