VIVITY OR EYHANCE which to choose
Posted , 18 users are following.
l am 48 and having cataract surgery this year, My main aim is to have exellent distance vision for things like driving with enough intermediate for things like reading the car dashboard, l dont mind glasses for near reading. l have narrowed it down to either Vivity EDOF or Eyhance monofocal but l am having trouble deciding which one to go with. Which one do you think l should choose, is one a safer option then the other and less likely to have negative side effects or problems
0 likes, 44 replies
indygeo john20510
Edited
Some great advice in this thread. My thoughts are this... If you go with Eyhance, it seems to me that you'll hit your objectives and then some particularly if you offset them slightly (say 0.50D). Set your dominant eye plano and the other one to 0.50. You'll keep your contrast sensitivity, gain solid intermediate (and maybe a bit closer), and the eyes will still be seeing predominantly stereo.Of course, discuss with your opthalmologist /surgeon and don't just go by what people on an Internet forum say. But at least this is a point of discussion for starters with your doc. I hope someday you'll let us know what you decide ultimately and how it went. Cheers.
IndyG
john20510 indygeo
Posted
Thanks for your advice , yes l will let you know how it goes later this year. Yes my opthalmologist recommended vivity but l will now talk to him about Eyhance becasue l dont want the contrast loss of vivity, but l also want enough intermeidate for things like cardashboard and making a meal , l dont mind glasses for reading close up. l will suggest your idea
Myope_PSC john20510
Edited
I have rapidly progressing PSC cataracts and will need cataract surgery this year or early next year. My appointment for measurements is soon. I'm just about certain that I'll choose the Eyhance. Like John, I think I'd be happy with good distance vision and assured intermediate vision for seeing the car dashboard and some household tasks & would use reading glasses as needed. I want good contrast sensitivity, good stereoacuity and to also maximize the benefit of binocular summation so I've pretty much ruled out multifocals and most monovision strategies. I'm not interested in the Vivity EDOF because of greater loss of contrast sensitivity than the Eyhance.
The -0.50 target option in the non-dominate eye mentioned above is interesting. It appears to me that there's a chance that option could result in 0.2 logMAR / 20/32 vision at 18" and retain 20/20-ish vision for distance (probably in a best case scenario). Any result worse than the -0.50 target in the non-dominate eye would affect distance vision and begin to affect night driving I'd assume.
It would sure be a lot easier if we could be assured of ending up with a chosen target! I'll probably end up choosing the 1st minus target. I will likely need toric iol's and I expect that there will be some residual astigmatism left.
Google "eyhance getting started guide" and download the PDF file for some great info intended for professionals.
RonAKA Myope_PSC
Posted
I think you can minimize the impact of contrast sensitivity loss by only using the Eyhance in the non dominant eye, and using the standard monofocal in the dominant eye set for distance. Yes, using a -0.5 D target for the Eyhance in the non dominant eye would be a good idea in my opinion. It probably assures computer vision, but not likely smart phone vision.
kyle33489 john20510
Posted
Hi John,
I'm 41 and had one eye done with the Vivity EDOF. My distance vision is great, intermediate is pretty good as well and can still read a little. However, I'm one of the rare ones that has bad halos and light streaks around lights...especially bad at night. I'm a type A personality and don't deal well with imperfections so it really bothers me. If you're more go with the flow kind of guy I'm not sure if it would be as big as a deal to you. After doing research after the fact...I've heard your personality type really matters when considering what type of lens to get and everyone's brain adapts at a different pace. Might be worth asking your doctor their thoughts. Hope that helps! Good luck!
john20510
Posted
Just to update , l saw ophthalmologist today and told him l wanted Eyhance, he said its no better then any other monfocal lens and l should go with vivity . He said he would go with vivity himself if he needed cataract surgery and l am lucky l am eleigable for vivity because l have healthy eyes apart from cataracts. l told him my concern about the lower contrast of vivity and he said because l have healthy eyes l wont notice any lower contrast. l am not sure what to do , go with monofocal or vivity, l am a bit worried he may be trying to sell me vivity because its higher cost
RonAKA john20510
Posted
You should be aware that some ophthalmologists have "arrangements" with IOL suppliers in that they may only offer one brand. The more common ones in North America are Alcon (AcrySof, Clareon, Vivity, PanOptix) and J&J (Tecnis, Eyhance, Symfony, Synergy). Some doctors will offer both manufacturers and others not.
