Alcon Acrysof IQ Vivity IOL Unhappy Night Vision
Posted , 22 users are following.
Hello
- Age 25
- In both eyes have been implanted a Acrysof IQ Vivity IOL Femtolaser assisted
- Surgery is 8 Months ago
- Good Day vision, need reading glasses to see food sharp
- Terrible Night Vision + Contrast Sensitivity
- Glare, Starburst, Halos,
- Lightstreaks from street lights going from top to bottom
- Tried Pilocarpine drops - No Effect
I don't know what to do, my surgeon almost yelled at me when I talked about monofocals and driving back then saying "YOU CAN'T DRIVE WITH MONOFOCALS YOU WON'T EVEN SEE THE DASHBOARD"
S****y Situation and I wish I could turn back the time and actually chose monofocals and went with progressive glasses, multifocal contacts or whatever.
Night Driving is possible as it was possible to drive for me when I had -15 Dioptrien when my cataracts formed and I still managed to go to places more or less safely.
But the Joy is definitely GONE.
And driving was my number 1 Hobby. Like my absolute number 1. My plans were to buy nice cars in the future and to just drive and enjoy driving. But now I feel like 50 percent of it is gone. Night driving is so much more fun so ofc it's nice to see well at daytime, but I don't want to miss night driving for the rest of my life.
I've read people with monofocals also experience contrast and glare problems, so I I'm not sure what to do.
I was thinking if an explanation could maybe fix this problem, because I'd happily have the inconvience of using different glasses for everything, when I can see at night again crystal clear. And the dark spots won't turn into pure black making me think is there a person crossing the road or not.
I do have PCO forming on both eyes, but the night vision problems we're there from day 1 of the surgery, so I don't think it's that causing my problems.
What can I do at this moment?
TL;DR - Unhappy with vision at night from EDOF IOLs, what are the options?
help
1 like, 52 replies
amy99928 mister84231
Posted
I have the same problem I am 49 and got a Vivity for the first surgery non dominant and the night driving is bad but also the reading letters have slight blur halos too. The free monofocals my dr uses I think are Alcon Sof IQ or something (there is no Eyehance option) and that is what I will do next month I think? Because your post reminds me of my situation like I was just driving before sunrise and it is ridiculous it's like before surgery. It may be like this with a monofocal too but maybe I should save the other $3,000 and just use glasses.
RonAKA amy99928
Posted
You should ask if your doctor has the new Clareon monofocal. It is essentially identical to the AcrySof IQ but is made from the new and improved material. I have one of each. There might be a small cost for the Clareon over the AcrySof IQ but I think it is worth it to get the newer material. They are both made by Alcon.
adam06539 RonAKA
Posted
At this stage she should get a Sofport Silicon IOL or hydrophilic one, not any Clareon or whatever as long as Positive Dysphotopsia is the reason (no matter multifocal or mono). It's not wise to change for the same material in such a case.
RonAKA adam06539
Edited
Halos and reduced contrast sensitivity are caused by the optics of the Vivity lens, not the material. It is hard to find surgeons who still use silicone lenses.
adam06539 RonAKA
Edited
Hydrophobic IOLs are most prone to dysphotopsia and the fact the you don't have it doesn't mean that there aren't plenty of people suffering from it. Besides, you never know how much of it is being caused by the IOL (not only optics). There are some internal reflections as well. Lots of surgeons who use Sofport in the US.
RonAKA adam06539
Posted
Based on a recent survey, only 2% of surgeons use the Softport lens, compared to 37% that use the AcrySof IQ, and 20% that use the Tecnis 1. Some of the stats for other new lenses as a bit misleading as some are have not been widely used yet. But, these three have been around for a long time. Google this:
.
Review of Ophthalmology PUBLISHED 10 JANUARY 2022 E-Survey: New IOLs Begin To Take Root
adam06539 RonAKA
Posted
Because they are being paid by Alcon and other companies... don't you understand how it works?
Dapperdan7 adam06539
Posted
is the sofport a monofocal iol? thx
amy99928 mister84231
Posted
This just happened to me my surgeon seemed almost upset that I am going with standard for the second eye. She said, "you'll need glasses." I am afraid because my new Vivity is 20/20 and I do not need glasses and things are bright and cheery. But there are halos and little fuzzy outlines around each letter and even a slight duplicate of everything. It's almost too vivid like it's reverberating. Do you think the IOL is the wrong size- too short a diameter? No prescriptions here, no astigmatism or anything and I'm 49.
laurie30147 amy99928
Posted
I have two Vivity lenses in a mini monovision setup: one eye is set for distance and the other is set for closer vision. When you say that your operated eye is 20/20 but your "reading letters" have a slight blur, what kind of reading are you talking about? A book, or road signs?
