Preprint: Eyhance Gives Statistically Superior Significant Intermediate and Near Vision vs. Clareon
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Currently under peer review for Springer International Ophthalmology is an article—available as a preprint under the Creative Commons Attribution 4.0 International License—reporting on a study, comparing visual acuities at intermediate, near, and distance three months post-op on the second eye, of patients implanted bilaterally with the Eyhance, Clareon, or ZCB00. The study found statistically significant superior visual acuities for intermediate and near vision with the Eyhance without negative effects on patients’ quality of life. Non-statistically significant differences were observed for distance visual acuities. The article is “Visual Outcomes and Patient Satisfaction after Bilateral Implantation of an Enhanced Monofocal Intraocular Lens: A Single Blind Prospective Randomized Study”. Rosa Giglio, of the Department of Medicine, Surgery and Health Sciences at the University of Trieste is the lead author. (Patients appear all to have received the non-toric version of the IOLs, unlike the recently-announced Alcon study, which may have biased results in favor of Clareon by, among other things, implanting both toric and non-toric Eyhances but only non-toric Clareons.)
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Mean UIVA ± SD was 0.17 ± 0.12 for Eyhance and 0.31 ± 0.09 for Clareon; p<0.001
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Mean DCIVA ± SD was 0.13 ± 0.11 for Eyhance and 0.29 ± 0.09 for Clareon; p<0.001
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Mean UNVA ± SD was 0.23 ± 0.11 for Eyhance and 0.33 ± 0.12 for Clareon; p<0.001
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Mean CNVA ± SD was 0.23 ± 0.11 for Eyhance and 0.33 ± 0.12 for Clareon; p<0.001
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I’ll post defocus curves separately in hopes of avoiding delay to the post.
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Note that the authors report having no relevant financial or non-financial interests to disclose. The study itself was supported by an unrestricted grant from Johnson & Johnson. (FWIW, Dr. J. Morgan Micheletti, who undertook the favorable-to-Clareon study at his practice and gave a video “paper” presentation at the recent ACRS annual meeting, discloses being a paid Alcon consultant.)
0 likes, 21 replies
RebDovid
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Here are the defocus curves from the Giglio article discussed above.
soks RebDovid
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shouldn't the area under curve be the same same for all lenses. it appears that eyhance is able to allocate more acuity at all distances.
RonAKA soks
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You are correct. Those curves look suspicious.
RebDovid soks
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Not necessarily. The design, material, and size of an IOL are some of the factors affecting the amount of light passing through to the eye.
stefan64833 RebDovid
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The university could have received a big grant from J&J and still reported no conflict relative to the study. Happens all the time!
RebDovid stefan64833
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As I noted, the article reports both that J&J supported the study with an unrestricted grant and that the individual authors had no financial interest. Whatever one make of these disclosures, the comparison is to Dr. Micheletti, who presented the video paper at the recent ACRS conference asserting no significant difference between Eyhance and Clareon for intermediate distance and who has disclosed being a paid Alcon consultant.
RebDovid
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An article published in February 2021 Springer International Ophthalmology, compares the Eyhance to Clareon's predecessor, the SN60WF IQ AcrySof. My understanding is that, apart from the materials, the Clareon and AcrySof IOLs are substantially similar. The conclusion, quoting from the abstract, is: The Eyhance IOL, which features a new optical design based on a continuous power profile, was determined to be superior to a classic monofocal IOL (that is, the AcrySof) for intermediate visual acuity and not inferior for corrected and uncorrected distance and near visual acuity.
The article, "Vision outcomes with new monofocal IOL", is by Esat Cinar and six other authors affiliated with Ekol Eye Hospital in Izmire, Turkey. None of the authors declared a conflict of interest regarding the research. Although the article as published in International Ophthalmology is not available without charge, a pdf of the "author's personal copy" is available through Research Gate.
