Eyhance or Tecnis Monofocal?
Posted , 10 users are following.
I am a 67 year old woman and I am trying to decide between Eyhance or Tecnis monofocal. My last eye glass prescription was -2.00 for the right eye and -2.25 for the left eye, with -.50 cylinder and 130 axis for the left eye. I tried progressives a few times years ago and could never focus with them, so I went with bifocals instead. When I am reading or using the computer at home I always take my glasses off as I find that more comfortable than trying to look through the bifocal portion of my glasses.
I have been reading the posts on this forum and there have been a lot of positives about Eyhance, but also some negatives. Some of those negatives seem to be surgeon “error” among other things, but some seem to be dissatisfaction with the Eyhance. Also, most Eyhance comments/reviews have been days, weeks maybe a few months after surgery. I have seen very few posts a year or more after getting the Eyhance (I realize this could be because of how new the Eyhance is). I am having a hard time deciding if I should go for the Eyhance or play it safe and go with the tried and true Tecnis monofocal.
I would be getting whichever IOL I get set to distance, so I am realistic and realize I will need to wear readers for computer and reading. I also know myself well enough to know getting monovision is just not an option for me. I am also aware there will be a trade-off with whatever I pick.
My worry about the Eyhance is I wonder if it will be the same as progressive glasses and I will end up never being able to focus with them because of their change in power from the outside to the middle. I also wonder how your pupil size will affect your far or intermediate distance with Eyhance. Will my ability to focus on something be constantly changing because your pupil size is changing because of the lighting? I am outside a lot and realize it will be different on a cloudy day compared to a sunny day, but what about those days where it is sunny, but with a lot of clouds passing over the sun.
I have read numerous studies comparing the Eyhance to other IOLs, but there have been no studies that I can find where they go back a year later and retest/re-question the participants about their satisfaction. After getting over how great it is too see clearly again after getting the cataract removed, does that satisfaction continue or after a number of months are they dissatisfied with it. All the studies seem to agree Eyhance gives you a bit better intermediate vision. One study said it was pupil dependent, but did not expand on that.
I have looked at the defocus curves and I appreciate Eyhance does not give you a “huge” intermediate/near advantage over the monofocal, but when you are talking inches in the intermediate/near range those inches can mean the difference between being able to read your cell phone, see your watch, see the person sitting beside you clearly etc. without putting on reading glasses. My husband has monofocals in both eyes and I watch him put on and take off his readers numerous times a day and he can’t go anywhere without them. I am hoping for a bit better glass independence, but not at the cost of picking an IOL that has problems.
I appreciate all eyes and situations are different and my outcome will not be the same as yours, but I would appreciate any knowledge/experience people have about the Eyhance. This is a life changing decision and more knowledge and information can only help us to make the best decision for us.
Thanks.
0 likes, 91 replies
karin08666
Posted
Thanks RonAKA and Spring1951. My surgeon has suggested for Eyhance to target -.25 on my left dominant eye and -.50 on my right eye. I know I will need reading glasses and am fine with that because I wear glasses now. I don't want to target my eyes too differently as I know that will not work for me. If my depth perception is off I am worried about falling while doing the different activities I do and just always feeling unbalanced. Good information to know about targeting the Tecnis 1 to -.50, could be the answer if I don't want to go with Eyhance.
billy111 karin08666
Posted
Do you have astigmatism? If so, do you know many diopeters?
karin08666 billy111
Posted
I have a very small astigmatism in my right eye according to my surgeon and not enough to get corrected, .3 I believe. In my left eye he said it is 1.14. Not sure if that is diopeters, but it will need a toric lens.
RonAKA karin08666
Posted
0.3 D is not enough astigmatism to correct with a toric lens. But 1.1 is enough. You would probably need a toric lens with 1.5 D cylinder.
billy111 karin08666
Posted
Well, the Eyhance toric seems to perform quite well. Since your dr recommends the Eyhance I assume he has had good results with it. If your astigmatism is corrected with a toric, you should have no problem if you wear progressives. RonAKA often suggests the mini-monovision approach to be essentially eyeglasses-free. There are many variables in cataract surgery. Your own ocular pathology, the surgeon's skill, the IOL, and well, just plain luck or chance, But considering that two million cataract operations are done in the USA every year, I am surprised this forum doesn't have many more posts, with questions or complaints. Presumably most surgeries go quite well. It's just that now patients have more choices than ever before, and in the coming years, there will be even more choices with IOLs. The odds are that you will be fine.
