Alcon AcrySof IQ Vivity EDOF

Hi

Just out of curiosity, why do you prefer edof over trifocals such as Panoptix?

By the way, about glare, I have no glare with my Zeiss edof, so hard to improve that, I do have starburst and concentric rings though.

The contrast with current edofs are very close to monofocals, how does your specialist mean that contrast is significantly improved?

Anyway it will be interesting to hear about your results, best of luck!

"Just out of curiosity, why do you prefer edof over trifocals such as Panoptix?"

Just that in the course of the short time I have spoken to opticans and eye doctors about the replacement surgery, most if not all have talked about the compromises of trifocals. In particular rings, poorer low light performance, glare and poor performance between the intermediate and reading ranges. I can quite happily live with reading glasses for extended, close work, but intermediate and night vision are important to me.

I had more-or less decided on a monofocal solution, with glasses for all intermediate and close work, but the specialist that the insurance company set up for me, happened to be one of a very few offering Vivity.

I can only refer to what they have told me, as other information about the Vivity is very sparse, but they claim that it outperforms just about everything else, offering near monofocal performance at everything except close reading. They are also one of eight "Centres of excellence" in Europe, so I have to trust that they value their reputation and won't lie to me. I will stick to the choice and see what it brings. If nothing else, I can warn other readers of this forum against Vivity if it turns out not to live up to expectations.

I should add that, like you, I live in Scandinavia, so am literally walking in the dark at both ends of the working day. I meet a lot of cyclists along my path and the glare around the new LED cycle lamps bothers me and obliterates everything else.

Ok, it will be interesting to hear about your results, and I cross my fingers and hope that it lives up to your expectations.

"If nothing else, I can warn other readers of this forum against Vivity if it turns out not to live up to expectations."-- lol

good luck!

mebbe get vivity in one eye and get pan optix in ither if you are unhappy.

would be perfect to get your experience...my surgeon told me the same...are you from germany?

thx in advance

I'm in Norway.

Op was originally scheduled for next Wednesday, but there is a problem getting hold of the lenses, so it has been delayed. Hopefully towards the end of next week. I'll be happy to share my experience.

HELLO- I'm from the US and wondered if you went with the VIVITY IOL ? If so - what is your outcome? I'm trying to decide between waiting for it as it isnt available here yet- or hoing with the mono iol THANK YOU

vivity got fda approval last month. so your wait should be short. i believe it should hit the market this summer.

vivity has 20/25 at 60cm and 20/32 at 40cm. that is a really good range without any circles. 20/32 at 40cm allows reading of J3. if true it will be a very good choice.

Hi BR

Have you implanted vivity IOL. Can u share your experience please. when did u implanted?

I have surgery due in nezt 10 days and thinking of using vivity IOL.

Thanks

Sanjay

Any other issue faces with vivity like ring, contrast, glare, haloes issue in driving car.

how is distance, intermediate or near vision. do yiu used glass while driving?

Hi DSR

Did you complete your surgery. Have yiu used Vivity iol and what is your experience.

hi Soka

Any experience about vivity iol and surgery due in 10

days and need to decide.

hi sanjay

i do not have experience with vivity. how old are you? had you started to use reading glasses? are you still working? are you in india or us or europe?

i have symfony and i have poor near vision with it. i would probably get a trifocal in my other eye - lisa, panoptix or synergy. i am 44. the circles are not a big deal. not being able to see near is a big deal. example videos on fone. i think you will need glasses with vivity to sharpen intermediate and for reading. good luck.

Hi Sok

I am 52 yrs old and lives in UK. I am not in favour of premium lenses due to side effects. Vivity seems to be monofocal with intermidiate vision and distance with little side effects of halos based on feedback data I got. I don't mind using glass so will go with Monofocal.

Any advise please?

with vivity u wont have rings. you will have generally better intermediate than monofocal but it wont be 20/20. in all likelihood u may need glasses for computer and reading. all this when set vivity to plano.

Sanjay, are you having both eyes done? Another option to "stretch" the range of monofocal lenses is to correct fully for distance in one eye, and under correct by about -1.25 D in the second eye, so it will give you decent intermediate vision. It is called monovision.

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I have had the first eye done with a monofocal for distance, and am debating/researching on what to do with the second eye, which is some time off. Currently I am considering the monovision, and now with the Vivity lens considering using it with undercorrection as well. The hope would be if I give up some of the distance vision by under correcting by about -1.0 D, I may actually get some reading ability as well as intermediate.

Ron

First eye is due this month. I am exploring this option too as you suggested call monovision or mini-monvision confused.

