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Vivity ... progress after 3-4 weeks

Posted , 4 users are following.

RandallG
RandallG

Some good news and hope for others with Vivity IOL ... or who are not seeing as well as they'd hoped a few days after surgery.

As I mentioned in a previous post, I had a really bad couple of weeks after my first (dominant eye) surgery.

I paid $3,100 extra for the Vivity based on the many enthusiastic success stories: "20/20 vision at distance and intermediate + decent near vision the next day."

Unfortunately my initial results were far less encouraging.

The combination of a refractive error (+0.75, requiring -0.75 correction) plus a lot of fuzziness left me with no clear vision at any distance—near, intermediate, or far. This lasted two, rather miserable, weeks.

Fortunately, thanks to Costco I managed to get a pair of prescription glasses after the second week, which really helped with distance. But even with the glasses I was at 20/32-40 distance.

Then, one morning, after about 3 weeks, I woke up and—behold!—my IOL vision was MUCH better than before. I was at 20/-32-40 WITHOUT glasses. This may sound unacceptable to you, but for me was a big win. It did not last long, but midmorning I was back at pretty lousy and blurry vision.

No more improvement for the next three days, then another good vision morning. And then another. And the good vision lasted longer each time.

Right now, it's been a little over a month and at my last visit the dr. confirmed a refractive surprise of +0.75 (mild myopia). But unlike before, my intermediate vision was clear and much less fuzzy and with reading glasses and distance glasses I am at 20/20 both near and distance.

Bottom line: the speed with which our eyes heal and adjust can vary dramatically. My friend was good to go after 24 hours (actually, the very same evening) ... my eyes took not twice or even ten times longer, but about one-hundred time longer.

True, I did not get the 20/20 vision I expected or hoped, but once you have to deal with blurry and fuzzy vision at all distances with or without glasses, being able to see ANYTHING clearly feels like a huge win and a huge relief.

Now I'll take a pause of a few months and then I'll have to decide what to do with my other non-dominant eye ... and I think I'll diversify my risk and go with a monofocal set for distance which should minimize the odds for another refractive error. With any luck, I'll have mini monovision. ANY ADVICE IS WELCOME.

I hope my case brings some relief to other people who come to this forum in a situation similar to mine.

Don't lose hope, it may take 2x, 10x, 100x longer than what you read for your eyes to adjust and adapt.

A number of people in this forum were very nice and helpful with their advice and have my deepest thanks.

1 like, 11 replies

11 Replies

  • indygeo
    indygeo RandallG

    Edited

    Hi Randall,

    I think at +0.75 you're actually hyperopic and not "myopic". In any case since your non-dominant eye remains to be done you need to ask yourself which end, near or far, you'd prefer to wear glasses.

    Typically the non-dominant eye is set "near", although there is success as well oftentimes when the dominant eye is set to near particularly when the difference between the eyes isn't very large (say, a 1.0D difference or less).

    I actually think you could still wind up in a situation where you're glasses-free most of the time if, say, you had better luck with another Vivity lens in that non-dominant eye or perhaps a lens like the Rayner EMV (which I have in one eye). I'm really happy for you in that you're getting clear vision finally with the Vivity.

    IndyG

    • RandallG
      RandallG indygeo

      Edited

      Thank you IndyG.

      I am actually myopic after the surgery (-0.75 is the correction I need in my glasses) but I was temporarily confused by the different way that optometrists report Sphere (for some reason, they use opposite signs.) I had never seen an opthalmologist or gotten one of their prescription until after the operation, so I was used to the flipped +/- sign and falsely believed that I was hyperopic since, for a while, I could not see clearly at ANY distance.

      Much to my relief I am slightly myopic which I am told is easier to deal with than hyperopic in deciding on a second lens.

      I appreciate your suggestion and I'll look into the Rayner lens.

      Thanks again.

    • indygeo
      indygeo RandallG

      Posted

      Hi Randall,

      Yes, understood about the confusion of these plus and minus numbers. Sometimes I'm not sure I understand it all entirely myself. You are indeed better off a bit myopic than hyperopic.

      It does seem to me that things could work out rather well for you if you targeted your second eye for distance with the Rayner EMV lens. Please do some research on that lens because it may suit you. In my view, theoretically at least, you could target emmetropia or slightly less and have a high likelihood of excellent distance vision with maybe a 50% chance or more (70% according to a study) of functional reading vision. Check out the numerous YouTube videos on the Rayner EMV lens. Best of luck ylto you.

      IndyG

  • carol07114
    carol07114 RandallG

    Posted

    Than is wonderful news. Congratulations!

    • RandallG
      RandallG carol07114

      Posted

      Thank you, Carol. I am hopeful that your issue will be improved as well ... and with the amazing capacity of the brain to adapt and habituate I am confident that it will.

  • RonAKA
    RonAKA RandallG

    Edited

    Slow recovery, but all in all not a bad outcome. Being 0.75 D myopic with the Vivity lens should give you decent intermediate and reading. I would go with a monofocal targeted to leave you 0.25 D myopic in the other eye. A monofocal like the Clareon will give you better contrast sensitivity and will make up for the lower contrast sensitivity with the Vivity. The surgeon should have learned something on the first eye, and be closer to the mark on the second eye.

    • RandallG
      RandallG RonAKA

      Posted

      Thank you, Ron. Your replies and expert suggestions really helped and I appreciate.

      A couple of quick questions:

      1. Why target for 0.25D myopic, rather than, say plano? Is it to minimize the chances of an hyperopic error?

      2. Is Clareon considered a premium lens and do all ophtalmologists offer it?

      Thank you!

    • RonAKA
      RonAKA RandallG

      Edited

      1. Yes, the idea is to try and avoid going hyperopic as that brings both poorer distance vision plus poorer close vision. 0.00 Sphere is ideal, but it is risky to target it.
      2. Clareon is the newer Alcon material. Compared to the AcrySof IQ monofocal it is more resistant to glistenings, the light transmission is a bit higher, and due to sharper edges it is said to be more resistant to PCO. Where I am in Canada I paid a premium of $300 extra for it. The AcrySof IQ, which I got in my first eye, is fully paid by our public healthcare system. The rules here are confusing and in flux, but a "premium" lens cataract surgery can be done in private clinics, but I believe the basic lens can only be implanted in a hospital. Not sure. I had my AcrySof IQ procedure done in a hospital, while my Clareon was done in a clinic. I picked it mainly because having it done in a clinic reduce the wait time from a year or more down to 3 weeks.
      3. I would think all ophthalmologists that do Alcon lenses should have it in the monofocal version. The plan is to expand the use of the material to the torics, Vivity, and PanOptix, but I am not sure where they are at with the rollout.
    • RandallG
      RandallG RonAKA

      Posted

      Thank you, Ron.

      Yes, the idea is to try and avoid going hyperopic as that brings both poorer distance vision plus poorer close vision. 0.00 Sphere is ideal, but it is risky to target it.

      That's what I thought. I am learning quite a bit from this experience and this forum.

      The $300 extra for the Clareon sounds like a bargain compared to the $3100 for the Vivity. Having said that, I can see how without a significant refraction error the Vivity is well worth it if it allows one to go glass free.

      Thanks again.

    • RonAKA
      RonAKA RandallG

      Posted

      I believe we pay the differential between the basic lens (AcrySof IQ or Tecnis 1) and the so called premium lenses. I recall it was $300 for the Clareon monofocal, $1,100 for the AcrySof Toric, and $2,100 for either the Vivity or PanOptix. In Canadian dollars of course.

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