Spring1951 karin08666
Edited
I joined an older group called Eyhance Review on this site which I found on google. Here is a post I found.
"My first days seemed okay too. A year out my vision is terrible. I cannot read or knit for more than a half hour. Everyone should know that these IOLs were developed as a medium price point. It was for those that did not want to pay for state-of-the-art multi-focals. I learned this one operation too late. My vision is not good enough to go without glasses and glasses are not compatible with the IOLs. Unusual blurred spots in my field of vision. It is on the table to have them taken out. My new ophthalmologist clinic does not have Eyhance on their approved list.
It is not right that a patient ends up with such a bad outcome and the only recourse is leaving bad reviews. I did contact J&J about their misleading brochure. No one in the brochure is wearing glasses. What did they want patients to think? Also it is not in the brochure that it is a mediocre lens for people looking for a cheap way out, which I was not".
RonAKA Spring1951
Edited
I can't say that I am a big fan of Eyhance, but I certainly cannot agree with that comment that Eyhance is a budget IOL and is compromised due to the price, and are for those that did not want to pay for state of the art multi-focals. I would think the person that said this that is unhappy with the Eyhance is much more likely to be dissatisfied with "state of the art multi-focals". I would suggest this is an example of the very misleading information one can find on social media.
.
I do agree that when targeted for distance the Eyhance is highly unlikely to give you an eyeglass free full range of vision. I have not seen any J&J Eyhance claims that it does though. The Clareon lens is not going to give you a full range either, unless you target different distances for each eye.
billy111 Spring1951
Edited
The Eyhance is not a "mediocre lens." It is being used world-wide by cataract surgeons. I would not take that review seriously.
Spring1951 RonAKA
Posted
I never wear glasses so it will not be something I relish and I probably will shun them anyway if I can!
RebDovid Spring1951
Edited
I don't question the poster's honesty, but there is not enough difference in the design of the Tecnis 1 and Eyhance to attribute the poster's difficulty to the IOL rather than an unfortunate result or individual condition. That said, my opinion would change were there widespread reports of such results connected to something distinctive about the Eyhance.
I confess not understanding the point of the price point reference. At least when introduced in the U.S., it cost surgeons a modest amount more than a conventional monofocal. But in most (nearly all?) cases the difference can't be passed on to patients because of Medicare rules and surgeons' agreements with health insurers.
Spring1951 billy111
Posted
It is hard to know what to believe but I like hearing all sides but I was surprised to read this?
Spring1951 RebDovid
Posted
Good to know there were there no widespread reports of such results connected to something distinctive about the Eyhance. I didn't know if there were and don't have a vast knowledge on the subject matter.
RonAKA Spring1951
Posted
My wife is the same. I think she would do well with monovision, but can't as she only has functional vision in one eye.
karbonbee Spring1951
Edited
I read that comment and thread also, but I think that poster has other problems with her eyes, or maybe the surgeon didn't do a good job of inserting it. The Eyhance is definitely not a "budget" IOL. It's design, especially with regards to the Toric version is held in high regard by many independent surgeons from around the world I've heard talking about it, especially in Europe where it has been used since 2019. I've read a number of them commenting that the "haptic" shape of the Toric makes it the most stable Toric lens they've worked with, with the least amount of destabilization after the surgery and they think that it will become the standard design in the near future for Toric lenses. I'm paying an extra $600 CAD for the normal lens and if they have to use the Toric version, it will be $800 extra per eye. From everything I've read about it, and the results most people have had by using it, it's going to be money well spent.
Spring1951 karbonbee
Edited
My doctor informed me that at my HMO Eyhance is free to me. I can not get the toric version though because my stigmatism is not enough. Any toric at my HMO I think is about $700 extra.
karbonbee Spring1951
Posted
Oh, that's nice. Good to know if you decide to take that route for the second eye. I couldn't wait any longer for my name to come up for the free surgery in the hospital, my vision has declined so quickly. The waiting list is really long in Ontario because of Covid surgery backlogs in general. It could be another six months to a year before my name would come up. With my luck though, I'll probably get a call the week after I pay for the surgery in a private clinic, lol.
