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Intervention was cataract surgery with implantation of either a neutral or a blue\u2010blocking intraocular lens (<jats:styled-content style=\"fixed-case\">IOL<\/jats:styled-content>). Main outcome was activation of the intrinsically photosensitive retinal ganglion cells (ip<jats:styled-content style=\"fixed-case\">RGC<\/jats:styled-content>) measured by chromatic pupillometry. The circadian rhythm was analysed by 24\u2010hr melatonin profiles and actigraphy; the latter was also used to determine objective sleep quality. The Pittsburgh Sleep Quality Index determined subjective sleep quality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One year after surgery, peak melatonin concentration was 3.3\u00a0pg\/ml (95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 2\u20135.5) corresponding to 50% lower for the participants allocated to blue\u2010blocking<jats:styled-content style=\"fixed-case\">IOL<\/jats:styled-content>s compared with participants allocated to neutral<jats:styled-content style=\"fixed-case\">IOL<\/jats:styled-content>s. Compared with preoperative levels, the ip<jats:styled-content style=\"fixed-case\">RGC<\/jats:styled-content>response had increased by 13.7% (95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>], 3.2\u201322.6) 1\u00a0year after surgery. Objective sleep quality was also improved as the time of wakefulness after sleep onset had improved by 5\u00a0min (95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 1\u201310) for the entire population while sleep efficiency had increased by two percentage points (95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.42\u20133.65) although exclusively, for the participants allocated to blue\u2010blocking<jats:styled-content style=\"fixed-case\">IOL<\/jats:styled-content>s.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Blue\u2010blocking<jats:styled-content style=\"fixed-case\">IOL<\/jats:styled-content>s increased sleep efficiency but lowered nocturnal melatonin secretion compared with neutral<jats:styled-content style=\"fixed-case\">IOL<\/jats:styled-content>s. Cataract surgery improved the response of ip<jats:styled-content style=\"fixed-case\">RGC<\/jats:styled-content>s and sleep quality. However, the effect of cataract surgery on sleep quality may be unrelated to circadian photoentrainment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aos.13323","type":"journal-article","created":{"date-parts":[[2016,12,15]],"date-time":"2016-12-15T07:13:56Z","timestamp":1481786036000},"page":"344-351","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["The effect of blue\u2010blocking and neutral intraocular lenses on circadian photoentrainment and sleep one year after cataract surgery"],"prefix":"10.1111","volume":"95","author":[{"given":"Adam Elias","family":"Br\u00f8ndsted","sequence":"first","affiliation":[{"name":"Department of Ophthalmology Center of Head and Orthopedics Rigshospitalet Glostrup Denmark"},{"name":"Faculty of Health Sciences University of Copenhagen Copenhagen 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