Regarding near vision, the study found what the authors term "a significant difference" between the two IOLs in that, to read comfortably at logMAR 0.2 at 40 cm (15.7"), Eyhance patients required an ADD of 1.74 D ± 0.40 D versus 2.19 D ± 0.37 D for the AcrySof patients (p = 0.003).
soks RebDovid
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why compare clareon amonofocal and eyhance? isnt even comparison between clareon monofocal and tecnis zcb00. between clareon vivity and tecnis eyhance?
between clareon panoptix and tecnis synergy?
RonAKA soks
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Because an Alcon presentation at ASCRS earlier this month found no significant difference between the defocus curves of the Clareon compared to the Eyhance.
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RebDovid soks
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There seems to be at least some interest in how the Eyhance extended range or monofocal plus IOL compares to pure monofocal IOLs. Most studies compare the J&J Eyhance to the J&J Tecnis 1. Some studies compare it to other extended range or plus monofocals that do not meet the U.S. definition of an EDOF IOL.
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Recently, @Lynda111 began a thread about an Alcon presentation at the ACRS annual meeting claiming that Clareon is "non-inferior" to Eyhance for intermediate visual acuity. After closely watching the video presentation, I posted in that thread about possible reasons to question the claims, including that Clareon only achieved parity with Eyhance when comparing the Clareon’s Target Corrected Intermediate Visual Acuity, with a -0.25 D offset, to the Eyhance’s Distance Corrected Intermediate Visual Acuity targeted at plano. It seems to me logical to expect that if the Clareon is 0.25 D more myopic than the Eyhance that difference should mitigate or eliminate any advantage the Eyhance would have when both IOLs have the same refractive target.
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At any rate, the Alcon presentation prompted me to look for journal articles comparing the Eyhance and Clareon IOLs. The first, and so far only, one I found is the preprint about which I started this thread. The other day, I found the article comparing the Eyhance and AcrySof, which I understand to be substantially similar to the Clareon, apart from the change in material.
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I suppose the reason for posting about this is that some people consider both the Eyhance and Clareon as possible choices for themselves. As I'm not interested in getting a multifocal IOL or the Vivity, I'm not on the lookout for those comparisons (although IIRC at least one early study of the Eyhance compared it to the Tecnis Symfony).
Lynda111 RebDovid
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I will agree with you that many studies have shown the Eyhance to be an excellent IOL.
steven64823 RebDovid
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Thanks for posting this - it's useful info for me as I consider whether to replace my Vivity IOLs (see the "Are you happy with vivity" thread for reasons) but still maintain at least some 60cm-1m vision assistance.
RonAKA steven64823
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Keep in mind that offsetting standard monofocals by as little as 0.5 D can give more intermediate vision than an Eyhance set to plano. And, that assumes the Eyhance claims are actually valid. Getting good near and intermediate vision along with good distance vision is more about selecting the right targets for the lenses than about picking some magic brand of lenses that claims to do it all.
soks RonAKA
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i am looking for monocular defocus curve for clareon monofocal. straight google search isnt giving anything useful.
soks steven64823
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hi steven, read your experience. you might want to stay away from anything that elongates focus. perhaps the clareon platform does not work well for you. maybe go with tecnis zcb00. also if you are at 6 months and going to exchange then do it sooner rather than later and with someone who is experienced at lens exchanges. i am stuck at 4.5 years.
RonAKA soks
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It will be the same as the AcrySof IQ monofocal.
RonAKA soks
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A defocus curve for the AcrySof IQ
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Lynda111 RonAKA
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That is so true. There is no one magic lens that will work wonders for everyone. There are factors to consider when planning for cataract surgery.
soks RonAKA
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if -1.5 is 66cm, what distance is -1 and -0.75?
RonAKA soks
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You just divide 1 meter by the defocus diopter to get distance in meters:
1/1.0 = 1 meter
1/.75 = 1.33 meter
1/.25 = 4.0 meters
1/0.0 = infinity
soks RonAKA
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thanks.