Vivity lens contrast sensitivity terrible
Posted , 11 users are following.
Hi! I had the vivity lens implanted in my left eye about six weeks ago. My contrast sensitivity in even mildly low light (cloudy day, inside, before sunset, etc) has been terrible. One of the opthmologists I've been working with says that because of my moderate miopic maculopathy my retina is stretched thin and that I never should have had the lens reccomended to me. They are reccomending a Technis Eyehance for my right eye and also reccomending I do that eye first and see how the two blend together before I decide to do an iol exchange. I drive for a living and right now, I can get by with a contact part time in the right eye. Im concerned that if I have a problem with the eyehance, I'll be giving up the somewhat usable vision I have now, so I've thought I might do the explantation first. Both my opthomologist and my surgeon are saying the eyehance is no more risky than a regular monofocal, but my surgeon had sold me on the vivity by saying it was only slightly more risky than a monofocal. Any feedback for me? Thanks!
1 like, 14 replies
RonAKA cindyken
Edited
How is your close vision with the Vivity in normal light? If it is good, then I would consider getting a monofocal like the Clareon or Tecnis in your right eye. The monofocal will have the best contrast sensitivity and will help compensate for the reduced contrast sensitivity of the Vivity. The combination of the two lenses may give you good all around vision.
cindyken RonAKA
Posted
Thats the plan! My close vision is pretty good with the Vivity. But is there an advantage or disadvantage to using the Eyehance instead of a conventional monovision lens? I worry that I wiill have problems with the Eyehance.
RonAKA cindyken
Edited
Both the Vivity and Eyhance are extended depth of focus lenses. Vivity has more extension of the depth of focus and enough to claim that it is an EDOF. Eyhance has a little less. But it still stretches the image and there is a cost to that. That is why I think the monofocal is the better choice. If you already have good close vision then that is basically in the bank, and you can go for good distance vision in the other eye.
rwbil cindyken
Edited
Take this with a grain of salt, but everything I hear is the Eyhance is the least risky option next to a monofocal. The goal of Eyhance is to have the same vision clarity of the monofocal and yet get just a little bit of EDOF.
But I am concern you had terrible contrast sensitivity with Vivity. Vivity website does say one can have Contrast Sensitivity loss, but your describe yours as terrible.
Due to the fact you did not do well with Vivity, my advice would be to go with the safest monofocal, as the last thing you want to do is an IOL exchange. That is a last ditch solution.
john20510 cindyken
Edited
vivity webiste comes with a warning "
"Most patients implanted with the Vivity IOL are likely to experience significant loss of contrast sensitivity as compared to a monofocal IOL. Therefore, it is essential that prospective patients be fully informed of this risk before giving their consent for implantation of the Vivity IOL."
thats why l think l will go with Eyhance
cindyken john20510
Edited
John, I think my experience is a cautionary tale for anybody considering the Vivity lenses to take that warning seriously! My surgeon did not say anything about this until I found out while doing research and confronted him about it. He told me the CS loss was very minor and probably would not be noticeable. He also did not discuss the problems I have with my eyes and I did not realize until far too late how seriously they could interfere with the lens.
I don't know what issues you have with your eyes, if any. I am highly myopic with elongated corneas and a retina that is stretched very thin because of this. No deterioration of the macula, but the rods and cones that sense light and color are more spread apart. Also, my cataracts were not very advanced, so I still have a pretty good point of reference with my corrected right eye to show me what my vision should be like. I think a lot of people have already lost so much vision from their cataracts that anything is an improvement!
In very bright sunlight I see at all distances almost ( but not quite)as well as with my contact eye. In anything less, its as if a layer of vasoline is over my eye, and the darker it gets, the thicker the vasoline. Objectively, I've got 20/25 vision. But on a cloudy day I might not know if the small animal 10 feet away is a cat or a rabbit until it moved.
The Vivity is not being explicitly marketed as a lens that is safe for people with "less than perfect" eyes, but many surgeons are presenting it that way. To be fair, I think the majority of people who get it do well. My surgeon claims he's implanted many 100's of Vivity lenses in all types of eyes and I'm the first with a major problem. I just wish he had been more forthcoming about the risks.
