25 YEARS ACRYSOF VIVITY EXCHANGE WITH MONOFOCAL?
Posted , 7 users are following.
Hey some people probably still know me.
I'm thinking of an explant for my right eye - where I got an Acrysof Vivity implanted and am totally unhappy with the night vision, so unhappy that I want the doctor who talked me into it to get corona and rot in hell.
So basically I have the Vivity in both eyes and wondered if it would be possible to exchange the right eye with a monofocal to have night vision quality like I had before cataracts.
Would there be any problems mixing and EDOF with a monofocal?
Are there any monofocals which are better than others or would I be fine with an standard monofocal - I really don't want to give any more money to these greedy people.
Greetings
1 like, 13 replies
RonAKA mister84231
Posted
I don't believe there is an issue in mixing the lens types. Some do it routinely and call it hybrid monovision where the close eye has a EDOF and a standard monofocal in the distance eye. The question I can't answer for you is whether or not it will make the negative effects of the EDOF in one eye go away. That is kind of up to your brain selecting which eye to use while ignoring the effects from the other eye.
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I think the standard AcrySof IQ Aspheric monofocal lens would be fine. That is what I have and I have no issues at all with it. There is a new series called the Clareon which is a monofocal, but is supposed to be improved, and may have a premium price to it as well.
mister84231 RonAKA
Posted
Hey, thanks for the reply!
Is the AcrySof IQ Aspheric also a premium lense?
And how do you feel like is the night vision with your monofocal? Do you feel like it is just like before?
Main reason why I want an explant is, because I want to be able to enjoy night driving again. Beeing able to drive fast without endangering anyone. Back then I could spot humans on the darkest spots possible in 300m distance at night. Now everything is so dark and the glares are insane.
mister84231
Posted
Also what I notice now because my right eye has some pretty far developed PCO, that my brain uses the quality of the left eye, otherwise it would be very bright and blurry if I look through my right eye. So maybe theres some hope for that, otherwise Im gonna have to dry with an eyepatch lol
RonAKA mister84231
Posted
There is a more basic spherical AcrySof lens and the IQ Aspheric is a slight premium over the spherical one. However it is covered by our public health care system, so I expect is is a very small premium.
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My night vision is excellent with the IQ Aspheric, but all I really have for comparison is my memory of normal vision. It is certainly much better than my non operated eye which has a mild cataract and I also wear a contact in it.
Sue.An2 mister84231
Edited
I do not think there is any issue mixing EDOF with a monofocal lens.
To minimize the night effects using that approach you will want the monofocal targeted for best corrected distance. Hopefully one of your EDOF lenses is set for mid or less than plano. If there is one that is set for nearer that is one you keep. Normally you'd want the dominant eye targeted for best distance with monofocal before doing EDOF lens but given you are exchanging you need to have monofocal lens see further than EDOF to minimize the concentric circles and other night vision issues.
Good luck to you
mister84231 Sue.An2
Edited
Yeah already planned to go for distance. I dont know how the lenses are set to be honest. I can see with both eyes the same distance, except the left eye has a little more near vision but like 1cm.
I'm just worried about 3D vision if that will make any difference. Since at daytime my eyes are almost perfect and both see the same distance - Except the PCO happening on both eyes but right eye is stronger.
At night I just notice that the darkness is blurrier, like it just feels like I want to put on glasses, but even with glasses it misses some sharpness. I guess that's the reduced contrast sensitivity.
Right eye is so bad, that if there is a car 500m away in my direction the glare takes over the whole street.
The lightstreaks are so annoying since they often come from streetlights and they move with every step I take throught the vision.
I wouldnt even know where to go, since after this experience al I can think of is that all they want is money and patients are a one time thing. Feels like Im a hooker to them, except im the one who pays.
But I really can't imagine having a life without night vision.
I got the YAG LASER still infront of me but Im waiting until I get enough money, so the explant wouldnt be even riskier if I did the YAG before the surgery.
Also there are also bad stories about the YAG Laser - Feels like I'm gonna have to go through all these emotions again, the huge amount of hate I get, the anger, the dissapointment.
If I didn't have people that care for me I'd probably had done something which would have brought me in jail. But yeah, luckily I cannot act stupid since I got a life to live.
Sue.An2 mister84231
Edited
I hear your frustration. It is good you have support. Doing something to yourself or landing you in jail is not what you want - would only compound issues. Vent here - we all understand and live with this.
If you can get your previous records it would give you info on the achieved targets for both eyes. You may want yo see if pupil constricting drops help with night vision. If it helps then you'll know if part of the issue is your pupils dilating beyond your IOL.
Imadoubter mister84231
Posted
I had one iol monofocal distance lens inserted. It's a standard Alcon hydrophobic acrylic, which Medicare paid for. My night vision in that eye is awful with every possible dysphotopia, including long streaks. the only exception is contrast, which seems OK. There seems to be no rhyme or reason to the dysphotopias from what I can glean; however, the best odds are to avoid square edged hydrophobic acrylic lenses. Unfortunately PCO is all but guaranteed without the square edges. There are hybrid edge designs but again no guaranteees. The Starr collamer lens has round edges (pco for sure), but with the advanced material one would think there would be no dsypotopsias. Not what I have read about them though.
For the 2nd eye, I am considering a hydrophilic Acrylic EDOF lens (Rayone EMV) but am concerned about the neural adaption issues with the two different types of lenses plus some dsyphotopsias.
Night-Hawk mister84231
Edited
I have heard that getting the YAG procedure that cuts hole(s) in the capsule/membrane behind the lens can make later replacement of the lens very difficult.
So I would suggest not doing the YAG procedure on an eye that you may consider having the lens replaced with another cataract surgery.
As far as new types of monofocal lenses, the newer Tecnis Eyhance lens offers the advantages of a monofocal but with a bit wider focal range allowing some intermediate focus when targeted for distance focus. I currently have only one eye with a toric monofocal IOL and whenever my other eye needs cataract surgery, the Eyhance is my current top choice unless an even better enhanced monofocal is available by then.
RonAKA Night-Hawk
Posted
Keep in mind that Eyhance and Vivity are not all that different. Both are essentially EDOF but Eyhance does not quite add enough depth of focus to be technically called an EDOF.
Guest RonAKA
Edited
I would say the Eyhance is much closer to a monofocal IOL in terms of its design than it is to the Vivity. The Vivity design is very novel. The Eyhance is essentially just a minor tweak of the Tecnis 1.
Imadoubter Night-Hawk
Posted
As the Eyhance is a hydrophobic acrylic square edge iol, the chances are very good of having severe dysphotopias, especially at night.
RonAKA mister84231
Edited
Some thoughts. Not sure if the OP is still following. Your best measure of surgery outcomes is your eyeglass prescription taken 6 weeks or so post surgery. That will tell you where you ended up with each eye. The normal target unless monovision is the objective is to be left with a residual of -0.25, but anywhere from -0.50 to 0.0 D is very good.
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With a Vivity in both eyes, I would replace/exchange the one in the dominant eye with a distance monofocal as the first choice unless your residual vision dictates something else.
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The Eyhance is an option, but it is still an EDOF and is not likely to give you the best night vision, compared to a pure aspherical monofocal. The power of the lens changes with the radius of the lens and it is not a true aspheric correcting monofocal.