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
maria18743 kip33412
Edited
Hi Kip
I just wanted to say thank you for posting this. It really helped me in considering which lens to choose. I am 60 yrs old, pretty near sighted (-4.5 to 6.0 over decades) and wearing glasses since the age of 12 pretty much 16 hours a day except for occasional contact lenses in my 20s and 30s. I am a graphic designer so being able to see colors, patterns and fonts is extremely important to me. In my mid 40s I looked into getting LASIK but ultimately decided not to. I’ll never forget the experience… I generally come off as a pleasant friendly person, and during the consultation with the LASIK doctor, he said, “You’re never going to see like you do with with your glasses but you don’t strike me as a picky person”. I said nothing of course but inside my head I’m thinking, “Oh buddy, you have got me SO wrong!” Ha! I did not go through with the LASIK.
When I saw the surgeon for my recently diagnosed cataracts, I told him my goal was to see with clearest, most perfect vision that I could, even if I had to wear glasses sometimes to get it, that was my top priority. My doctor didn’t try to upsell me on premium lenses and I appreciated that. Money wasn’t important since it’s my EYES, not a pair of shoes or even a car.
He currently uses Alcon AcrySof and Vivity (Clareon to arrive this summer like a blockbuster movie 😃 ) and recommended a toric lens for one eye with a 1.25 astigmatism but the choice of monofocal or EDOF was up to me. He said that while I was a good candidate for a multifocal/EDoF lens, I was not a “perfect candidate”. At first, I was leaning towards the Vivity because like you, I do more close/intermediate tasks (I actually considered getting lenses set for near vision at first), but in the end, I couldn’t get past the loss of contrast and the slightly higher chance of seeing glares, flare, halos, etc. The loss of contrast especially gave me anxiety. It is baked into the technology of the lens and my understanding is you WILL have some loss of contrast in low light. My surgeon said that for many people it’s not that big a deal and for most it’s worth the trade off of getting more near vision but you can’t “test drive” them to see how you like them like say, mono vision with contact lenses. Oh BTW, I tried the mono vision test with contacts back with the LASIK doctor and HATED it. I know lots of folks love it and it works for them but for me it was awful and I couldn’t wait to get them out of my eyes. Maybe mini mono vision could work, but again, can’t test that out to see so I decided that wasn’t an option for me.
In the end, I chose to go with Alcon Clareon monofocal distance and a toric lens for the other eye. Hoping to get them implanted this summer. Waiting for them to come in. I could probably get the AcrySof monofocal and Vivity sooner but since I’m going to have them for (hopefully) two decades at least, I might as well wait a few weeks/months for the newest model.
I’m not super hung up on having to wear glasses since I’ve been wearing them for 50 years. The worst part will probably be getting used to a new routine with reading glasses and seeing distance as opposed to my near Superpower vision from 0” to 6”. 😃
In fact I laugh when the doctors said, ”You know, you won’t have the same perfect vision you had in your 20s!!” Well…hahaha, joke’s on you my friend, in my 20s my vision was -4.5 so uh yeah, I actually AM hoping to get better vision than I had in my 20s! 😃
Hope it all works out but I know if I got the Vivity and then had problems with it I would be kicking myself regretting that I didn’t go with the safer option. Now, if something does happen after surgery, at least I know I did all I could to get the best vision.
So thanks again for your post. It really helped me read about someone with similar concerns.
RonAKA kip33412
Edited
I suspect your surgeon was referring to close vision without your glasses on. When you are significantly myopic you always have the option of taking glasses off and having super vision close up. When you get a monofocal IOL set for distance that ability is gone. You absolutely need reading glasses to get real close vision. The only way you can keep that very close super vision is to ask to be corrected to -4.0 D or whatever you choose. Then of course you are into progressives to see distance.
maria18743 RonAKA
Edited
I know....sigh...I'm a little bummed about losing my "superpower" vision. 😉 I can read three point type now with NO glasses so I know it will be a big change. I mentioned that I considered getting my lenses set at near distance so it would be similar to what I have now but then I decided against it.
My husband pointed out that as we are getting older it might be better to be able to see distance. He reminded me of a time we were on vacation and my glasses broke...twice! I had a spare pair but can't see well through them. I was able to get them fixed but the guy had to cannibalize my spare pair to do it. Then they broke again in a different spot! Was able to fix them a second time using parts from the spare pair but I was dead in the water as far as seeing anything beyond 6". It did put me in a bit of a panic at the time. I thought our vacation was ruined for awhile.
With a distance setting I can always buy some cheap reading glasses to get by if needed. I also worry about tripping and falling which I think will be better with distance than near. One of the reasons I am choosing standard distance over Vivity, the loss of contrast at night.
The problem with choosing any lens is that we can't test drive any of it. What for some people would be perfectly acceptable vision might not be for the next person which is what makes it such a hard decision.
RonAKA maria18743
Edited
I agree. Your thinking is essentially the same as mine. I considered a Vivity in the near eye, but I did not get a lot of support from the surgeon on that choice so I dismissed it as an option. I still think it would have worked for me, but a monofocal is a safer more predictable choice.
Guest maria18743
Edited
That's an excellent point that I'd never considered before. Setting your IOL for distance means you can always function in the world without any kind of help (glasses). Setting your IOL for near makes you 100% dependent on glasses to function in the outside world… lose them or break them and you're up a creek. And you can't just go buy a pair from a drug store as drug stores only sell positive powers not negatives.
maria18743 Guest
Posted
That experience is what actually tipped the scales in deciding to go with standard distance. My glasses breaking and feeling essentially "blind" was an awful experience at the time but it taught me something. It's going to be an adjustment since I've been near sighted since age 12 but I think I'll also enjoy seeing full vision without glasses for a change. I'll have to readjust my strategy and have reading glasses all around the house or just wear them all day like I do now. Glad I could help!