Guest cindyken
Edited
Ya, Vivity contrast is right on the edge of being problematic whereas monofocals have contrast to spare… more than you need in most situations. But Vivity is borderline. It actually failed FDA minimums in monocular testing but passed in binocular testing. In healthy eyes in most normal lighting scenarios it does perfectly fine! And there are legions of very happy patients that bear this out. But I think caution is still warranted in less than perfect eyes or if you are big into things like overnight backcountry camping or something where you want excellent night vision.
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Surgeons seem to really just focus on the fact that it is non-diffractive so it "uses all the light" which is true! But on the bench a lot of multifocal IOLs (even though they lose some light from splitting) actually test a little better than Vivity for contrast.
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Anyway sorry about your situation. I'd go monofocal or Eyhance for the second eye and see where you end up. That might make up for it.
RonAKA Guest
Posted
Unfortunately Alcon just provides contrast sensitivity data on the Vivity when looking through it with one eye only (monocular), and with the Vivity in both eyes (binocular). What they don't do is provide data on what the binocular contrast sensitivity is when a monofocal is used in one eye and a Vivity is used in the other eye. My expectation would be that contrast sensitivity would be far better than a Vivity in both eyes. But, Alcon of course would prefer you bought two Vivity lenses instead of one Vivity and one monofocal.
joeyde cindyken
Posted
I got the Vivity lens in both eyes. I told the doctor when he did my first eye that I had terrible halos and flares. Instead of re-evaluating my second eye he put another Vivity lens and I told him now both eyes have halos and flares than he told me it could take a year to heal. He sent me to a specialist who told me there are a percentage of people who have this same result from Vivity lens. He also said after 3 months my eyes are healed and will not improve. My only option is a lens replacement. He did say the lens are placed properly so not the doctors fault except the doctor told me I would not have any issues with halos or flares after I made it clear that was my most concern. But this cost me 7000.00 when the mono lens would have been covered. Follow the money!
Guest joeyde
Posted
So sorry to hear that. The year he is referring to isn't for healing by the way, it's for neuro-adaptation… a fancy word for getting used to it. Some people never get used to it though. And yes some people get these side effects even with a straight monofocal. It is rare but not unheard of.
steven64823 joeyde
Posted
"He also said after 3 months my eyes are healed and will not improve. My only option is a lens replacement."
If you do decide on a lens replacement do it sooner rather than later. The longer you wait the more adhesions can be an issue and the risk of complications increases.
steven64823 cindyken
Edited
I had this exact same issue with Vivity lenses - like my eyes were smeared with vaseline. I had them replaced at 10 months left eye and and 11 months right eye for Rayner EMV monofocal lenses. The difference in vision quality is astounding - irrespective of lighting conditions. From night through to sunny days my vision quality is miles better with the Rayner lenses. If I were you I would definitely not get Vivity in your other eye. I know from experience that both eyes with Vivity is way more than twice as bad as one eye Vivity, one eye not. FWIW my surgeon was tossing up Rayner vs Eyehance for my replacement lenses, but went with Rayner after consultation with other surgeons. He had experience with Eyehance curing the issues you and I shared, so that would probably be a good option.
aspen88 steven64823
Posted
hi! why did you choose Rayner monofocal instead of Eyhance?
steven64823 aspen88
Edited
I left the decision to my surgeon who was very diligent in canvassing opinions and technical information from manufacturers and other surgeons/ophthalmologists. My surgeon was confident that the EMV would give me a tad more close vision than the Eyehance, as well as a "pure" monofocal experience with no night dysphotopsias whatsoever. The decision was mine at the end of the day, but I deferred to my surgeon's recommendation.
As I mentioned, my surgeon had experience with the Eyehance resolving the multiple issues I was having with the Vivity lenses, so that was a good option. I'm very happy and satisfied with the quality of vision from the Rayner EMV, so would happily recommend that lens.