Computer screen - "near" or "intermediate" vision? Do I really need EDOFs for it?
Posted , 8 users are following.
Hello! Just spent entire month to convince myself that I'll be unhappy with PanOptix or any other multifocal IOLs due to decreased vision quality, dysphotopsias and other side effects. So now I'm between EDOFs and Standard Monofocals and really want to avoid being tricked by Youtube "Experts", Google's censorship of patients reviews to protect lense makers and doctor's sales pitch. I don't have any serious problems with my vision except Cataract, dry eyes and age-related minor presbyopia. I see a lot of discussions lately about EDOF lenses but due to being relatively new to US market, can't find anything useful except marketing material and optic characteristics. Do these lenses really offer glasses-free computer screen reading abilities? $5000 extra for Premium EDOF lenses is not that cheap for me but I'd pay it easily in exchange of being glasses-free working 8 hours per day in front of a computer screen. I'd really appreciate for any input. Thanks!
0 likes, 15 replies
RonAKA dreamer2020
Edited
I have one monofocal IOL and I can see down to about 18" for reading text on a computer. However I find that an uncomfortably long distance, when your hands still have to reach the keyboard. When I put on some +1.25 readers I can see the screen perfectly. I think the Vivity and possibly the Eyhance would allow for computer screen vision without readers.
Sue.An2 dreamer2020
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I have EDOF Symfony lenses implanted in both eyes in 2017. I rarely use glasses for anything. I can thread a needle or repair my sunglasses (that tiny screw fell out a couple of times). Vision is honestly seamless - no dip like you'd get with a trifocal and light isn't split as much so contrast sensitivity not as great an pact. I had 6 weeks between surgeries so could compare that.
I have +1.25 readers that I use for extended periods of reading or reading pill bottles. I work on a computer 90% of my workday - zero issues. I play golf, snorkel and enjoy hiking - no issues there either. I see well to read from 11 inches.
I do see to this day huge concentric circles around certain lights (cars when they brake, red traffic lights.). These get smaller the closer I am to light source. If you spend a significant amount of time night driving these may not be right lenses for that person. (truck drivers/pilots)
Our needs change with time but at 53 when I got these lenses I spend a lot of time in front of a computer so that influenced my decision.
Guest dreamer2020
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I'm not sure the halos and such are any (or much) better with a diffractive EDOF vs. a diffractive multifocal. Personally I would look into Vivity or Eyhance with a slight micro-monovision offset if you're worried about photic phenomenon (halos and such)
dreamer2020 Guest
Posted
I've read that Eyehance and Vivity are slightly different. Vivity has a filter that affects in slightly decreased color perception while Eyehance is clear just like standard monofocals. Plus Vivity is based on similar to PanOptics platform using diffractive rings compare to Eyehance which makes me think that Vivity is giving a slightly more intermediate vision than Eyehance but results in less contrast sensitivity and bit more disphotopsias.
Guest dreamer2020
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All Alcon lenses have what they call Blue Light Filtering. I don't think it's a huge consideration unless you're a photographer or something. Alcon claims the resulting colour is more natural. All J&J lenses are clear except for the new Synergy lens which has Violet light filtering. Nothing to do with monofocal or not. Just the colour of the material that different manufactures claim is best.
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Vivity is not based on PanOptix and does not have diffractive rings. It is a very novel optic and it is refractive not diffractive. Studies have shown that it's dysphtopsia profile (halos and such) is comparable to a monofocal.
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Yes Vivity does give more intermediate than Eyhance. Please don't expect clear reading vision however. Might be ok for computer use (your results may vary) and certainly for reading your car dashboard but it cannot promise good near vision (reading restaurant menus, books, iphone, etc.)
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I think the main trade off with Vivity is loss of contrast sensitivity. However you will likely only notice this in low light situations (dim room, maybe driving at night or in low vis conditions like fog). If you go Vivity I would personally target both eyes for plano with no offset (i.e. no monovision… both eyes the same). This will give you the best possible contrast from the lens since the contrast peaks of both lenses would be at the same focus point (i.e. working together).
RonAKA Guest
Posted
I would agree, except perhaps for the bit about not offsetting the lenses with Vivity. I think there is something to be gained in range of focus and while the contrast sensitivity peaks will be offset, each eye is still going to have the best contrast sensitivity at the peak. The range of contrast sensitivity will be increased.
