Alcon Clareon IOL review (said no to Vivity but still got similar result)
Posted , 21 users are following.
I got a lot of good info out of this sight when researching IOL implants for cataract surgery and wanted to offer my experience so others might benefit. I'm adding some lifestyle info as well so it can give some perspective to why I chose what I did. It's a real struggle to determine if the drawbacks of the premium IOLs are really worth the risk. So here's some background.
I'm a 55 year old male. Have been wearing contacts since I was 12 years old for being nearsighted. The correction was always the same in both eyes, starting out not so bad but has been in the -4.25 range for the better part of 30 years. I had EXTREMELY good closeup vision without contacts/glasses. I also had what I would call EXTREMELY good corrected vision. 20/15 if I kept my contacts fresh and clean. At age 48 if I wanted to see something up close while also wearing contacts I began to need readers. Otherwise, I was pretty happy with my corrected vision. I considered lasik when I was younger but just never got there. I like to hike, cycle, shoot sporting clays, build furniture, maintain my own home and autos. Vacations are typically trips to see natural wonders, so color, clarity, and contrast are extremely important to me....even though 90% of what I do is considered in the up-close to intermediate range.
I developed a cataract in my left eye in late 2021. Literally went to bed seeing just fine and woke up the next morning with considerable blurring. The right eye was just fine. In January of this year I needed some retinal repair work done in both eyes with a laser by a retinal specialist. Once that process was complete I was cleared to go get cataract surgery. I agonized over my options. The cataract was aggressive and by late April my left eye was little more than a garnish on my face. My initial consult was 4/11 and I could have literally had surgery the next day if I'd wanted, but I scheduled it a month out to give myself time to fully grasp my options and their potential downsides. Since it was my eyesight, money wasn't even a factor. Vivity really stood out and seemed to be the best option since I was already wearing contacts that corrected some for presbyopia. But there was that nagging loss of contrast issue with Vivity that I couldn't wrap my arms around. I relaxed, took a vacation, took inventory of just how much up close/intermediate vision I engaged in. (a lot) I waffled at least 3 times before finally coming to the conclusion that I'd have to kick my own backside if I went with anything other than whatever gave me the best color, clarity, and contrast even if it means I have to wear readers for that 90% up close things I do. So I confidently went with the Alcon set for distance vision and made sure it was the Clareon version.
So on 5/11 I got that left eye done and had 20/20 vision before 8hrs had passed. I also took note that I had pretty decent intermediate and functional close up vision, but up close was a little more comfortable with 1.25 readers (looking at my phone or reading a book). I went for a walk that afternoon and there was an unexpected depth perception issue between my right eye and my newly clear left even though both could see clearly. It felt as though judging rough terrain or throwing a ball could be more challenging that I was used to. Also, being able to compare, I realized my right eye was a little subpar compared to the newly fixed left. I went for a drive when the sun went down and there were no halos or starbursts. I could also see the dash just fine. The only thing I noticed apart from my natural lens was during the day, a little flickering at certain angles when light was coming from the side during eye movement.
The doctors office called to check on me and based on my progress, offered to do the right eye as early as 2 days later. At that point I needed no convincing. 5/13, just like the previous surgery, within 8 hours I could see 20/20. The depth perception issue was also gone. I'm typing this with my naked eyes and can see just fine. Even though I was formerly wearing presbyopia correcting contact lenses I need readers less now than I did with those, really only in low light. I'm really super happy with my decision. I have great color, clarity, and contrast and I basically have what was promised with Vivity without the risk of contrast loss. But truthfully, even if I had to wear readers for all things intermediate and closeup, I wouldn't complain one bit. Glad I took the time to settle in my heart what was important and didn't knee-jerk react to what seemed best to me in the beginning.
3 likes, 80 replies
susanlb kip33412
Edited
Hi there, Kip, John and others, I have worn contacts nearly all my life, for distance vision. My near vision was very good without contacts. My cataracts developed fairly quickly over a three-year period, and my eyesight, which had been improving significantly over time, began to revert. I had trouble driving at night, and began to have trouble walking or driving during the day under bright light conditions, which were blinding, and also having trouble with contrast vision. My contact prescription also could no longer make my vision clear. I spent some time on this forum (thanks everyone!) and thought about the Vivity and the Multifocal, but I am a perfectionist, everything in my world needs to be “even,” and I am very sensitive to changes in my environment. For all of these reasons, I opted for a basic Alcon lens in both eyes, set for distance. Clareon is not yet available in the practice I chose, but I did pick the Alcon lens that is aspheric and filters out blue light. I decided against Vivity due to the contrast issue. I also elected to pay for laser-assisted surgery, to fix a slight astigmatism in both eyes. I had my first surgery on my left eye 3 weeks ago and the second surgery on my right eye one week ago. Within 1 week, both eyes were seeing close to 20/20. I can read my phone (text or email) outside if the light is bright, but I am more comfortable using +150 readers to look at my computer, my phone, or a book. These are the same readers that I had to put over my contacts to see up close before my surgeries. I can see fine in my car, both the steering wheel and the dash. My eyes are pretty light sensitive, which can continue for a year I’ve heard. They are also quite dry, which I understand is likely to continue for 3-6 months, although eye drops help a lot. I was also not expecting that there initially would be shimmering as the new IOL moves around in the eye a bit, but that has already settled down. (I felt a bit like “Mad Eye Moody” from Harry Potter!). In between surgeries, colors seemed similar, but whites were definitely brighter in the eye without the cataract. It’s a little awkward between surgeries so I thought two weeks in between was a perfect amount of time for me. I can see all things in the distance very well, so I am very happy with my result, and even though I’ve lost my near vision, it’s still better than I was expecting and perhaps will continue to improve with time?
