cannot stand fixed intermediate vision
Posted , 8 users are following.
I am wondering if I might be a candidate for a Vivity lens. I have bilateral monofocal lenses (IOLs). The power calculated was incorrect for distance vision, and I was left with intermediate vision. I wear bifocal glasses to drive so that I may see the road and the dashboard. I need different glasses for different things though- computer, reading, watching TV etc. I feel miserable as the lack of accommodation has negatively impacted my daily activities.
I do also have both negative and positive dysphotopsias, although, they don't both me as much as the lack of being able to see at multiple distances. I'd be happy with just being able to drive and read the dashboard without needing two different refractive powers.
I have read that many are happy with Vivity lenses. However I am also post YAG and vitrectomy in both eyes. Would that make for a contraindication for Vivity lenses?
0 likes, 14 replies
Myope_PSC gmhmd
Edited
Have you tried eyeglasses with progressive lenses? They should give you seamless vision covering near, intermediate and far. Others here will know more about post YAG and post vitrectomy IOL options.
gmhmd Myope_PSC
Posted
I have tried progressives and did not adjust well to them. If I could just get decent distant and intermediate, I wouldn't be bothered by wearing readers for near vision.
Guest gmhmd
Edited
FWIW I bought cheap progressives online from Zenni and hey were horrible and impossible to adapt to. Then I went to my optometrist and got "real" progressives and the difference was night and day from the second I out them on. And I easily adapted in about a week. All progressives are not made equal
.
Unfortunately I think being post YAG may make an IOL exchange difficult or risky.
RonAKA gmhmd
Posted
You could consider replacing just the lens in the dominant eye with a distance set monofocal. I believe post YAG a monofocal is the typical choice.
Night-Hawk gmhmd
Posted
Maybe you could try contact lenses, one eye set for good distance focus and the other set for good intermediate focus - mini monovision.
RonAKA gmhmd
Posted
Being post YAG probably does present a contraindication for the Vivity. Have you tried progressive glasses? They give you a range of vision instead of steps. The more modern progressives are pretty good.
rwbil gmhmd
Posted
You have 2 monofocal IOLs and both power calculation are off for distance. What is your distance vision?
For anyone else reading this I cannot say loud enough, never do both eyes at the same time. Do one at a time and evaluate your vision before proceeding to the 2nd eye.
If only your power is off, why can they not adjust refractive point using contacts or LASIK? Are there other issues. Could they adjust such that you could get monovision to allow for more intermediate vision.
Post YAG things get much more complicated and very few doctors will do a lens exchange.
Plus it seems like you have other eye issues.
My best advice is contact some of the top ophthalmologist in the country and discuss your condition and go see them even if you have to fly to see them. If I mention resource or names I will probably go into moderation, so you can PM me.
gmhmd rwbil
Posted
My doc has offered an exchange of the IOL to a different power. I just keep thinking that if I am to undergo more surgery, I'd prefer it to be something where I can get both distance and better intermediate vision- street and dashboard. Otherwise maybe better to wait for improved tech to come out.
rwbil gmhmd
Edited
I don’t understand why your refractive point cannot be set back to Plano with either glasses, contacts or LASIKs. Have you tried this and still having issues and if so what are those issues.
I would also be concerned when you are having issues with a monofocal why would you go to a higher riskier IOL such as Vivity.
With a monofocal, set to Plano, you should get decent vision down to around 3 feet or so.
I guess I would need clear answers to some questions:
2)What is the reason the doctor is saying your vision cannot be corrected back to plano?
3)Or if your vision is being corrected back to Plano, what is your distance vision 20/20 or what?
4)With your distance vision corrected, how bad is your intermediate vision?
5)Have you tried monofocal vision using contacts to see if that will be satisfactory?
RonAKA gmhmd
Posted
If you have intermediate in both eyes now, and you want distance as well, what I would consider is to do an exchange to the right power monofocal in the dominant eye. Then you will have intermediate vision from your non dominant eye and full distance in the dominant eye.
Guest gmhmd
Edited
Exchange is only really advisable within 6 months of the original operation. New technology takes years to come to market and there is nothing game-changing in the immediate pipeline. If you wait years the capsular bag will adhere to the IOL and build up scar tissue making and exchange not routine, not easy, not risk-free, and probably not even advisable unless 100% medically necessary. If your surgeon is willing to do an exchange due to your "refractive surprise" I would take them up on it and go with monofocal distance. MAYBE the surgeon would be willing to use Eyhance but with an exchange I'm guessing more surgeons would rather not "mess with" anything but the simplest and more reliable time-tested solutions.
rwbil gmhmd
Edited
Would not allow me to edit so expanding and rewording my comment:
Without knowing the history of what happened, your vision acuity after surgery, changes to your vision acuity with time, overall vision issue and your overall eye health, it is impossible to provide accurate information.
One patient recently posted that her doctor wanted to do a YAG because of PCO and then another doctor said the issue was residue Astigmatism not PCO. Quite scary if you think about it.
When were your cataracts removed and were both eyes done simultaneously or how much time after the 1st eye was the second eye done.
What was your overall vision quality right after your first eye was done. What was your distance vision? What was your residue Refraction and your residue Astigmatism. What visual issues did you have.
After that first eye was done did the doctor correct of residue refraction and astigmatism. And what were the results. Where you able to achieve 20/20 corrected distance? With correction how was the rest of your vision. If the doctor could not correct to 20/20 distance or close what was the reasons.
I don’t understand why your refractive point cannot be set back to Plano with either glasses, contacts and if that worked then get LASIKs. What happened exactly.
Did you have PCO right after surgery and that is why you had YAG? Again need the details of what happened.
I would also be concerned when you are having issues with a monofocal why would you go to a higher riskier IOL such as Vivity.And yes Vivity is higher risk than a monofocal. And lens exchange after YAG is not minor surgery.
With a monofocal, set to Plano, you should get decent vision down to around 3 feet or so. Have you tried monovision using contacts to see if that is satisfactory?
I based on the information you have provided in a million years I would not use this doctor again and would find a top Ophthalmologist. It sounds like this doctor did both eyes simultaneously or in close proximity when you had issues with the first eye. On top of that he dramatically missed the mark on both eyes and apparently not providing much information on exactly what is going on to the point you want to get a lens exchange.
I cannot stress this enough get a 2nd opinion to make sure there are not other issues like lens placement. It is also possible you have other eye health issues causing your problems that we are unaware of.
Sue.An2 gmhmd
Posted
I agree with rwbil. Personally I would not let current surgeon do an exchange given you are post YAG (and why would a YAG be done if you were contemplating an exchange). Along with other eye issue I think you should consider any other alternative (lasik, contacts, progressive lenses) vs an exchange. Take rwbil's advice if you are wanting the exchange and go to an expert in exchanges post YAG. Even if you have to fly some place else.
Even at intermediate you should have functional vision. Have you been to your regular optometrist for a refraction test? Getting glasses there vs online could be much better. Or consider lasik to correct refraction in your dominant eye to get better distance vision.
Just out of curiosity did you get both IOLs same time or have a wait period between surgeries? Usually cataract surgery there is a wait so that adjustments can be made to 2nd eye
caroldancer gmhmd
Posted
gm
I you are in the USA , do a google search for "cornea anterior segment opthalmologist." These drs specialize in cataract surgery. Some are in private practice, some are in university medical centers. You don't need a referral to see one. I would do it ASAP.