Zusammenfassung
Daten aus experimentellen und epidemiologischen Untersuchungen haben einen potenziellen Zusammenhang zwischen dem Entfernen der natürlichen Linse, den damit verbundenen, in der Folge entstehenden, photooxidativen Veränderungen der Netzhaut und dem Fortschreiten der altersbedingten Makuladegeneration hergestellt. Ein wesentlicher Faktor könnte der ungeschützte Einfall von blauem Licht sein. In den letzten Jahren wurden deshalb sog. Blaufilterlinsen zum Schutz der Netzhaut eingesetzt. Der vorliegende Beitrag basiert auf einer Datenbankrecherche (Pub Med, National Library of Medicine, USA) und fasst den momentanen Kenntnisstand zum Einsatz von Blaufilterlinsen zusammen: Modellversuche haben gezeigt, dass Blaufilterlinsen im Vergleich zu herkömmlichen UV-Filterlinsen für deutlich reduzierte Mengen an blauem Licht durchlässig sind und sowohl Zellschädigung als auch Bildung von Entzündungsmarkern wie VEGF reduzieren. Die Mehrzahl der vorhandenen klinischen Daten belegt die Kompatibilität von Blaufilterlinsen hinsichtlich Sehschärfe, Kontrast- und Farbsehen sowie subjektiv empfundener Sehqualität, jedoch berichten einzelne Beiträge von einer verminderten Kontrastsensitivität und eingeschränktem Dämmerungssehen. Das gilt auch für den zirkadianen Rhythmus, wobei zu diesem physiologischen Parameter nur theoretische Erwägungen existieren. Langfristige Studien, die belegen, dass Blaufilterlinsen tatsächlich die Inzidenz von Netzhauterkrankungen wie AMD senken, sind bisher nicht verfügbar.
Abstract
Data from both experimental and epidemiological trials have suggested a potential correlation between extraction of the natural lens associated with exposure to photo-oxidative stress to the retina and a progression of diseases such as AMD. A fundamental factor could be the unchecked exposure to blue light. This is why in the past years so-called blue light-filtering intraocular lenses have been implanted to serve as a protection to the retina. The following contribution is based on a data base research (Pub Med, National Library of Medicine, USA) and summarises information currently available on the use of blue light-filtering lenses. Experimental modeling has shown that, compared to regular UV lenses, blue light-filtering lenses block a considerable part of blue light transmission to the retina and reduce damage to retinal cells and production of inflammatory markers such as VEGF. The majority of the clinical data demonstrate that blue light-filtering lenses are compatible in terms of visual acuity, contrast sensitivity and colour perception as well as patient-rated quality of vision. But a few additional studies report reduced contrast sensitivity and limitations in mesopic vision.This is also true for the circadian rhythm. However, the evaluation of this parameter in connection with blue light-filtering lenses has only been done on a theoretical basis. Long-term data showing that blue light-filtering lenses actually do reduce the incidence of retinal diseases such as AMD are currently not available.
Schlüsselwörter
Intraokularlinsen - Blaufilter-IOL - Photopigmente - zirkadianer Rhythmus
Key words
intraocular lenses - blue light-filtering IOL - photosensitive pigments - circadian rhythm
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Prof. Dr. Albert J. Augustin
Augenklinik, Klinikum Karlsruhe
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