RonAKA dreamer2020
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As David has mentioned the blue light filtering of the Alcon products is to simulate the colour profile of the natural lens. It is the J&J clear lenses that are not natural and will give a more blue colour profile than the natural lens. The clear J&J lenses will be similar to the SA60AT (clear) lens in this graph.
Guest RonAKA
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Just bear in mind Alcon recommends both eyes being set the same. I'm also aware of at least one anecdotal report of someone that did an offset with Vivity and has issues in low light distance vision (night driving and watching indoor sports) that are fully resolved by using a contact lens to get the eyes back "in sync". But of course your mileage may vary. And I'm aware that a -0.5D offset with Vivity IS becoming very commonplace with many surgeons including top surgeons that often speak at Webinars and participate in trials etc. But not all surgeons agree. And I personally would not take that risk. The data is right there for all to see in the trials. Vivity fails FDA minimum requirements for contrast loss in monocular testing. It only passes the contrast loss minimum requirements in binocular testing (both eyes and both set the same). But it's not at all uncommon. My own surgeon does it and has had no complaints (according to him). Although he admits low light performance with Vivity is not ideal.
RonAKA Guest
Posted
I would under correct by 0.75 D. But I think even better than under correcting the second eye, may to use an aspheric monofocal in the distance eye, and a Vivity at -0.75 D in the second. I considered that for a long time, but have now decided that I will just do another monofocal at -1.25 in the second near eye.
dreamer2020 Guest
Posted
talking about Vivity lense... I had a personal consultation with some clinical IOL integration expert, Alex (YouTube channel called "Eye surgery explained") and looks like he is not really impressed by Vivity data. He recommended me Tecnis Eyehance instead. I'm starting to believe that Alcon marketing team is doing really good job of promoting their newest products. Internet is a lottery where you never know if you are reading a real patient's testimonials or Alcon "agent". I just hope to find a skilled doctor who cares more about patient's satisfaction than his/her J&J or Alcon contracts.
Pifutoast dreamer2020
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I have mono vision, Dominate RE distance, LE intermediate and do not need glasses to use the computer or cell phone. Standard Mono focal lenses.
catherine67046 dreamer2020
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I'm very nearsighted (-5.00) with age related presbyopia and I had a Synergy lens implanted 3 weeks ago in my RE. With that eye I can read computer (arm's length) distance, but activities closer than that are problematic (reading phone, writing notes, reading labels at grocery store, polishing nails). So much so that I've put off my 2nd surgery. I'm using a contact lens in LE for now.
I'm just one person, but I spend 4-6 hours a day in front of computer so there's that. At this point, towards end of day I put on 1.25 readers for greater clarity but that may be due to low light.
I didn't know about EDOFs, but think it's no longer an option as I already have a multifocal. I hope you get the answers you need!
RonAKA catherine67046
Edited
I have a monofocal that gives me 20/20 distance vision (0.0 D spherical correction), and I can read a computer screen at arm's length just like you can with the Synergy. I have to think your surgeon must have left you a bit far sighted and that is limiting your close vision. One option would be to target the second eye for closer -- perhaps about -0.75 D myopic with the Synergy.
catherine67046 RonAKA
Posted
You would think so, but I had my vision tested and at the 3 week mark it's 20/25. My eye doctor was not optimistic about it getting better. I heard a lot about the many measurements the surgeons do of length and depth of the eye and that sometimes they don't get it quite right the first time, but will use the first eye to adjust the 2nd lens. None of it sounds great so I'm waiting. The contact works.
rwbil dreamer2020
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First EDOF are also defractive IOLs and subject to dysphotopsias.
No one can give you a guaranteed answer as everyone results will vary. Everyone has different eye conditions. In fact I did not know there were so many eye conditions until I came to this site. Everything from short eyes to large amount of astigmatism.
And the doctor might not hit the mark. So if you shoot for Plano he might end up -.5 slightly myopic giving you a bit more close vision, But he also might hit +.5 giving you less close vision.
And the other issue is Just how good does your computer vision need to be? Again everyone is different. Do you need 20/20 at that distance or is 20/40 good enough?
I would suggest looking at the defocus curve the IOL you are thinking of it and see what the clinical trials show the results to be. But keep in mind there is a standard deviation around that curve.
To have the best chance of seeing the computer clearly, you might look at the less risky Refractive EDOF lens; Vivity and Enyhance (Not sure this one even qualifies as EDOF).
Then if this is you non dominate eye shoot for -.5 diapoters, giving a boost in the intermediate and close vision.
Another option is look at the LAL. Then you can adjust your vision after surgery to see what works best for your situation.