RonAKA susanlb
Posted
Vision is probably 95% there 3 weeks after surgery, and should be as good as it is going to get post 6 weeks. I think adaptation may take longer with multifocal lenses where the brain has to learn to ignore some of the optical side effects.
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One article I read said that those who get better closer vision from a distance targeted monofocal are likely to be myopic before surgery, and have a smaller pupil size.
kip33412 susanlb
Edited
Fantastic result. There is a real lack of reporting of positive outcomes on this platform and I wanted to contribute to changing that and appreciate your contribution.
susanlb kip33412
Posted
One other thing I've noticed is that I am getting a lot of headaches. I am now two weeks + out in right eye and four weeks + out in left eye. I assume it is related to eye strain and the brain adjusting in that I used to be able to see up close either with or without contacts and now I really need to put on my reading glasses to see something up close. I tend to get headaches anyway (and don't sleep well), so hopefully it will resolve in time. Light sensitivity may be contributing to it too. I am just trying not to spend too much time working on the computer, and giving myself periodic breaks.
RonAKA susanlb
Posted
I would think you should not be seeing anything much different than what you were seeing with distance contacts and reading glasses as needed. The difference of course is that you have the contact correction "built in", and you have no ability to remove them to see up close without glasses. You may be missing that ability to but it shouldn't lead to headaches. I suspect it may be just a matter of time to adjust to the new vision arrangement.
Sue.An2 kip33412
Posted
Agree wish there were more positive stories. People usually on search and fond forums such as this one when things go wrong . Those happy with results rarely give it s 2nd thought. Many in my circle of people I knee had cataract surgery were pleased with results and wondered why I had so many questions! Some better stories come from people who like to know more about options and find this forum before their surgeries will post their results bit not dire they represent the majority. Perhaps those in that category tend to be the 'picky customer' who should go with monofocals.
That comment not directed at anyone as I myself found these forums looking at options for me.
john20510 kip33412
Posted
lm having surgery in a few months, my doctor said becasue l have healthy eyes the lower contrast from vivity wont be a problem, but my plan is to have vivity in one eye first and if l dont like the contrast l will get a monofocal set for distance in the other eye which should improve the overall contrast. But if l am happy with the vivity l will get another vivity in the second eye, what do you think of that idea
kip33412 john20510
Edited
I don't think that's a bad idea at all John20510. I came really close to following that exact plan. In fact, my surgeon isn't shy about swapping them out if you aren't happy, which sweetened the pot for me to try it.
One influence that I hadn't mentioned is that my wife can't drive at night. She had RK years ago and has all kinds of issues with her sight, especially at night. while that alone didn't sway me toward the monofocal it did have some affect on my final decision. There are a ton of folks interested in hearing about your outcome. Myself included. Be sure and let us know.
john20510 kip33412
Edited
l spoke to my optomerist today and he mentioned a couple of his patients recently got vivity and they were both very happy with it and have no problem with contrast.
kip33412 john20510
Posted
My optometrist told me the same, however, she knows I'm an engineer and told me that if I'm a perfectionist then the monofocal is going to be my best bet. Her husband is an engineer and perfectionist....she said she wouldn't even bother mentioning Vivity to him.
I just shrugged my shoulders....I am a perfectionist though soooo.
Guest john20510
Edited
There really needs to be a way to try these things before surgery. Or a modular platform that makes exchanges quick and simple and risk-free. I suspect I'd be fine with Vivity and love it too but as an extreme perfectionist I'm too afraid to take the risk.
Tenuki kip33412
Edited
(eye-doctor here)
Alcon Clareon Monofocal and Vivity lenses are two worlds apart.
You are a myopic person (short-sighted) and, therefore, have had very good reading vision your entire life without glasses. Myopic patients tend to be very demanding and perfectionist when it comes to reading distance.
The Alcon Clareon lens has given you extremely crisp image quality for far away... but lacks reading ability. It was to be expected and the doctor should have explained this to you. Vivity, on the other hand, has some issues (specially image quality, colour contrast and reading distance). Congrats on your eye-doctor for explaining this to you.
Since you were myopic, vivity would have been a poor choice.
soks Tenuki
Posted
what are your thoughts on panoptix for myopic people. also what are your thoughts on glistening with alcon and has it really been fixed with clareon?
Guest soks
Posted
I'm not Tenuki but answer to the second question is 100% yes. Studies have proven it. Even less glistening I believe than J&J.
Myope_PSC Guest
Posted
This paper "Clareon v PCB00 manuscript - FINAL.pdf" confirms that Alcon's Clareon material glistening rate is similar to J&J's Tecnis so it's an improvement over the already improved Acrysof material of recent years it would appear.
Guest Myope_PSC
Edited
Thanks for this Myope_PSC. I read that paper awhile ago but didn't have the time to find it again.
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I read another paper that found that even the Acrysof material has improved greatly in recent years. Off the top of my head (again) Acrysof used to have glistenings numbering in the thousands but in recent it was more like a couple hundred… not enough to be clinically significant.
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Long story short, the glistening thing has been essentially a non-issue for years now and with Clareon it's even better.