How is you experience with distance vision and which IOL brand u used . Any side effocts or recommendation.

Thanks

Sanjay

I think monovision is a good option. It can be simulated to some degree with contact lenses. I have used it in the past with contact lenses in both eyes with some success. My plan now that one eye has been done for distance is to simulate monovision with one contact in the other eye under corrected by about -1.25 D. I also plan to try as little as -1.0, and as much as -1.5 to see what I like. With contacts you can do some trial and error. With an IOL it is a one shot deal. I found these two articles if you Google them to be helpful in understanding monovision.

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Optimal Amount of Anisometropia for Pseudophakic Monovision Ken Hayashi, MD; Motoaki Yoshida, MD; Shin-ichi Manabe, MD; Hideyuki Hayashi, MD

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Monovision Strategies: Our Experience and Approach on Pseudophakic Monovision Misae Ito CO* and Kimiya Shimizu

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My first lens is an optimized for best distance AcrySof IQ Aspheric Monofocal. I thought I would need a toric version but when they measured my eyes, my astigmatism was too low to use one. I am only about 5 days post surgery and have about 20/25 vision. I hope it continues to improve to get 20/20. With the current contact I am using in the other eye, which is not ideal, I am getting 20/20 with both eyes open. So far I have had no issues. The day after the surgery the operated eye was very sensitive to light changes. I wore dark glasses and the following day it was fine. If the Vivity is not available when my second eye needs to be done, I will probably go with this same lens again. It is very similar to the Vivity but without the EDOF feature.

You are from which country. Is vivity iol not available there?

I lives in UK and vivity is available. Do you recoomend to go with vivity? Will itl be better with mini monovidion ( Distance and intermediate) or vivity in both eyes.?

I am in Canada and Vivity is not available here yet. To me Vivity sounds like a good idea if it performs as it is being advertised. I think it would perform best when used in both eyes (no longer an option for me), and it should give better reading potential when one eye (preferably the non dominant one) is under corrected. There would be some loss of distance in that eye, so it kind of depends on your personal priorities. These are things that should be discussed in detail with your surgeon.

thanks fir your quick response. I have appoitment with Dr. and will discuss next week.. i prefer to have reading glass separate if jt can control both distance and intermediate vision without any correction.

seems to be good result of vivity so far I came across. Few people reported little halos in night.

Here is a phrase to search for a Alcon consultant presentation comparing the Vivity to the lens I have, AcrySof IQ Aspheric, SN60WF. It does look impressive on paper!

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Clinical Outcomes of a Novel NonDiffractive Extended Vision IOL CATHLEEN MCCABE, MD pdf

Have you reviewed Johnson and Johnson's eyhance IOL in competence to Alcon Vivity . Eyhance has been launched in Canada.

Any comment?

Yes, the Eyhance is somewhat similar to the Vivity in application. Have not done a lot of research on them, but I understand the Eyhance achieves the EDOF with spherical aberration, which has some impact on image quality, and is limited to low add effect of 1.0 D or less. I believe the Vivity may achieve closer to 1.5 D, but not sure of that. Also Alcon may be using the spherical aberration as well, but call it X-Wave or something like that.

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With all things being equal, and not often they are, my preference is for the blue light filtering AcrySof material. It seems to have more resistance to PCO, and potentially is more stable in the eye. The colour I am getting with the AcrySof IQ Aspheric monofocal lens is just amazing. We have an older plasma large screen HDTV, and this lens seems to have "converted" it in being much more like the newer super bright OLED TV's.

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At this point I have lots of time to decide. I suspect I am a minimum of 2 years away from being able to get the second eye done.

that is greats so bright like OLED . Amazing.

that what I sometime feels to go well proven standard monfofical distance which 90% people use. and manage intermediate and near by glass with addtional prescription of distance if needed based on error on iol fittd.

these all new technologht multifocal, distance+ intermediate new addition vivity have some or other side effects .

by the way how u control intermediate and near on operated eye. with glass ? and what prescription. Any side effects?

I am scheduled to see my optometrist in 10 days or so to get my eyes tested. At that point I will get an updated prescription for my non IOL eye. I will use that to get an updated contact lens to simulate monovision. Until then I am using a much less than perfect contact lens that I had on hand already. I can read a computer screen quite well, but my iPhone is way less than ideal.

