Type of IOL lens best for me

"And night vision should not have any glare or halos or maybe a minimal amount"

You know, "should" is a funny word. 😃

I have Vivity lenses in both eyes and I also see halos at night, in some very specific conditions. They're not crippling my night vision but I gotta say, I don't like them at all.

Here are the specific conditions:

1. it never happens indoor
2. it only bothers me outdoor because the lights have to be further away, maybe more than a few dozen meters
3. blue lights are the worst, red are the best and yellow and white are OK-ish.

   I did NOT enjoy this last Christmas season, I can tell you that.

   On the bright side, I see no glare or starbursts.

   Other than that, my vision is very good for any distance and I use my smartphone without glasses.

I am facing the 2nd Vivity implantation. the 1st implantation was successful. Very good distance and intermediate medius (70cm), functional proximity, in good light and good contrast from 40cm good visual acuity for reading. I don't have glare and co. Since the 5th week I see when I look into a lamp, lantern, moon, sun, etc, 2 thin lines through the circle of light, but does not bother me any further. According to my surgeon, this is due to a small capsule algae that has formed. Would dissolve with a YAG treatment...

Loss of contrast is significant, at least with unilateral implantation. When the light is dim, reading is hardly possible, unless the contrast of the font is good.

I wish you the greatest possible success!

I am 72 and have always been near sighted, and for the last 20 years or so had some astigmatism as well. Then I developed cataracts with my right eye more severe than my left. With some limited research I dismissed the MF PanOptix lenses. A good friend had less than idea experience with the, and my surgeon said he would not put them in his eyes. Vivity was not available at that time so I got AcrySof IQ set for distance vision. I got 20/20 vision with a 0.0 D spherical, and -0.75 cylinder. My surgeon said I was not suitable for a toric and expected less than 0.40 cylinder, but this is what I got... Bottom line is that I got 20/20 vision or a bit better and I can see down to about 20". Not quite close enough to use a computer monitor, but no problem reading the dash instruments in my car or truck.

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Now I am coming up to having the second eye done and I am trying to decide between another monofocal lens but set for mini-monovision (under correction by -1.25 to -1.50 D) an the Vivity. I am currently simulating the min-monovision with a contact in my left eye and really like it. I am essentially eyeglasses free except for when my contact is bothering me late in the day.

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So, I have been flip flopping between another monofocal and the Vivity. The knock on the Vivity is that it has low contrast sensitivity especially in lower light conditions. Alcon says that can be mitigated if you use the Vivity in both eyes. I think that a monofocal (which has much higher contrast sensitivity) in one eye and Vivity in the other eye is an even better solution. You will find some long threads here on Vivity and some users report halos and flare with Vivity which is not supposed to happen. That is certainly giving me some pause for thought.

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If you want good reading vision I suspect Vivity will come up short. If I go that way I plan to ask for an under correction of about -0.75 D.

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Short story is that if you want to go with Vivity, I would suggest a monofocal AcrySof IQ or Clareon in your dominant eye corrected for distance (-0.25 D target), and an under corrected Vivity in your non dominant eye. This is something I would discuss with your surgeon as it is not the bread and butter standard way of going. And you should have a discussion with the surgeon about the probability of optical issues like flare and halos with the Vivity. It is much less likely than a full MF like the PanOptix, but it seems to still be possible.

Many users of Vivity have said they suffer from contrast sensitivity loss. In fact I think the manufacturer now states such on its website.

“Vivity Reading and computer will be good and readers will be required for the tiniest printing.”

The goal of Vivity was to provide just a bit of EDOF, maybe gain a line at intermittent and close distance, while simultaneously having the maintaining the advantages of a monofocal. I think it has failed at the latter.

Vivity only provides for 0.5 D EDOF. This is the bare minimum to even meet EDOF requirements. To put this in perspective, Symfony provides 1.5D of EDOF and people with Symfony still complain they do not get great close vision.

Everyone’s results are different, but unless you do monovision I doubt you will have great close vision with Vivity.

My suggestion is pull out the Vivity Defocus curve. The Defocus Curve is your best friend and then look what vision acuity you are likely to achieve at different distances. It is about what your goal is. Is it to get 20/20 at 16” or 20/50 at 16”.

pan optix and acrysof monofocal. one in each eye should do it.