Vivity Lens vs single focal lens

yes theres different types of monofocal, but l dont think theres that much difference between the different brands, l know Eyhance is a monofocal that gives more intermediate vision then the other monofocals thats why if l went with a monofocal thats the one l would choose

My Optomerist said two of his patients got vivity and both were happy with it and performed as expected. l guess most people will be happy with vivity and a minority not happy just like any lens

There are some minor differences in the more common monofocal lenses that are used:

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Tecnis 1 - First it is a clear lens. It has a -0.27 um asphericity correction. This theoretically reduces asphericity error to 0.00 in an average eye.

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AcrySof IQ - It typically has a blue light filter, which Alcon claims mimics the natural lens of a 20 year old. Alcon also uses a lower asphericity correction of -0.20 um to leave some residual. They claim to have done some research on people that have supervision beyond 20/20 and they have this amount of residual asphericity.

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Clareon - Also by Alcon and has similar features as the AcrySof IQ but is a newer material with about 10% more light transmission. I would get the Clareon over the AcrySof IQ and in fact did get it in my second eye. Was not available when my first eye was done.

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I do not consider the Eyhance a monofocal. It has EDOF of about 0.35 D, which is technically not enough to be called an EDOF. So it still has some of the advantages and disadvantages of an EDOF lens.

Thanks for that information. Will the Vivity len provide clear vision between the distance and intermediate range or is the clear vision only at two distance?

Clareon sounds good how long has that been available? I am not sure my doctor handles this len.

The Vivity lens is an EDOF lens and does not have a second or third focal point like a MF lens. It may not be quite as clear at distance as an aspheric monofocal but should give good quality vision down to about 20" or so. That is from theory and I while I considered it, I have no personal experience. I have an AcrySof IQ in one eye and the Clareon in the other eye.

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The Clareon has been available for the last year or so in the monofocal version. Not sure about the Vivity or PanOptix. The monofocal Clareon is from Alcon like the AcrySof IQ, Vivity, and PanOptix. It is more of a new material than a new design.

Note that Clarion is not an IOL design, it's a new material / IOL platform. So in the US right now you can get a Clarion Monofocal and a Clarion Vivity. If you are going with Vivity and you can get the Clarion version you should do that. The material has some slight improvements over the old Acrysof material.

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Vivity is continuous focus from far to intermediate / functional near. There are no "gaps" as can sometimes be the case with Multifocal IOLs.

I wonder if the Clarion Vivity has improved low light contrast.

it operates under the same process so l think the contrast would be the same

Ron has pointed out that the new material apparently is 10% more clear? So intuitively (as opposed to scientifically) I would think MAYBE there is a marginal improvement? But I think if the improvement was in any way significant Alcon would be pushing that with trial data or marketing materials and they are not. As far as I know. So yah... maaaaaaybe? You'd think so? But if so then it's likely not enough to notice.

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Also, another thought... that light gets spread out over a long distance by the optics of the IOL. So maybe once that theoretical 10% boost is spread out it works out to, let's say 1% at any one focus point? This is 100% pure speculation of course! But yah I'm guessing contrast it's probably no different than the original. At least not to a clinically significant (noticeable by the patient) amount.

I agree that the increased light transmission in theory could improve contrast sensitivity, but the effect is likely insignificant. The real issue with decreased contrast sensitivity is the blurring of the image which occurs when you stretch the focus point from the very sharp focus that an aspheric monofocal lens achieves. If you want an illustration of this just google "spherical vs monofocal iol" and then click on images. You will see lots of images of what the older spherical lenses do compared to an aspheric one. The image is focused over a range instead of a single sharp focus point. These EDOF lenses are doing the same thing as a spherical lens but more of it. They smear the focus point out more, which in turn reduces contrast sensitivity due to the ghost images around the main image. I recall reading that a spherical lens provides about 0.25 D extra depth of focus. This compares to a Eyhance at about 0.35 D, and the Vivity at 0.5 D.

thnaks yes l saw the images of sperical compared to aspecial iol and the asperical looks much better. would the image quality of vivity be just like one of those older sperical IOL's . WOuld Eyahnce give better image quality more like an asperical

Ok so if I understand what you are saying the vision between the distance and intermediate field will be slightly blurred with a EDOF. Correct?

Yes, and No. The Vivity and Eyhance are specially designed to extend the depth of focus, but they do it by stretching the focal point. They are not going to have as good an image quality at distance as an older spherical lens and will certainly poorer than an aspheric lens. That is the price of extended depth of focus. Where they provide better vision is in the closer intermediate range.

Yes, that is the price of EDOF. The difference at distance is not huge though. I think both Eyhance and Vivity are able to provide 20/20 or very close to that at distance.

l thought Eyhance has very close to the distance vision quality of a monofoical or is the image quality of eyhance not much better then vivity?

While it's true that the absolute best possible distance vision quality will be with a modern aspheric monofocal, everything I've read and heard says the distance vision quality of Vivity (especially in good light) and Eyhance are very close to monofocal, with Eyhance distance vision quality being almost indistinguishable from monofocal. I would take simulated images with a grain of salt personally,

So in good light would the image quality of vivity be close to an asperical monofocal

Yes, Eyhance and Vivity should be close to a monofocal, but there is always a compromise to adding the EDOF to a lens. As best as I can figure it out this is how much EDOF is added to each lens:

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1. Aspheric monofocal - 0.00 D
2. Spherical monofocal - 0.25 D
3. Eyhance -0.35
4. Vivity -0.50

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   Keep in mind that if the lens power is very close to optimum an aspheric monofocal can get you better than 20/20. So, while an EDOF addition may hurt the ultimate vision quality, it may still be 20/20 if the power is very close.

Google "Vivity Package Insert pdf".

On page 13 you will see a comparision graph between the monofocal and the Vivity. The 0 position on the horizontal defocus axis is full distance. A 0 on the logMAR vertical axis I believe is 20/20. Negative numbers above that are better than 20/20, and positive ones below that are poorer. A 0.2 value of logMAR is considered useable vision. And of course as you go closer which the curve to the right, the Vivity starts to outperform the monofocal.