Mt Vivity lens experience, would l go with vivity again?
Posted , 10 users are following.
Hi past 6 weeks l had vivity in both eyes with mini monvision, THe right eye plano or distance and the left eye slightly near. If l could do it over again would l still go with vivity and what would l do differenly.? THe answer is yes l would still go with vivity again but l would not go with mini monovision, l would have both eyes set for distance or plano? the vision in my right eye set for distance or plano is totall 100% fantastic from distance to near, clear sharp and high definition both in good and bad light. But the distance vision in my left eye is only good in good light. For example if l am outdoors in good light the distance vision in left eye seems just as good as the right eye but as soon as l go indoors where theres less light the distance vision in the left eye goes blurry while the right eye stays good. The low contrast in low light problem is only in the eye set for for nearer vision while the eye set for plano or distance has great contrast in all light. lm thinking about IOL exchange in the left eye for a distance lens but worried about the risk
0 likes, 19 replies
007Bond john20510
Posted
Thanks for your post I currently have the Panoptix in my left eye and have been thinking what I'll do in the future for my right eye one of my considerations is the Vivity. Still waiting to see how the Panoptix settles out but was debating if I did go with the Vivity how would I want to have it set. I notice the issue you're describing in the low light when viewing very small print.
I think that I would recommend that you wait more than six weeks before doing a lens exchange. But if you're seriously considering it true you don't wanna wait longer than you have to. I also wonder if you have the option of Lasik for that mild change without doing a lens exchange?
I'm learning that there's some very noticeable differences between my left eye with the Panoptix and my right eye with the natural lens. I don't plan on getting my right eye done until it becomes necessary which the doctor says could be sometime next year or even longer. His recommendation is don't do anything until it's necessary. I'm learning that even though there's differences between the two eyes together they work quite well. I know I often find myself testing one eye and then the other eye and comparing them. But I'm finding out that if I just keep both of my eyes open and go about my daily business things are moving along OK.
So my question to you is with both of your eyes open are you really noticing any issues?
john20510 007Bond
Posted
so the issue is poor distance vision in low light in the left eye not reading vision
john20510 007Bond
Posted
Thanks , the problem is the distance vision in the left eye( near vision eye) is bad in low light such as indoors, the near vision in that eye is good even in low light
007Bond john20510
Posted
I get you John but what I am asking is if you keep both eyes open how are things?
I get you that one eye at a time you notice this just curious how you see it not testing the eyes independently but both open?
RonAKA john20510
Posted
How is your reading vision with each eye alone? Is your reading vision better with the left eye? How is your vision at all distances with both eyes open?
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The reason I ask is that the purpose of monovision is to give a different job to each eye. Each eye is not going to be the same and offer the whole range of vision. But, together with both open, they should.
john20510 RonAKA
Posted
The strange thing is the reading vision is better in the distance eye then it is is the near vision eye, but with both eyes l can read well in all light unless its very small print then l need glasses
RonAKA john20510
Posted
Yes, that is kind of strange. It is not unusual that you would need reading glasses for fine print. But, you have not said what the target was for the near eye, so that is a bit of an unknown. It is unusual that the distance eye would have better close vision. That makes no sense, and would suggest something may be wrong with it.
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An eyeglass prescription post surgery would likely reveal some of what is going on.
RonAKA john20510
Posted
When I said "wrong with it" I was referring to the near eye.
greg59 john20510
Edited
Seems like Vivity is designed to work binocularly. Both eyes set roughly the same, close to plano or maybe -0.25D short. Better contrast sensitivity and decent depth of vision, some near if in good light.
I have the Eyhance and a very small amount of monovision (-0.9D and approx. -1.3D) but I can also notice the same effect as you at distance. Both eyes see about the same in good light but as the light gets dim, the near eye gets fuzzy while the far eye is much clearer. At intermediate, where my vision should be strongest, I can read computer monitors better in low light with the near eye even though it likely has a bit of astigmatism that the far eye doesn't have.
My dominant eye ended up being done last and is now the near eye....mainly because I wasn't satisfied with low-light intermediate vision in the other eye. In good light, when both eyes see well, I think my dominant near eye takes over for distance. My near eye is only dominant when my far eye gets fuzzy (lower light intermediate and near).
Eye dominance might explain your odd results as well.
I wouldn't consider an IOL exchange unless your binocular vision is somehow unacceptable. If the near eye is -1D or even more myopic, you might gain a bit with an IOL exchange that made both eyes work better binocularly. Binocular contrast sensitivity would improve. There might be a lower chance of a refractive miss on the 2nd try. To me, those potential gains wouldn't be worth the additional risks from another surgery if the binocular vision is acceptable as is.
john20510 greg59
Posted
what about lasik?
greg59 john20510
Edited
Lasik is the approach favored among surgeons for fixing less than ideal outcomes from cataract surgery. One place offered me a "free touch-up" if the IOL replacement wasn't satisfactory. Not sure how long I would have needed to wait but I'd imagine several months to get the Lasik "touch-up."
