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Photo Essay |

Use of Purkinje Images to Identify Colored Intraocular Lens Filters

Nathan J. Walker, BAppScOptom(Hons),  MBBS(Hons); Hamish D. R. McKee, BSc, MBChB; Gary K. Phelps, MD, FAAO
Arch Ophthalmol. 2007;125(6):851. doi:10.1001/archopht.125.6.851.
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While the clinical importance of blue light–blocking intraocular lens (IOL) filters remains controversial, with the theoretical reduction in risk of age-related macular degeneration competing with potential impairment of scotopic visual performance,1,2 it is important to identify the presence of a colored IOL in various clinical situations.

Although preliminary research has demonstrated no clinically significant deleterious effect on acuity, color perception, or contrast sensitivity when blue light–blocking IOLs are implanted bilaterally,3 there is anecdotal evidence that some patients report awareness of differences in color perception if IOLs with different filters are implanted in each eye. Furthermore, the presence of a different filter in each eye complicates comparative posterior segment examination (eg, detection of subtle nerve pallor) and may affect retinal laser settings. A technique for identifying IOL filters also has potential application in retrospective studies evaluating progression of age-related macular degeneration.

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Figure 1.

Purkinje image IV (right) demonstrated using a conventional UV–blocking intraocular lens (ACRYSOF SA60AT; Alcon Inc, Fort Worth, Tex) appears white.

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Figure 2.

Purkinje image IV (left) demonstrated using a blue light–blocking intraocular lens (ACRYSOF Natural SN60AT; Alcon Inc, Fort Worth, Tex) appears yellow.

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