1. Community
  2. Eyes
  3. Cataract

Cataract at 35 - which lens to choice?

Posted , 10 users are following.

DG12345
DG12345

Hello, I am 35 years old without health problems and without vision problems until yesterday.

I was recently diagnosed with cataracts in my right eye and need immediate surgery. My left eye is healthy, with vision 10/10.

The two ophthalmic surgeons I visited suggested multifocal lenses rather than monofocal. In fact, one of them asked me to choose between Alcon PanOptix Lens and AcrySof IQ Vivity. What scares me, apart from the procedure of syrgery, is the fact that my doctors have made it clear that I will lose some ability and quality of my sight and I have to choose whether I am more interested in having near or far vision.

They are also concerned about the fact that I will have to get used to a different way and function of vision in each of my eyes, as my left will work with its natural lens and my right with the additional multifocal.

Due to my age (35) and work, my vision is the most valuable ...

I am very confused and disappointed, as I feel that after the syrgery I will not see better but worse (today even the eye with the cataract has vision 8/10) ...

I would be grateful if you could answer some of my questions below:

  • Does anyone have experience with these two lenses Alcon PanOptix Lens and AcrySof IQ Vivity?

    -How does one see with the use of these lenses (I mean how it differs from normal vision), the doctors told me that I will see multiple images and in the process of months my brain will get used to it!!

  • Does anyone have an multifocal len in one eye and a natural len in the other? What is his /her experience with this?

Thanks a lot

0 likes, 48 replies

48 Replies

Prev
  • kevin77191
    kevin77191 DG12345

    Posted

    Agree with everyone here, do not do cataract surgery unless absolutely necessary. My right eye got bad really quick so I had that surgery in February 2016 and my left eye got worse slowly over time and I had that surgery 5 years later in January 2021 (delayed that as long as possible)

    I am also young like you, had my right eye done when I was 27 with a Symfony IOL, could not stand the side effects (glare, halos, weird vision in low light etc) that I got a Tecnis monofocal in my left eye.

    If I could go back in time, I would have got a monofocal in both eyes. I think that ophthalmologists oversell multifocals to make money and don't really tell you about the negative side effects you will experience. If they do, they make them seem like they are nothing and won't bother you. I also think the range of vision in a monofocal is actually quite good. I do have some side effects but I recently discovered I think it's from my eyelid dropping a bit. I read that can happen after cataract surgery. My distance and intermediate vision (computer screen 2 feet from my face)is really good, I will get glasses for close up. You could also try monovision as Ron mentioned. Any questions feel free to ask 😃

  • Guest
    Guest DG12345

    Posted

    Is that 2 foot distance monocular with your new ZCBOO Tecnis monofocal or binocular with the mono + Symphony blended? I'm assuming the latter. And were both eyes targeted for distance (and not too far off)?

    • kevin77191
      kevin77191 Guest

      Edited

      Hi David,

      I believe you were responding to me but responded to DG.

      Yes, if I close my right eye and only look out of my monofocal, I can see my computer screen 2 feet from my face with no issues. I can actually move a bit closer and read it as well and my front is actually pretty small. Yesterday I was in bed and tested my monofocal eye only and I could see my phone screen a foot from me when I only looked out of my my monofocal. It was a bit fuzzy but I could still read it. I am actually quite shocked its this good. I went for a prescription check yesterday and it was -.50 in both eyes. I have a -.50 astigmatism in both eyes as well. He did give me a prescription for computer glasses of +1 which I might use with a sunglass tint as my eyes get pretty tired from staring at a computer screen all day, but i've been without them for the past 5 weeks with no issues.

    • Guest
      Guest kevin77191

      Posted

      That's amazing. I guess having ended up at -.5 in both eyes helps. As well as the astigmatism. But still. And your story is not the only one I've heard about really good close up with monofocals. Makes me think maybe I should just stick with the simple option and hope for the best. Or MAYBE the Eyhance which sounds like it would be just a safe and simple as a regular mono but with a slightly bigger sweet spot... so an even better chance for good distance and intermediate outcomes. I was very excited about the Vivity option at first but I'm cooling on it now.

    • kevin77191
      kevin77191 Guest

      Edited

      I watched a webinar on the Vivity lens with some ophthamologists last week. They all talked about how amazing it is. They gave 3 real life examples and all 3 had amazing results as 20/20 vision and could read close up etc etc. All marketing bullsh*t. I did look into the Eyhance as well but decided just to be safe and get the monofocal. Monofocals still have side effects. I have/had some but I believe it's caused by blepharitis / my eyelids.

  • Guest
    Guest DG12345

    Edited

    image

    • RonAKA
      RonAKA Guest

      Posted

      David, what is the source of that graph?

    • Guest
      Guest RonAKA

      Edited

      David, what is the source of that graph?

      Search on "Delivering intermediate vision the new tecnics eyhance monofocal iol" and open the PDF. I'm going to make a new thread so I can stop "thread jacking" this one from DG12345. I'll post the link here if and when it gets approved by the moderators.

    • RonAKA
      RonAKA Guest

      Posted

      OK, thanks. I now remember reading that article. It makes me wonder if the blue light filter on the AcrySof lens impacts the MTF. The blue light filter does reduce the light level compared to the non filtered Tecnis lenses. The AcrySof filter is designed to match the natural lens which passes less light than the unfiltered Tecnis lens.

    • Guest
      Guest RonAKA

      Posted

      It makes me wonder if the blue light filter on the AcrySof lens impacts the MTF

      That thought occurred to me as well. Interestingly, Alcon claims the filter actually lets you see better even though it's filtering out some wavelengths. It's less light overall but (according to them) more functional and natural. I guess that's why it maybe comes back to focusing more on real world outcomes than theoretical laboratory tests.

    • Guest
      Guest RonAKA

      Edited

      My new thread on contrast sensitive comparisons still hasn't gone live / in moderation. I don't know if that it normal or not. And I can't even access my original text for that new thread. Rather than try to recreate it all I will just post the final findings that I made FYI:

      .

      MTF 50 lp/mm at distance

      .

      3mm (day)

      Tecnis: 0.56

      Acrysof: 0.46

      Eyhance: 0.46

      Vivity: 0.25

      .

      5mm (night)

      Tecnis: 0.42

      Eyhance: 0.36

      Acrysof: 0.28

      Vivity: ???

      .

      I believe these are lab tests done with a "model eye / ACE system" so maybe they should be taken with a grain of salt and are not that much of a concern in real world usage using two (mostly) human eyes (and brain) and looking at the world vs. "looking" at an abstract pattern with some kind of lab apparatus... but that 3mm Vivity number is concerning nonetheless. And I have seen a few complaints online from actual patients about contrast loss with Vivity (one in this forum and a YouTube comment from an Ophthalmologist saying he's had to do some explants already due to contrast complaints). It's contrast loss is actually worse that with today's multifocals. That makes sense because it's spreading the light out over a longer continuous range rather than focusing primarily on three points.

      .

      That said I always have to remind myself that you only hear from those with poor outcomes online. Online posts are anecdotal. You rarely hear from happy patients online. Still... 0.25... yikes. That result is the reason the FDA required the warning label on Vivity about CS.

    • RonAKA
      RonAKA Guest

      Posted

      I believe the blue light filter reduces chromatic aberration by filtering out the wavelengths that are impacted the most. The Tecnis Synergy now uses a violet filter, for I suspect the same reasons. The side effect is that total light transmission is reduced. But since I don't totally understand MTF I don't know how that is impacted.

Back to top
Prev

Report or request deletion

Thanks for your help!

We want the community to be a useful resource for our users but it is important to remember that the community are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the community is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.