Posted , 11 users are following.
I am scheduled to get one eye done. Other doesn't need surgery so will be long time between eyes. Would I be the only person to have first eye -1.50 and then see what I could tolerate when time for second eye. What has anyone targeted with EMV and what results did you get Any of you start nearsighted by moderat like me.
0 likes, 16 replies
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maura04015 loveanimals
Posted
Look for posts by indygeo. That's the poster I remember has the Rayner lens, although only one -- monofocal in the other eye and monovision setup.
allric loveanimals
Edited
I had the RayOne emv implanted in February 2023 in my dominant eye set for distance which corresponded with my previous prescription of -3.75. Quite happy with it. Crystal clear distance vision, better then my previous contact lens. Can read normal size text on my mobile phone in good light using only that eye although it's somewhat blurred.
I have been using my right eye, without contact lens , for near vision for many years and when that eye needs done will ask my doc to take same approach. Only further comment I would add is that I will ask my doc to sharpen up intermediate vision if possible. At present small typeface on my laptop or car dashboard can be difficult to read. However this is a minor inconvenience and I would prioritise near vision if it was a choice between the two.
steven64823 loveanimals
Posted
I have surgery booked for 21 August to replace the first of two Vivity lenses with the Rayner EMV. Will report back here once the first eye has settled. Hopefully I have a much more positive position to report back, as I've had a horror show with these Vivity lenses.
RebDovid loveanimals
Edited
Looking at Rayner's own defocus curve, the EMV at 0.0D has a mean visual acuity at -1.50 D (corresponding to 26.25") of more than 0.70 logMAR (or worse than 20/100 Snellen). Moving the curve to the right to simulate a targeted -1.50 result indicates at 26.25", for example, very slightly worse than 0.00 logMAR or 20/20 Snellen. And now mean visual acuity at -3.00 D, or 13.12", indicatively would be worse than 0.70 logMAR or 20/100 Snellen. Google RayOne EMV and TECNIS Eyhance: A Comparative Clinical Curve.
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On the basis of this defocus curve, then, the appropriateness of a first eye target of -1.50 D depends, I suggest, on whether you prioritize distance + intermediate or intermediate + near. If it's the former, then -1.50 D may be appropriate. If it's the latter, however, I suggest you consider -2.00 D.
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You also may want to look for a consider defocus curves from studies not done by or for Rayner itself. See, for example, the open access BMC Ophthalmology article by Aixa Alarcon and others, "Optical bench evaluation of the effect of pupil size in new generation monofocal intraocular lenses", using optical bench testing to compare, among others, the Eyhance and RayOne EMV. Among other findings, Eyhance intermediate results were found to be independent of pupil size, while RayOne EMV intermediate results improved with increased pupil size.
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Looking at the Alarcon study's simulated defocus curves for a 3mm pupil, visual acuity at -1.50 D appears to be about logMAR 0.23 (Snellen 20/34) for the EMV and logMAR 0.15 (Snellen 20/28) for the Eyhance. Again, moving the curves to the right to simulate a -1.50 D targeted result makes these visual acuities the indicated results at -3.00 D.
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I can't explain why the Alarcon study, which was "supported by Johnson and Johnson", found much better visual acuity for the RayOne EMV than that reported in Rayner's own report.
steven64823 RebDovid
Edited
I'm not sure if your post was in response to mine, RebDovid, but if so, thanks.
Most of that technical detail is lost on me, though. My surgeon considered Eyehance, but we jointly decided on the EMV lense after quite a lot of research and consultation with the manufacturer and other practitioners' experiences using the EMV.
Basically, my expressed wishes to the surgeon was the best, sharpest possible images for distance (over 2-3m) in all light conditions, whilst maintaining the ability to read the larger info on my car dashboard (speedo, reversing camera etc). I am happy to wear spectacles for reading, computer and all intermediate vision about the home (cooking etc). The plan is plano for dominant eye with a small (maybe -0.5d) offset in the non-dominant eye.
I have given up on the EDOF idea, as for me it has resulted in unacceptable vision at all distances. I need spectacles for everything with the Vivity. And that's just the start of the issues I've had with that lense.
