Has anyone used the Tecnis Eyhance IOLs?

Thanks for the reply.

I read that long thread and it was very informative, especially from a theoretical perspective, and your posts, in particular, were very interesting.

I was surprised that there weren't many personal patient experiences, though, which is why I started this new thread.

I know the Eyhance is not an EDOF, but I'm wondering if it has provided anyone with better intermediate vision than a straight monofocal.

I am not sure of your reasons for avoiding an EDOF, but keep in mind that the Eyhance uses EDOF technology and it is kind of a technicality that it is not called an EDOF. I believe they vary the power of the lens from the periphery to the middle. This smears the focal point across a range rather than to a sharp point like a standard monofocal. The Vivity achieves the minimum 0.5 D stretch, but the Eyhance just falls a tiny bit short of it. Nevertheless they are basically doing similar things to gain a bit of intermediate vision.

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To answer your question about how much more intermediate vision you get it would be best to google and look at the article below. It compares the Vivity to a monofocal and the Eyhance to a monofocal. The answer is in the defocus curve. The limit of good vision (20/32) is at a LogMAR of 0.2. Where the curve intersects with the 0.2 line look down and note the defocus value. If you divide 1 meter by that defocus value, you will get the distance, which you can compare to the monofocal. But, pay particular attention to the Eyhance chart where the monofocal lens has error bars associated with the single line. This is the individual variation of results, where the line is the average. That is the issue with depending too much on testimonials. Each individual can be anywhere on that error bar. Some get better results and some poorer. And, each of these curves will have a similar error bar even though they are not shown.

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Here is the article to google.

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15 APRIL 2021 IOL Review: 2021 Newcomers

Thanks, an interesting product summary of the Vivity and the Eyhance lens.

Now, I'm wondering if using a stronger EDOF like Vivity might be an option in my good eye, and using an Eyhance or Alcon monofocal IOL in my bad eye.

Has anyone out there mixed an EDOF lens with a monofocal IOL?

Would there be any difference in image size that might confuse the brain?

I have not heard of anyone using the Vivity and Eyhance combination. Vivity provides a little closer vision, but also comes with a higher risk of optical side effects.

Are you saying you think there will be more more visual side effects with Vivity vs. Eyhance, in addition to the lower contrast with the Vivity?

Are you talking about headlight glare?

Why would this be, since both lenses are not diffractive?

And I wonder if there are other risk factors for the Vivity vs. the Eyhance (e.g. surgical). With only one good eye, low risk is good.

Rick, I had cataract only in one eye, which was due to a trauma. If I develop cataract in the other eye, I'll surely get an IOL for that eye too. My experience is totally positive.

That's great feedback... thanks!

Honestly there are a lot of discouraging posts here about Eyhance results, so it's good to hear of a great result, or at least a result I would be happy with.

With my one good eye, I'm still interested in targeting a little myopia to give me even better intermediate vision, but I know it's a little bit a matter of luck how it ends up.

So, if I understand you, your surgeon targeted plano and you ended up +0.34D hyperoptic without glasses?

Sorry for the delay. I wanted to try to give lots of info. My targets were RE 1st minus and LE 2nd minus but I ended up at almost RE 2nd plus and about LE 1st plus so it was big miss. My eyes have long axial lengths and target predictions tend to miss by a lot in eyes with >26mm axial length.

IOL's are most often sold in 0.50D power steps (lens plane) but the actual effect on your vision is only 0.34D (cornea plane) for every power step increase or decrease.

By trying the +0.25D, +0.50D & +0.75D contact lenses after my eyes healed I was able to find out that any correction at all to my left eye makes that eye's outdoor distance vision worse and that a +0.25D contact lens slightly improved my right eye outdoor distance vision but a +0.50D contact lens made my right eye outdoor distance vision worse. That tells me that I could have had a bit better outdoor distance vision from my right eye with one IOL power (0.34D) step less correction than the power I received. (towards 19D, not away from 19D, 19D is basically the middle and least amount of correction)

Indoors it's is a bit different but also a similar need because I also benefit a bit from correcting residual astigmatism. It seems to me that my astigmatism mostly goes away with a small pupil size in bright light outdoors. Glasses with right eye 0.50D Sph 0.25 Cyl and left eye 0.25 Sph 0.50 Cyl sharpen things up a little bit indoors. That's a right eye Spherical Equivalent (SE) correction of +0.37D and left eye Spherical Equivalent correction of 0.00D so it basically confirms that with one IOL power (0.34D) step less correction (towards 19D, not away from 19D) than the power I received would have also helped my right eye vision indoors and again, no correction really necessary for my left eye.

I would have gained more near with 2 IOL powers difference (0.68D) in my right eye and 1 IOL power different in my left eye from my plus side outcome but I'm certain my 20/10 outdoor vision would have been lost. Even 20/16 would have been lost I think. 20/20 would still have been in play at least binoculary if not monocularly. The near vision gain would not have been enough for most of my near vision requirements though. I see better using +1D readers instead of +0.75D readers for computer use for example so a +0.68D near gain (2 IOL powers) wouldn't have quite done the job. It would have given me more comfortable arm's length phone use indoors. Any current make-do without readers situation would have been improved with +0.68D near gain though.

In daylight outdoors, I can already read the smallest text on a Jaeger reading test sheet so there would have been no reading vision gain for the trade off loss in distance vision outdoors.

I'm pretty sure I get a 0.25D or a bit more myopic shift in daylight outdoors compared to normal lighting indoors. That shift plus what I suspect is a pinhole effect from really small pupil size gives me great all around vision in daylight outdoors, both 20/10 distance and reading small print. Search for "zcb-iol icb-iol mtfa" for the text from a lab study that predicts a myopic shift occurring from 2mm pupil size.

Because I ended up on the plus side I suspect that my indoor vision is more like a very good standard monofocal result rather than an expected Eyhance result. As I previously mentioned, it's +1D readers for desktop computer use, +1.5D for some kitchen tasks and phone use at the dining table etc. and +2.5D readers for reading in bed. It all depends on how much blur you can tolerate. For reading, I prefer no blur. I did an oil change on my car today without using readers. The car was in my garage with overhead lighting. I did not have a light under the car but had no difficulty doing the job. I could make out the socket size for example. I'm getting more comfortable with some blur for some tasks.

I think I'll end up with progressive glasses being my readers to simplify things and eliminate needing to put readers on/off when moving to different sections in stores. I won't need them outdoors but will bring them with me if going into a store or restaurant just in case they're needed. At home, I will use them for some kitchen tasks and phone use indoors reading the news & messages etc. For desktop computer use, I'll continue using the +1D readers because it's so nice to see all the text on the screen clearly without having to move my head as would happen using progressives.

It'll will be interesting to find out if any other Eyhance recipients also get full reading ability outdoors but not when indoors or if they notice a small myopic shift occurring in daylight outdoors. It could be something that just applies to me or just to others with eyes that have similar parameters as mine.

Good feedback...

I never could get used to progressives myself, but I agree - the less glasses shuffling the better.

What was your vision before the Eyhance IOLs?

When do you have to put on those cheaters? (anything except driving or outdoor activities?)