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I attempted to get the lens on my IOL side out of my current eyeglasses but can't get it out. I will have to go to Costco to see if they can do it. My plan is to make do with the contact solution or eyeglasses (if I can get the lens removed) until the 6 week mark. My surgeon said I should not get full eyeglasses until I get my eyes tested again at 6 weeks. At that point I will get a prescription for progressives in both eyes. I expect that will give me very good vision at least until my non IOL eye starts to go bad again. My plan however, is to continue using the contacts as much as I can to try and determine how much monovision works for me. I am not a big fan of contacts, so I think that will be just an experiment, and I will continue to use my eyeglasses until the second eye surgery is done.

sanjay45...did you decide to go with Vivity? Im still waiting for our doctors to get the lens and hoping for more reviews

I am going for mini-monovision. Vivity is not so popular currently in UK and Drs. don't have training so no feedback from them being new.

Mini-monovision can be used with Vivity as well as a standard monofocal. However if your surgeon is afraid of the lens, then you probably should be afraid of it too!

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That said, I wonder why they would be reluctant as the lens is so similar to the standard AcrySof IQ Aspheric Monofocal. The both use the same injector to put them in your eye, so the surgical training should be very limited. I suspect the skill may be in deciding how much monovision to use for power. Normally mini-monovision is in the range of -1.0 to -1.25 D. I recall reading that less is normally used with the Vivity. I guess it depends on how much you want to compromise your distance vision.

Hi

Surgeon told me that there will be Little difference between IOL and hardly to make out difference/imbalance by the brain.. It will be -0.25 on dominant right eye for distance and -0.5 to -0.75 for intermediate on left eye. There is no astigmatism issue for me based on measurement so he will use standard technic pcboo preloaded IOL.

He is well known opthalmogist in UK and published cochrane review article on multifocal vs monofocal iol. cochrane is british international charitable organisation to facilitate evidence based choice about health interventions involving professionals, patients and

policy makers. He said vivity will too have side effects like other multifocal and no many patient reviews yet being new to market. You can search article by googling

"multifocal versus monofocal intraocular lenses after catract extraction"

Based on my lifestyle he recommeded to go mini-monovision which I am planning for and doing more research. I will see first how distance IOL works and accordingly decide for left eye whether to go intermediate or same distance

Some things to keep in mind:

• The Vivity is a very new non diffractive EDOF lens, not a multifocal that was compared in that quite old study, which is really just a summary of other studies.
• I think -0.5 to 0.75 D monovision is not going to give you any reading ability, just some limited intermediate. A more normal range to consider is 1.0 to -1.5 D . I have tried -1.25 D using contacts to simulate it, and found it kind of OK. I plan to repeat those tests now that I have one IOL for distance and see what I get for results. I posted a couple of good articles on monovision for you about 5 days ago in this thread. They are well worth reading.
• How long do you plan to go between doing both eyes? You would still have the option of using a Vivity in the second eye combined with monovision.

You're right, -0.75 D will provide Intermediate vision at arm length to work on Computer and doing day to day work. Reading will require Glasses of +1.5 to 2.00 D.

Current appointment between both eyes is 2 weeks.

You are right Vivity can be other option only issue No Dr. ready to use Vivity in UK. Tried with 3 Drs.

Do you think above prescription of -0.75D for computer work or arm length day to day vision will not sufficient.

why no doctor willing to use vivity in UK?

No idea, what I hear it is recently launched and they're not trained and fully equipped. Looks like it requires some additional Medical equipment's and Hospital don't have.

I think you will be able to read at 1.5, but perhaps not the smallest of print. My current plan is a residual of -1.25 when it comes time for my second eye. However with an IOL the correction tolerance is +/- 0.25 so I would have to be prepared for -1 to -1.5. Soon I will be trying contacts that are better than the ones I have now, and hope to refine what I can use for monovision. With the ones I have which are off in astigmatism, I can read the computer screen OK, but not well closer than that. With the computer it kind of depends. If you have a big screen and sit further away, it is easier. Currently I find myself enlarging text to make some technical articles clear enough to read comfortably.

You may want to contact Alcon in the UK about who may be implanting the Vivity. I can't post a link, but they have a contact page if you search for Contact Us uk alcon. It seems most of the implants so far have been in Spain and Australia. It may be an issue of supply of the lenses.

I am always skeptical of Early Results. I remember Symfony original results showing it had no more issues than a monofocal.

If you decide to go with Vivity, I think a sound strategy is to just do 1 eye at plano and see the results. Maybe you can then play with contacts to simulate monovision in the other eye before making any decisions.

Theoretically I think 1 eye at plano and the other eyes with just micro monovision would give you good distance and IV, but you would probably need some correction for close up reading.

