Tinting of Acrysof Toric IOL's and Astronomy

[MrAstro]

I'm about to have some implants put in and I'm a keen amateur astronomer who enjoys observing faint galaxies at the bounds of dark adapted vision using averted vision. My vision pre-operation is +6.5 with some astigmatism and +8 with reading glasses (hyperopic)

I note that Acrysof Toric IOL's seem to be tinted. The best info I could find suggest that it cuts about 30% of blue light.

This worries me because I don't want to reduce the light that reaches my dark adapted eyes at all - in fact the whole point of increased aperture on astronomical telescopes is to maximise light and ensure every photon reaches your eye.

Can you allay my fears about the tinting at all - or should I worry about it and intervene in terms of the choice of lens that my refractive surgeon would otherwise implant.

I also note the lens is 6mm - I always thought a dark adapted pupil could be up to 7mm in size.

I'm currently 43 years old.

[achillea]

Jodie, about 2 1/2 years ago when I got my reStors, I ran into references to an earlier, untinted version--which was of course what I would also have preferred, but which was not available for my surgery.  As it happens, my color vision is superb (she said in all modesty), though I obviously have not tested my dark adaptation for astronomical tasks.  

It seems that the addition of the yellow tint was based on genuine concern about damage caused by exposure to certain wave lengths, as discussed (and referenced) in this paper:

http://www.touchophthalmology.com/articles/achieving-best-visual-outcomes-monofocal-intraocular-lens?page=0,3

MrAstro, you will also find technical mention here of dark-adapted scotopic spectral sensitivities.  You may find it reassuring.

As an aside, my husband has also noted the 'demon glint' from my implants.  He says it's a tad eerie, all right.

[JodieJ]

Good luck with your surgery.  I really don't think that you'll lose the edge, and you'll be able to use your old glasses as a paperweight.

[MrAstro]

Just an edit on the lens type - I made a typo

It's an Acrysof IQ Toric Lens. I'm a fumble fingers these days on the keyboard...

[MrAstro]

I wondered what they meant by eye glint - it's kind of cool that now that I'll be eligible to star in the next exorcist film :-)

I rang surgeon after I wrote my first post to identify the exact lens they are going to use rather than just guessing. It's a Acrysof IT Toric Lens. I'm happy with all the features of the lens itself with one noteable exception of course :-)

I'm also happy they seem to think it has good rotational stability - as long as they get the positioning right in the first place.

It's a good hint re: the Lasik touch up - I must remember that just in case and hope they won't have to of course.

I found this brochure that shows their range of lenses and some of them were clear - just not this particular type. I think I'm going to have to suck it up and take it - I don't think I like the alternatives very much - it's just such a shame about the tint.

Deep sky astronomy is all about hunting faint galaxies on the edge of perception. It's quite competitive in terms of whether you can see what your fellow observers are looking at. It's a crying shame I'm going to lose the edge that I could have otherwise had and inherit the yellowed eyes of an elderly person at such a young and spritely age ie. 43 lol :-)

[JodieJ]

Don't laugh--but when I first read the research that constituted the "scientific" basis for Alcon's blue light blocking, I wondered whether the idea originated in their marketing department.  What a sales pitch--an IOL that prevented age-related macular degeneration!  And no one could prove that the yellow tint didn't work--at least not for many years.  

Strangely, I believe that an older version of Alcon's ReStor was available in 2 versions:  both with and without blue light filtration.  I seem to recall reading that the version without the tint was marketed to people in certain professions who needed exceptional color discrimination ability!  (If you do some extensive online research, you can probably find the reference.  Or you could try calling Alcon's customer service.)

My Acrysof lenses are aspheric (without astigmatism correction), and there's only one feature that I don't like.  In certain lighting conditions, my IOLs have a visible glow to onlookers.  (It's similar to the glow in the eyes of the alien children in the old horror film "Village of the Damned".)  I believe that all the yellow tinted Acrysof lenses share this feature.  Lenses from other manufacturers (such as the one-piece Tecnis monofocal) don't emit a glow.

I don't know what your goals are for your post-surgery vision.  For a refractive lens exchange, you could probably find a surgeon willing to provide a no cost LASIK touch-up to eliminate astigmatism and any residual refractive error.  This option would eliminate the need for a toric IOL, and it would probably provide your best uncorrected vision.  Alternatively, limbal relaxing incisions at the time of surgery might also work well, depending on the skill of the surgeon.    

[MrAstro]

Thanks Jodie,

I know it probably isn't an issue for most people but it annoys me that Alcon effectively cripple their prosthetics. It's really sad and depressing you can't get them without the tint ie at least get a choice in the matter.

From what I've read I would agree with your analysis that in other respects they are the best on the market. I just wish you could order them with this accursed tint - it seems to be a solution in search of a problem - given the lack of hard evidence on the benefits.