I looked into Lasik about 10 years ago but didn't get it. Glad I didn't after finding out that having it makes the outcomes future surgeries (like cataracts) less predictable and larger refractive errors more common. A huge risk that was not explained to me when I looked at Lasik.
There's a limit to the number of surgeries your eyes can handle. Each additional cut makes the results from the next cut less predictable. Every eye surgeon strongly prefers to cut "virgin" eyes for that reason.
Dry eyes and floaters are fairly common Lasik risks and there some more serious but far less common risks as well. Some go away, others stay around.
I'd look into correcting the vision with glasses and/or contacts first, just to see what might be achievable. If you can't fix the vision to your satisfaction that way, Lasik isn't likely to do any better. If the corrected vision is far better than what you have now, then you'll know what the rewards will be. Then you can weigh the risks/hassles of glasses/contacts/Lasik against the potential rewards. One contact lens would be the easiest way to experiment if you can tolerate them temporarily.
john20510
Edited
My advice for anyone thinking of getting vivity , l would say yes its a great lens that will give you great distance , intermediate and some reading probably , but dont go with mini monovision get both eyes set for distance or plano , because my plano distance eye has great contrast in all light levels but the eye adjusted slightly for near as bad contrast in low light
RonAKA john20510
Edited
When the Vivity is set for distance (0.00 position on defocus graph), the peak contrast sensitivity (MTF) is at distance (0.00 position). However when you set the lens for a closer eye in monovision, the peak position of contrast sensitivity moves to the right. For example see the graphic below. The standard distance power peak MTF in black is at 0.00. But, if you shift the curve as is done in monovision the peak now shown in blue shifts to the right. The peak contrast sensitivity is now at 1.00 D or about 3 feet. This is not all bad as distance set lens is not all that good at 3 feet. The closer set lens will make an improvement at this closer distance. So while at distance the closer set eye is not going to have the same contrast sensitivity, it will be better than the distance eye closer up. You do not lose contrast sensitivity in the closer eye, it just peaks at a different distance. Across the whole range of distance you will have better contrast sensitivity than if both eyes are set for distance.
greg59 john20510
Edited
That's what I've surmised about Vivity as well. Set it close to plano for both eyes. One surgeon wanted both of my eyes set at plano with Vivity and didn't encourage my discussions of setting both eyes to intermediate or mini-monovision. He was probably right. Vivity makes lot of tradeoffs (see the low-humped flatter defocus curve that adds visual acuity at intermediate/near by taking it away from distance) to get the depth of focus it achieves (distance, intermediate, some near). Setting both eyes to intermediate with Vivity would likely make low-light distance unacceptable since the defocus curve quickly bends below acceptable vision left of the peak. Most will want both eyes working together to get acceptable contrast sensitivity and decent low light vision with Vivity.
Seems like people who have refractive errors during surgery with Vivity don't fare as well as others with similar errors. A miss of 0.5D or more in either direction can substantially impact the quality of vision, especially contrast sensitivity. When the targets are hit in both eyes, it can nearly match the depth of a multifocal with far fewer halos, starbursts, and webs.
laurie30147 john20510
Edited
Everyone is different. I have mini-monovision with Vivity in both eyes, and I like it a lot. It's even crossed monovision (I think). My right eye is set for close, and it measures at -1D. My left eye is set for distance, and the latest measurement put it at +0.25D. I had the replacements done in January and February of this year.
An aside about the refraction measurements. I visited the optometrist in March, six weeks after the second IOL, to get a quick pair of glasses. I visited again in September. My right eye was the same at both exams, but my left eye seems to have shifted. In March, the prescription for the left eye was -0.5D with -0.25 cylinder at 155 axis. In September, the prescription for the left eye was +0.25D with -0.5 cylinder at 075 axis. So maybe there was additional healing during that time? (As a side note, my sister had a poor experience with this optometrist, and I might try a new one next year; there might be a teeny bit of question about the prescriptions.)
HOWEVER -- whatever the numbers, I have been really happy with my Vivity mini-monovision. I never wear glasses indoors; I am very comfortable reading, watching TV, using the computer, and anything else. Outdoors, I have options. My left eye vision is quite good and during daylight hours, I feel fine driving without glasses. Binocular vision is a wonderful thing--the two eyes really do help each other even if they are mismatched. But I have some prescription sunglasses (distance only, with my September prescription) and some clear progressives (with my March prescription). Driving at night or in unfamiliar territory, I like to have the clearest possible vision, and that is what the glasses provide. Since I was myopic all my life, I don't mind glasses at all.
I would not want to have both eyes be the same as either my left eye or my right eye. I suppose that if both eyes were the same but somewhere in the middle, it might be more perfect? It's hard to say. I learned from reading this forum that achieving that perfect state is definitely not easy! But I don't agree with the blanket recommendation to avoid mini-monovision, because it works for me.
I don't see any issues with contrast, but maybe my standards are low. This is so much better than having cataracts and than my pre-cataract vision. The only artifacts at night are a bit of a small ring around bright lights (car lights, traffic signals), but it's not a big deal to me.