Posted , 9 users are following.
It seems that Alcon has released the Vivity earlier this year to a small number of surgeons for use. They have now opened up distribution to everyone in Canada. More details can be found by googling the phrase below.
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Alcon Canada introduces AcrySof IQ Vivity, the only presbyopia-correcting intraocular lens with X-WAVE technology
0 likes, 31 replies
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Curious3123 RonAKA
Posted
what about technis synergy?
RonAKA Curious3123
Posted
It looks like the Synergy and Eyhance lenses were launched in Canada on August 13, 2020 in Canada. Google this:
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Johnson & Johnson Vision Launches TECNIS Synergy and TECNIS Eyhance Intraocular Lenses (IOLs) for the Treatment of Cataracts in Canada
rwbil RonAKA
Posted
I really wish this place allowed links.EyewireTV just put out a video showing the Acrysoft IQ vivity calling it an Extended Depth-of-Focus IOL and will be available early 2021. The video is from Alcon so buyer beware, but in that video they show 20/20 close, 20/25 intermediate and 20/32 close (16").
I find that hard to believe as I have been thinking about getting the Tencis Symfony but I go to their website and look at the defocus curve and it does not look any better than Acrysoft IQ Vivity.
I am going to try and paste both graphs here.
Can someone explain this to me and if true why would one get the Symfony and its associated vision problems like halos.
RonAKA rwbil
Posted
The Symfony provides closer vision than the Vivity. I think if you want as good of a close vision ability with Vivity as with Symfony you would have to get the Vivity in both eyes with one in a monovision configuration. Or, a monofocal in one eye and a Vivity in the other eye.
pam81255 rwbil
Posted
I don't understand any of these graphs. Bu t I do know I just had the Vivity put in my right eye yesterday . And Im reading my phone without glasses.
susan03345 pam81255
Posted
Did you get Vivity in both eyes? How is your vision now?
rwbil RonAKA
Edited
That is what I would think but then I look at the defocus curves and don't see it.
One thing I don't get a sense of is if instead of setting distance at Plano 20/20 and set it for micro monovision at 20/25 how much close vision would I pick up.
And along with that is there a way to test how distance is if I degraded to 20/25. Right now I get 20/20 at distance with my current left eye IOL. Is there a way to degrade that to 20/25 and see how that is.
You never know what to believe as much of it is promotional, but on youtube their is a recent video called, "VIVITY Lens Technology: One of the FIRST in the Nation 🇺🇸 & World" by Gulani Vision Institute which is near me that show one person reading close up card J1 with Vivity.
RonAKA rwbil
Posted
I can't think in the Snellen numbers for monovision. What I most commonly see is the diopters of myopia that you are left with. Micro monovision is typically in the range of -0.5 to -1.0 D of myopia. Mini Monovision is -1.0 to -1.5 D, and full monovision is -2.0 to -2.75 D.
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Right now I am experimenting with a monofocal AcrySof IQ lens in one eye and a contact lens in the other eye. I have tried -1.25 and -1.5 D of myopia. I prefer the -1.25 but the -1.5 D is acceptable. I tried in the order of -2.0 D and it was a total no go. What I don't know and don't know how to simulate is how a Vivity lens would work as the near vision eye using monovision. My plan is to do the testing with contact lenses, and then tell the surgeon what I like when the time comes. I am hoping that the surgeon can give me a good idea how much monovision is acceptable with the Vivity lens. Not 100% convinced I will go with the Vivity, but it is certainly on my radar.
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I watched that video and would not put much stock in that. With my -1.25 D monovision I can read J2, but really struggle with J1. Perhaps with some monovision a Vivity could do it though.
soks rwbil
Posted
"Right now I get 20/20 at distance with my current left eye IOL. Is there a way to degrade that to 20/25 and see how that is." -- wear +0.5 contact lens or glasses. contact lens will be more indicative of the 20/25.
soks RonAKA
Posted
ronaka is it possible that u can read j2 only because of the accommodation left in the natural lens eye? and that -1.25 iol may not allow you to see j2 or better?
RonAKA soks
Posted
I think anything is possible, and I have no way to estimate accommodation left other than with age charts. I am 71. About all I can say is that the reading vision I have is quite sensitive to light level. I suspect much of the close vision I am getting is due to pupil constriction and the pinhole effect. Reading vision is about J4 in low light. In full sunlight I can quite easily read J1.
rwbil RonAKA
Posted
According to the literature Vivity is supposed to give, "≥0.5 D greater than monofocal control".
So maybe you could read J1 if you did -1.25 monovision with the Vivity.