In general, an IOL does not cover the entire range of vision (except Panoptix, see other chats about that lens). Vivity has a larger range than standard monofocal lenses. However, even a Vivity lens set for distance is not going to be good for close up reading of small print--and vice versa. That is why many people choose to have different power IOLs in each eye. Yes, I can read my tablet at 10 inches with my distance eye, but it is sure blurry.
I can't tell what your expectations were. Your doctor should have explained the tradeoffs. And in my opinion, a doctor should not say "you'll need glasses" as if that is a horrible thing. Many lens choices result in needing glasses for specific purposes, like reading or driving. To be glasses free (if that is even your goal) usually requires some amount of monovision. It works for me...
RonAKA amy99928
Posted
Vivity is an extended depth of focus lens. It can have the issues you report. I think in your situation, I would go with a standard monofocal lens in your second eye.
stefan64833 RonAKA
Edited
Monofocals set to plano supplemented by reading glasses appears to be the cleanest and optimal approach to IOLs replacement or mini-monovision techniques trying to replicate human vision assuming power choice of IOL is correct and physician can achieve refractive calculated results. It seems that patients are the ones not satisfied by the reality of optical physics and the compromises of IOLs ability to reproduce youthful human vision. No surprise! The human lens is a unique feature that mortal man cannot currently duplicate currently based upon knowledge and technology. The Juvene accommodating lens appears to be the closest step forward, but right now it looks like 2025 is the current approval timeline. The convenience of expanded field vision and the elimination or reduction in the use of spectacles seems to be more vanity or convenience then true visual function or acuity of human sight.
RonAKA stefan64833
Posted
Actually I am quite satisfied with my mini-monovision solution to being eyeglasses free. I very seldom use reading glasses and almost never use my backup progressive glasses. After a lifetime needing glasses or contacts I am enjoying my glasses free experience. Best vision I have ever had. Mini-monovision does not require the use of anything more than standard monofocal IOLs.
.
Would I recommend it to someone that does not have cataracts and just wants to be eyeglasses free? No, the natural eyes work better, and it is best to hold off using IOLs until it is really necessary.
joseph54594 mister84231
Posted
@mister84321 your original post was 2 years ago. Have you had your night vision corrected, and, I'd so, how?
dan79005 mister84231
Edited
@RonAKA it looks like you are certainly the most well versed on these things, so if you dont mind. i currently havr a Alcon Restore multifocsl in my right eye (done 5years ago) and am going to get the left done now but my Dr's office just called and said that lense is no longer available and recommended the Panoptix or the Vivity multifocal. im not crazy about the loss of contrast with the Restore i have now and need to use a flashlight for reading if indoors. im considering the monofocal so thats not a problem but didnt know if you have read/heard peoples reaction to a multifocal in one eye and a mono in the other. most of what i find online seems to ve sponsored by the lens manufactureres. Any feedback would be greatly appreciated at this point!
RonAKA dan79005
Edited
I would suggest that if you are happy with the near vision in your Restore MF eye, then just do a monofocal like the Clareon for distance in the other eye. It is a good idea because it will help restore the loss of contrast sensitivity in the Restore eye. But, set for distance it of course is not going to help with reading vision. If the Restore eye is providing that, then you are good. The Vivity and PanOptix have contrast sensitivity loss and other issues, so good to avoid them.
dan79005 RonAKA
Posted
thanks for the fast reply! i can see pretty well up close for reading with the Restore eye, other than everything is dim. if it wasn't for the contrast id definitely do another multi focal, but i dont want to take a chance it gets worse with another .
with a monofocal set for distance, will readers be good enough to read out of that eye , or is it just not a practical expectation ? I'm a home inspector by trade, but do quite a bit of outdoor activities that really rely on distance .
RonAKA dan79005
Edited
I am about -1.6 D in my near eye, and -0.4 D in my distance eye. What I find is that although it is not a perfect match for my needs I just use some +1.25 D readers when my reading jams out with very small print in dimmer light. I guess one could be more sophisticated and buy two pairs of readers one best for your restore eye, and one best for the monofocal distance eye, and then install the appropriate lens for each eye in one set of frames. Just choose frames that are easy to remove and install the lenses. Or, you could get prescription readers that would optimize both eyes.
Guest dan79005
Edited
I don't think a monofocal set for distance will help you read better with your restore eye (without readers anyway) because the monofocal will be set for distance. All the light will be going to the distance focal point. It would help for distance vision in low light but for near you may still need your flashlight to provide more light OR readers to shift the available light to the reading focus point. You won't need both though. You'd need reader OR the flashlight.