Vivity is definitely on my possibility list, just waiting to hear more Real Life results. Right now I am leaning towards the new Symfony plus with maybe micro-monovision to get a little more close vision

Has anyone see a really good presentation of monovision refractive setting and what you can expect. Ideally I like to see examples of real expected results with pictures of what it looks like if you go -1.0 vs -1.5 and so forth. The effect on how distance to close would look. What setting takes you from 20/20 to 20/25 and what is the gain on close up for that lost. I just don't want to give up much on distance. Yes, I know there are defocus curves out there, but I like to see exactly what that means in real life vision terms.

Have a look at the graph below. It shows the resulting binocular visual acuity in Snellen equivalent with 1.0, 1.5, and 2.0 diopters of anisometropia. I think 1.25 D is close to optimum, but they selected 1.5 as the best. My plan is to try the range of 1 to 1.5 with contacts to see what I can adapt to.

This image comes from this article.

Optimal Amount of Anisometropia for Pseudophakic Monovision Ken Hayashi, MD; Motoaki Yoshida, MD; Shin-ichi Manabe, MD; Hideyuki Hayashi, MD

One needs to consider that IOLs typically come in increments of 0.5 D, and the surgeon has to consider what that theoretically will give while allowing for an error of +/- 0.25 D due to surgical variability. That means one probably cannot get exactly 1.25, and a more probable target is to be between 1.25 and 1.5 for example.

I contacted Alcon and they said they have not launched vivity fully yet in UK. They are only selling throught two eye clinic surgery who mostly do lense laser surgery and few cataract too.

Don't know reason behind this type of launch.

By the way how to check vision for intermediate iol using contact lens. I use glass of higher prescription currently.

The basic process is to take the eyeglass prescription of the eye you will use for closer vision and first convert it to a contact lens prescription. If the power is lower it will be the same. If the power is higher then it might be adjusted slightly to the contact lens power. Last you reduce the prescription power by the amount of monovision you want to try.

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For example if you need a contact lens with a -3.0 D power and want to see what a -1.25 D monovision would look like you would use a contact lens with a power of -1.75 D. Then depending on how that looks you may want to try .25 more or less, which would be a lens of -1.5 or -2.0 as well as the -1.75.

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Your contact lens provider should be able to help you with the conversion from eyeglass to contact power, and also give you trial lenses to try. It would be best to do this after the first eye is done for distance (ideally the dominant eye) with an IOL and it is fully healed.

if contact lens prescription is reduced from -3.0 D to -1.75D, how

vision will be clear, will it not be blurry with cataract.

Does vision get corrected due to other operated eye with distance?

Can this be not cross-checked with glasses. My prescription increase every six months and have multiple prescription glasses in range with difference of -1.25 to -1.5D. Does it need to checked with contact glass only?

If you cannot see well enough to evaluate your reading ability with the cataract it will be difficult if not impossible to simulate monovision with contacts. And if your most current prescription is -1.25 or -1.5 D, then you do not need a contact to simulate it. You will only have to go without any correction in the non operated eye after surgery. And, yes based on my experience you will get some reading ability with a monofocal IOL in one eye. I can't read fine print up close but I can reasonably read my computer monitor at 20" or 50 cm. with my distance IOL eye only. I think that is partly because my computer screen with black text on a white background is quite bright and I suspect my pupil closes down to increase the depth of focus. If the lighting is poor reading text on paper is very difficult with the IOL eye. My arms are not long enough to hold it far enough away!!!

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The issue you describe is the reason I am doing my monovision simulation with contacts now. I can sill see pretty well with my non operated eye. I thought it was near perfect, but now when I compare it to my IOL eye I see that the colour is way off. Whites are yellow to almost orange in comparison to the now very bright IOL eye.

same question about contact lens I asked Dr. and he said it is not needed for me. He will add -0.5 to -0.75 D in left eye and I will be able to see at arm length. right eye will have - 0.25 D for distance.

Per Dr. there shouldn't me imbalance issue for me as brain doesn't make out so small difference and many people manage it daily basis. In case of any issue, he can correct through laser late.

as you mentioned, you are able to see computer with distance iol, I will check too first and then decide if prescription glass with intermediate and reading will be better instead of going for mini monovision.

Your doctor is right about mini monovision - the brain will meld the images and it should not be an issue. Some wind up that way even if both eyes targeted for plano as the IOLs during 6 week healing process shift back and forth before adhering/settling.

"Reduced" glare or NO glare as I was told NO glare with Vivity.......Please let me know as Vivity was recommended by 2 different Drs for my eye in which I have a catarat due to a detached retina....only having ONE eye done though......How did the Vivity work for you?

Marius, did you get the Vivity lenses? How were the results? I am scheduled for them Jan 20

What kind of lens do you have?