My question is what effect -1.25 monovision has on your far vision. Just looking at defocus curves, it looks like a -1.25 (assuming they hit this perfectly) would take you to somewhere between 20/20 and 20/25. What are you experiencing with -1.25.
If I can get better than 20/25 distance vision and still get J1 close vision with vivity and Monovision that might be the way to go.
I think I will wait for you to get the surgery and report back.:-)
RonAKA rwbil
Posted
I suspect you are correct that -1.25 D of monovision with the Vivity may allow reading finer print. Don't know what it would do to distance. But in my case I will have a monofocal IOL optimized for distance, so I am sure I will have pretty good distance vision. I currently easily see 20/20 and bit of the next line with my IOL eye. So, I am not really worried that much about distance. I just wonder if I would get that much better reading with a Vivity lens for closer monovision. It will come with a price. A monofocal with a power for monovision would be essentially free for me. Not sure of the price of the Vivity, but suspect it may be $1000-$1500 extra for the lens in Canada.
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You may not have the patience to wait for my experience. I am a year away from my next eye exam where I could get referred for cataract surgery, and getting a lens would be 1+ years beyond that. I've got a couple of years minimum of using a contact in one eye. So far I don't mind it.
rwbil RonAKA
Posted
I know contacts and a IOL will be different, but you stated you, "tried -1.25 and -1.5 D of myopia."
Unfortunately my other eye cataract is bad enough that it makes it impossible for me to do that experiment.
I am wondering what your experience was with the -1.25 D of myopia as far as distance vision was. If you just look out of that eye does distance seem clear. How does it compare to the other eye.
I was actually thinking of doing maybe -1.0 D with the Symfony Plus lens, hoping for really good distance and close.
RonAKA rwbil
Posted
My distance vision with an eye chart using the contact lens eye is poor. I see 20/70 with it. However the lens I am using is not correcting for astigmatism, and I do have a minor cataract in that eye. However, when you under correct by that much (-1.25) distance vision certainly suffers. You depend on the other eye to pick up the distance, and that is what see. Both eyes open I see 20/20.
rwbil RonAKA
Posted
Gee I did not expect distance to go to 20/70. If that is the case I would not be interested. Has your doctor stated what they think your distance would be if you did -1.25 monovsion with an actual toric IOL?
I find it so confusing, maybe you can provide an explanation. Why when I look at a defocus curve at plano and then go out to 1.25D there is little drop in visual performance yet you are going from 20/20 to 20/70. Can you show this on a defocus curve so I can better understand the relationship between going more myopic to visual performance.
I understand that hopefully the brain will adopt and pick the best image, but there are issue with that if the images get 2 far apart plus sometimes you look to the right or left and only see from one eye. I would not mind going down to 20/25 maybe 20/32 for distance in one eye. I am just not sure how that relates to diaptor adjustment calculation.
The other thing I saw on a youtube vidoe was a surgeon who said his patients noticed halos more when he did > .75 D myopic. That was with the Symfony lens. Have you heard of that before.
RonAKA rwbil
Posted
I am not sure a toric lens would make much difference. I don't have a lot of astigmatism. I can read part of the 20/60 line, and perhaps with a full astigmatism correction I would see 20/60. With monovision there is no intent to give crisp distance vision with the closer focus eye. See this chart which shows one eye visual acuity vs distance for the various myopic under corrections. There is no -1.25 curve, but the -1.5 D curve looks to be in the range of 20/90, so 20/70 is about right for -1.25 D.
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However unless you plan to do a one eye activity look shooting with that eye, it seems to me that the binocular vision is what really counts. Here is the binocular visual acuity for the various degrees of monovision. This shows just under 20/20 for the various degrees. I know from actual vision tests at the optometrist that I have slightly better than 20/20 with binocular vision (contact in left, and IOL in right).
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The other issue you may be thinking of is stereoacuity which is the ability to judge distance. The various degrees of monovision reduce stereoacuity. There is major reduction with a -2.0 D myopia, and very minor reduction with -1.0 D. And -1.25 would be little different than -1.0 D. See this graph of the reduction effect.
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While I am a long way off of getting my next eye done, my wife was referred to the same cataract surgeon as me, just a few days after my surgery. I have suggested that she might want to consider the Vivity lens to get some intermediate vision. However, she has amblyopia so it is kind of all or nothing with her one good eye, which now has a cataract. Monovision is not an option for her. I will leave it between her and the surgeon to decide if she goes monofocal or Vivity. A multifocal lens is off the table.
soks rwbil
Posted
symfony plus is not available in any country. why not do plano synergy instead?