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I can't agree with your surgeon that Eyhance is the same as a monofocal. It does offer some extended depth of focus beyond a monofocal. Not, quite as much as Vivity, but still some. The issue with both of these lenses if you get them optimized for distance in both eyes is that you are still likely to need glasses to read closer. The safest most complication free option is monofocals set for distance in both eyes, and then use reading glasses for closer.
valerio01538 john20510
Edited
Twice my post went to moderation due to something like an external link, and as I believe it won't be publicized, I'm posting again. I'm not an eye doctor and I can't say for sure which is the best. I also don't have a Vivity lens to compare. All I can do is evaluate the information available. In my case, I have a Symfony lens in one eye and a Synergy lens in the other. J&J reports that Symfony's MTF is 0.44 photopic and 0.40 mesopic, while Synergy is 0.34 photopic and 0.37 mesopic. In many practical situations I can feel and confirm this difference, even though it is small between the lenses. Alcon reports that the Vivity has an MTF of 0.25 for a 20.0D IOL with white light, 50lp/mm, 3mm aperture, which I believe is the best conditions. If your question is about the loss of contrast, I would also do more research before choosing this IOL, but each person is different.
jeanetk john20510
Posted
my ophthalmologist adviced me with vivity because it acts a bit like a monofocal and less halos like other trifocal lenses.
due to my retinal pathology with laser and retina detachment he said I cold choose vivity, because of the monofocal like lens.
he also recommended me to go through the health care system and ask them if they would give vivity to me. then it would be free.
so even though he could earn money on me he advice me to do so.
just in contrast to your latest post š
jeanetk valerio01538
Posted
I am in the same consideration as john.
I am aware I might need glasses either way I vivity or not. but I find it nice that at some point in the daily life you are not dependent on glasses. my cataract is distuption my reading vision with cloudy / foggy vision some times, and its only the one eye to begin with and its the dominant eye.
valerio01538 jeanetk
Posted
I will speak for myself! Luckily, I was lucky enough not to have any visual problems other than cataracts, and I ended up choosing premium lenses, as I also wanted good intermediate and near vision, even though I knew that would come with nighttime visual effects. But if I wasn't a candidate for premium lenses because of some visual problem, even if some ophthalmologist tried to convince me otherwise, I would choose monofocal lenses for both eyes doing monovision, the dominant eye for distance and the other adjusted for near. With that, there would be no loss of contrast or light, it would be free of night visual effects and still have vision at all distances, even so, it would still be risking a not very good intermediate vision. But that's a risk I'd be willing to take, because the eye doctor needs to hit the targets for this to work. My father, who is still alive, had his surgeries over 10 years ago and he doesn't even know which lenses were implanted, he only knows they were monofocal, doesn't wear glasses and sees from all distances. I believe he is either a phenomenon or he has monovision, not least because I consulted with his ophthalmologist in 2018, and he proposed monofocals with monovision as the first option for me. There is another member of this forum who has monovision and is happy with it, I actually don't remember reading about anyone not happy with monovision...
jeanetk valerio01538
Edited
i actually have a ok vision, despite of the areas that has been treated. he didnt push me to get vivity, but I really want the wider range of vision and he said Im not a candidate for multifocal but vivity is breaking the light in another way than multifocal/trifocal lenses, and advice me if I could ask and maybe get it for free through the hospital /health care system. i think its a good service.
its only one eye now, so I consider getting vivity in this as distance/plano and the other one later maybe with a monofocal lens with monovision /closer up, depends on my experience with vivity.
Guest jeanetk
Posted
jeanetkā¦ I highly doubt that any public health system would offer Vivity for free. First of all, no public health system is going to consider presbyopia correction to be medically necessary and second of all, the Vivity lens costs about 4-5 times as much (just for the lens) as a monofocal. Public health might offer Eyhance tho' (although you may still have to pay the cost difference) as it's technically marketed as a monofocal.
jeanetk Guest
Edited
sometimes they do in Denmark. depend on the circumstances.
so worst case i get a no.
im 37, PSC cataract (moderate) after surgery from retina detachment and a dry eye patient..I suffer from severe light sensitivity.
I was told vivity is the only premium lens at the moment that Is ok for a person like me if I want to be less glass dependent.
though I still consider Eyhance.
do you have any experiences with vivity ?
RonAKA jeanetk
Posted
At age 37 I think I would consider Clareon monofocal lenses in a monovision configuration to be less eyeglass dependent. Best to try it with contacts first to see if you like it.
Guest jeanetk
Posted
I haven't had surgery yet so no personal experience with any IOL. Yes if you have some pathology and want to be less dependant on glasses Vivity may be the best (only) option (other than monovision).