RebDovid steven64823
Edited
Actually, I was trying to reply to @loveanimals, but the same principle applies, namely, the primary importance of deciding on your visual priorities, for which there is no single right answer. Given what you write in your second paragraph, I think your basic plan is correct. I have only two suggestions.
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First, because there's always a chance that even a highly-skilled cataract surgeon will miss the targeted refraction by up to 0.5 or even 1 D without any fault on his or her part, I suggest targeting the first minus in your personal IOL calculations rather than plano. Second, before choosing a target for your second eye, I suggest waiting enough time, at least 4-5 weeks, (1) for a refraction of your first eye to reveal how close your surgeon came to the target and (2) perhaps more importantly in your case, to see how much of your visual goals your first eye satisfies. Answers to those questions should inform the decision about how much to offset your second eye.
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Good luck.
aspen88 steven64823
Posted
hi steven, what issues did you have with vivity and why are you replacing with EMV and not eyhance? i am choosing between these 3. thanks.
steven64823 aspen88
Posted
Hi.
I've detailed my experiences with the Vivity lenses in the "Are you happy with your Vivity IOL" thread, but to summarise:
In discussing IOL replacement options my Opthalmologist initially recommended Eyehance, but after his research, suggested the Rayner EMV would be the best option - due to slightly larger field of focus than the Eyehance. Plus his peers apparently had great things to say about the lense and their results.
I have the first surgery scheduled in three weeks, and will report back here after my eye has settled.
aspen88 steven64823
Edited
thank you. hope all goes well with your surgery!
RonAKA loveanimals
Posted
I do not have experience with the EMV lens, but I have looked into it a bit. Information on what the lens does is a little sketchy with no real defocus curves to look at. But, based on MTF (contrast sensitivity) curves the lens does seem to offer some enhancement compared to a standard monofocal to the LEFT of the peak visual acuity point. This is of no value when the lens is used in the distance eye, because the enhancement is at distances beyond infinity. However, when used in the near eye, it can provide a very small improvement at the intermediate distance range. I think it could be questioned whether or not the improvement is significant or not. But, in any case I think if it was used in the near eye, there is no need or value to using the EMV in the distance eye. A standard monofocal would be fine. There may be some small value in using a monofocal like the B+L enVista in the distance eye which has an increased depth of focus due to their neutral asphericity approach.
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But, overall I think the value of it compared to just using mini-monovision with a standard monofocal like the Clareon could be questioned.
stefan64833 RonAKA
Posted
Some might question standard monovision or mini-monovision in general.
RonAKA stefan64833
Posted
True that mini-monovision may not be for everyone. However for those that do not want to take on the risks of multifocal or even EDOF IOLs, but want to be eyeglasses free it can be a good choice. When done well it can deliver all the benefits of a full range of vision without glasses and without the optical side effects of MF and EDOF lenses.
SandyRose loveanimals
Edited
After more hours of research on all types of IOL than I care to remember, I had my first eye done yesterday with a RayOne EMV toric lens. Its obviously too early to assess the outcome, but as I found very few patient experiences of this lens, I'm happy to post my own on here as things progress, particularly as the EMV appears to be becoming much more favoured here in the UK now rather than the Eyhance.
aspen88 SandyRose
Posted
hi Sandy, how is your experience with Rayner Emv so far? why did you choose this lens? this is one of my options.
indygeo loveanimals
Edited
Here´s my experience:
Indeed I had a standard monofocal placed in my left distance eye with excellent results. My right ¨near" , but dominant, eye (I think) got the Rayner EMV with an offset of about 0.75 D from the distance monofocal. I could not be happier with the outcome. I can see the tiniest of print with my Rayner lens from about 11 inches out to a bit beyond intermediate (i.e. computer distance). Even my distance vision in that ¨near¨ eye is, in my opinion, about 94-95% as good as my distance monofocal. I could never have imagined in my wildest dreams that when I first went in to see my surgeon when all this cataract stuff started happening that I´d be sitting here today glasses free. I´m very happy with the Rayner EMV lens.
I hope this helps.
IndyG