Spring1951 karbonbee
Edited
In fact now I looking at Eyhance and Tecnis for both eyes. The glistening is an issue with Clareon since they don't know yet.
Oh, you are going to a private clinic which would be right if your vision is deteriorating! One thing about my HMO I can get surgeries within about 3 weeks. I might even change doctors as we had an angry exchange recently and she is not responding to my emails. I can't believe this drama with this doctor?!!
karbonbee Spring1951
Posted
Yes, much faster using a private clinic. I could have had my surgery even sooner, like a couple of weeks ago, but they had to make sure that I hadn't worn my gas permeable contacts for at least a month before they did the in depth tests as they can change the shape of your eye and your results won't be as good.
.
No, not a good sign when your surgeon refuses to be accountable for mistakes at their clinic. Definitely doesn't create trust. Maybe do a search around your area for surgeons and read reviews if possible or ask around for some references. Although I've had some surgeons that were kind of impossible rock stars to deal with, but their work was impeccable, so I let it slide because the results were so good. Hard to know though if that is the case with your surgeon. Sometimes the nicest surgeons aren't necessarily the best technicians, and when it comes to surgery, I want the best technician I can find -- even if I want to smack them at other times, lol. Wouldn't hurt to have a second opinion though, even if you don't end up having the other person do the surgery.
Spring1951 karbonbee
Edited
Interesting points. My HMO has all the Opthamologists listed and I believe most or all do cataract surgery. I don't know if that makes them officially surgeons or not? I could easily go down the list and pick another one and get a surgery very soon.
It sounds like you have experience with surgeons that I simply don't have since rarely have visited the eye doctor until recent years. My doctor has done at least 1,000 surgeries as I had asked her that question. Unfortunately, I would not know if she is a good technician or not? Also, I wouldn't know if any of the others are? They do have a few reviews on there but they seem all good. Maybe I will get a second opinion, however.
The Rock Star Surgeon....that is a new one.... but I get it in that some doctors and surgeons I have met in the past seemed rather temperamental and egotistical. I actually hung up on a belligerent
Gastroenterologist a few years ago while I was discussing a colonoscopy.
Getting the best technician is as you say, definitely what one wants. You are lucky you know who is who in that regard!
karin08666 Spring1951
Edited
Just got back from my cataract surgery about 1 1/2 hours ago. When I went to see my surgeon before the surgery was set up he said I didn't need a toric lens because my astigmatism was too small for one and he would just put his incision in such as way as it would take the astigmatism away. Today, as I am laying there waiting for him to insert the lens he tells me "oh you might still need glasses to fix the astigmatism". Never mentioned this in his office, otherwise we would have had a conversation about it. So frustrating. He is the type of doctor that will not answer questions and does not tell you what he plans on doing. I know my lens power, but I have no idea what target he was shooting for. After he was done he just left the room without saying anything. He is one of these rock star doctors and is apparently very, very good. Once I can see out of my eye I will let you know if I think that is true. Right now everything is a big blur and my eyes are still very dilated and feel like they are full of glue. Thank goodness his staff are very, very nice.
RonAKA karin08666
Edited
Sounds like my surgeon. Each time I saw him I wondered if I was talking to the same guy. We seemed to start at zero familiarity each time I saw him. We think about these things for months, but I kind of think these guys that do 25 or more surgeries a day, we are just a 10 minute slice out of one day of their practice. I think the good news is that they get good at it after doing thousands of surgeries...
.
Wishing you the best with your recovery...
Spring1951 karin08666
Edited
Oh, that sounds hard on you! I can imagine just how that would feel and certainly would not help you feel more secure and confident!
I have trouble getting information from my doctor also. I have insisted on some telephone consultations where I present her with several questions. We had an argument in the last phone conversation and now she appears not to be returning emails! I just love temperamental and uncommunicative doctors!
Anyway, at least you made it through your surgery! Good luck on that. Now you can get some R and R after all the stress of anticipation!
karbonbee karin08666
Posted
Oh, goodness. How unsettling for you! Let's hope he is indeed a rock star surgeon and the results are worth the stress he's caused you. Hope your outcome is what you wanted!