Bookwoman maria18743
Edited
My glasses breaking and feeling essentially "blind" was an awful experience at the time
The difference with near-vision IOLs is that some of us are not as blind without glasses as we were with our previous natural nearsightedness. I was -8 before my surgeries, and now have -2 lenses in both eyes, and in a pinch I could drive on local roads if I absolutely had to. Back in the day I wouldn't have been able to see across the room, let alone farther than that.
I'm not trying to change your mind about getting distance lenses, but I did want to let people who are reading this know that, especially for us high myopes, near-distance lenses are also a huge improvement in our ability to see at both intermediate and far distances.
john20510 kip33412
Edited
For someone who cannot decide between a monofocal or vivity could Eyhance be a good third option, you get the image quality and contrast of a monofocal but you also get some intermediate but not as much as vivity . If you had Eyahnce in both eyes set for plano distance, how much intermediate do you get, can you read the car dashboard and make a meal without glasses
lil60662 kip33412
Posted
Would really appreciate if you can please share which Clareon you went with?
so glad you got good results.
thnks
Best,
Li
Fahad86 kip33412
Edited
Hi
I would like to know more about Clareon IOLs performance as I am going to have my Cataract removed in couple of weeks. I am already wearing glasses for my far sight correction since I was 10 years old. Its very difficult to chose between Monofocal and EDOF IOLs, I am personally interested to go with Eyhance or Ryner EMV IOLs but my doctor has recommended Monofocal Clareon to avoid any risk of defraction. I am 37 years old so I am looking to get my far and intermediate vision fixed but I am not sure how much would I achieve after Clareon IOLs implanted. My doctor is also not suggesting for mini monovision. let me know if you guys can assist me with your experience.
RonAKA Fahad86
Edited
I agree with your surgeon that there is a lower risk going with a standard monofocal like the Clareon compared to other extended depth of focus options. A monofocal is only going to give you good vision down to about 2-3 feet. It tends to vary from individual to individual. If you get a Clareon or other monofocal in both eyes set for distance you will need reading glasses for reading. Some may choose to get progressive prescription glasses instead. Prescription glasses can correct any residual error in refraction and/or astigmatism not corrected by the IOL, as well as give you good close vision. But, you will be back to needing glasses.
.
I can't say I agree with your surgeon that mini-monovision is not a good option to consider. It may may not be for everyone, but in most cases I think it is worth a try. If it does not work out, then reading glasses and/or prescription progressive glasses can work just as well as they would when you have both eyes set for distance.
.
If you still have reasonably good vision you can do a trial of what monovision would look like by using contact lenses to simulate it. The normal process would be to correct the dominant eye to full distance, and then under correct your other eye to leave you slightly myopic at -1.5 D. Prior to surgery you could do it with a contact in both eyes. Then after surgery (normally the distance eye is done first) you could do a recheck of how it would work for you by just using a contact in the non operated eye. This way you can evaluate for yourself whether or not mini monovision will work for you, and not have to depend on your surgeon opinion, who has likely never tried it.
.
Mini monovision had worked well for me using monofocals. I have an AcrySof IQ in my distance eye, and a Clareon in my closer eye. I went about a year between having the eyes done, and Clareon was not available when my first eye was done. This said, I know it is not for everyone, but I do believe it is well worthy of consideration.
.
The other thing to consider would be toric monofocals if you have sufficient residual astigmatism to justify them. If your plan is to be eyeglasses free it is best to correct excessive astigmatism with toric IOLs. If your plan is to wear prescription eyeglasses then they are not necessary as any residual astigmatism can be easily corrected by the eyeglasses.
Spoo RonAKA
Posted
Alcon advertised binocular defocus curves for the clareon monofocals (CNA0T0) looks like a pretty round arch, if that's factual then offsetting that as little as -0.25 would give you logmar 0.2 at -1.5 while retaining better than 20/20 acuity at distance which is a pretty similar to the eyhance but potentally with less side-effects. This got me somewhat interested in this option and possibly less scary than the eyhance with the edof hack.
I've seen comparative studies where the zcb00 provides generally sharper vision for folks across the board vs the alcon monofocals though. Their focus curve looks more like a mountain.
RonAKA Spoo
Edited
You have to watch the horizontal scale. If it is compressed then the peak looks sharper, and if it is extended then the curve looks more rounded. I have the AcrySof IQ which I believe is optically identical to the Clareon. It is effectively offset to -0.25 D, and I would agree based on binocular defocus curves it should achieve a LogMAR of 0.2 at -1.5 D or 26". I only have it in one eye, so it is going to be more like 0.2 at -1.3 D or 30". This compares to being able to read a monitor at about 18" with this eye only. However that is pretty fuzzy and not likely 0.2 vision. It is definitely better at 26" to 30" or so. It would not be comfortable for me to use a monitor at that distance or at least not the 24" model I have. I guess if the font size was increased and a bigger monitor was used, it may be possible.
Spring1951 kip33412
Posted
I am debating between Eyhance and Clareon and have to decide soon. Why did you select Clareon? Did you research Eyhance and do you have any comment on what your findings were. I am leaning toward Clareon as a wiser choice from some of my own research.
Spring1951 kip33412
Posted
It has been several months. How are your eyes currently?