Effect of yellow-tinted intraocular lens on standard automated perimetry and short wavelength automated perimetry in patients with glaucoma

Abstract

Purpose:To investigate the effect of cataract surgery and yellow-tinted intraocular lens (IOLs) implantation on perimetry indices of short-wavelength automated perimetry (SWAP) and standard automated perimetry (SAP) testing in patients with coexisting cataract and glaucoma.Materials and Methods:In this prospective comparative case series, phacoemulsification with implantation of yellow-tinted Acrysof Natural IOL was performed in 16 eyes of 16 patients with visually significant cataract (best-corrected visual acuity (VA) better than 20/120) and mild to moderate glaucoma. Pre- and postoperative values for VA and for perimetry indices including mean deviation (MD), pattern standard deviation (PSD), and foveal threshold (FT) from both SAP and SWAP testing were compared.Results:Postoperative VA improved significantly after cataract surgery and yellow-tinted IOL implantation (P < 0.001). After cataract extraction and IOL implantation, MD and FT on SWAP testing improved significantly (P = 0.001); however, there was no statistically significant change with SAP testing between the pre- and postoperative perimetry indices. There was no statistically significant change in PSD with either SAP or SWAP testing postoperatively. The differences between pre- and postoperative values for all perimetry indices under study were not significant when comparing SAP with SWAP tests, except for MD which had improved statistically significantly in SWAP testing (P = 0.03).Conclusions:In mild to moderate glaucoma patients with cataracts, the perimetry indices of SWAP testing improved after phacoemulsification and yellow-tinted IOL implantation. This suggests that the yellow-tinted IOLs have less effect on SWAP testing than visually significant cataracts.

Glaucoma and cataract surgery

“…Concern about the tint of blue blocking IOLs and potential interference with perimetry have been assessed by Nilforushan et al [15] in a small series of 16 eyes undergoing pre and postoperative standard and short-wavelength automated perimetry [Standard Automated Perimetry and Short Wavelength Automated Perimetry (SWAP), respectively]. Despite SWAP utilizing blue stimuli on a yellow background, no reduction in sensitivity was identified in this limited study, suggesting that yellow-tinted IOLs may indeed be appropriate in this population.…”