Why isn’t anyone talking about Technis Eyhance?

can you elaborate? u mean with symfony one would need +1 for intermediate and with eyhance you would need what? i dont understand the defocus curves.

how much more intermediate will you get with eyehance?

I will try my best 😃

I will insert the defocus curves below.

0.2 logmar is what we are aiming for or better, to feel we have good usable vision.

First the defocus curve for the Eyhance.

It shows you that at 0.2 logmar, the diopters of defocus is approx. 1.0 for Tecnis monofocal, and 1.3 for Eyhance, so the Eyhance adds +0,3 diopters compared to the monofocal.

And then defocus curve for Symfony.

It shows you, that at 0,2 logmar, the Symfony adds 1.0 diopters compared to the monofocal.

In theory you need +1,5 added to far vision to see at 80cm and +3 to see at 40 cm.

A monofocal also have some sort of range, so the best thing is to compare with your current Symfony lens.

If your Symfony now is good from far distance to approx. 60cm, the Eyhance in the same situation will be good from far distance to approx. 80cm, because the Eyhance is making 0,7 less power than the Symfony.

And the standart Tecnis monofocal would in the same situation be good from far distance to approx. 90 cm, the Eyhance gives you 10cm more than standart monofocal under similar conditions.

So as always, the Eyhance is not a world wonder, and a lot of hype is being made to promote it, that said I would like to have it, if I was going for monofocal, why not take all you can get.

Thanks so much for explaining all that.

what encourages me is:

"Furthermore, in large pupil eyes the TECNIS Eyhance IOL provides significantly better contrast than other monofocal IOLs."

the problem with symfony and large pupil is that the iol lights up where the pupil extends beyond the edge. with eyehance i hope to avoid it even if that means losing a bit more near.

i am happy to wear reading glasses. i need glasses anyway for the -0.5 astigmatism.

Hi John

From the info I have found about the Eyhance, the few places that actually present some proper numbers, it will give you approx. 10cm (4") more range into intermediate distance than a standart Tecnis monofocal lens.

Off course only you can decide, if it is worth the wait, but it will not give you anything like the Symfony.

Cheers

Christian

From the article and pdf i found on "theophtalmologist" website it sounds like it provides a lot more than 4" closer vision in real world results. From what most doctors say, a typical patient can expect to have blurry near vision out to about 5-6 feet with a monofocal, although others have posted on here that they see closer than that. Apparently many of the Eyhance subjects can play cards and read smartphones and would only need glasses for extended close reading like someone in the 50s. The big plus is it is without the nightime issues many symfony users have posted on here because it doesn't use the diffractive optics that symfony does. Some also post on here that they like mixing monofocals with symfony because it tones down the nighttime issues so it seems like Eyhance would make that an even better option for those who don't mind sacrificing a little near vision for improved nighttime vision. I just don't know if I will be able to wait until it is available in the US. I will try to add the link to the article too

i would like to know where these findings are for just 4" improvement. actual patients reviews would be even more helpful.

this is what the brochure says "Eyes implanted with the TECNIS Eyhance IOL had significantly better monocular intermediate vision at 66 cm than the controls (mean TECNIS Eyhance IOL DCIVA value was 1.1 lines logMAR better than the mean DCIVA for TECNIS® Monofocal: p<0.0001), and better results were obtained for UCIVA outcomes, too."

now what is significantly better?

"this is not a monofocal but falls more closely into the category of an EDOF IOL without any of the possible compromises"

if monofocal was 5 feet, edof was 2 feet and this lens was 3 feet. i would take it and lose the artifacts.

I have read all that stuff too about the Eyhance, but sadly it is mostly hype to promote sales, just like the Lara is hyped to be better than Symfony, but in reality, when studies are made by surgeons that are not payed by the Zeiss factory, Lara and Symfony have very similar outcome in real life

I was considering the Eyhance for myself, because it really sounded so good, that is why I have gone so much into details about that lens.

But all the hype is like gas mileage on cars, it is selling points to promote sales.

Problem with most of the info available about the Eyhance, is that it is so new, most of information available is made by the manufacturer to sell a product, with very small sample sizes with chosen patients and some few surgeons that have got a good deal from the manufacturer.

The defocus curve speaks for itself, the Eyhance only makes +0,3 diopter more than the standart Tecnis monofocal in the area with useable vision, you get what you get, I have really tried my best to explain it in my other reply in this thread.

I would have loved the Eyhance to be the game changer in iols, then I would have chosen it for myself, but sadly it is not.

If you use two of the Eyhance with monovision, with the relative same overlap as standart monocofals, you can sum up the difference and this will push the close up eye a lot into the midrange.

I am quite sure this must be how they get this stated difference at 66cm, because one Eyhance set for plano will never cover that distance, it is just not possible, that would require Eyhance should have the same range as Symfony, and it is nowhere near that.

I am really just trying to help here 😃

Yes I tend to agree with you that most of the studies going to market ate by manufactures (much the same for drug industry too). Patients are selected carefully and wording also favoring the lens. Symfony's night halos were very much downplayed. No mention of the huge concentric circles anywhere. Learned about them through other patients posting here. Still I do think they are a good lens and best there is at this point in time. For me I chose them anyways (I knew prior to surgery) but for others (maybe personality plays a role) they are most disappointed. Both surgeons and manufacturers should be more upfront with both pros and cons and let patient make informed choice.

I like analogy of technology - really describes things well. We buy our laptops and mobile devices based on best available at the time. Perhaps when it comes to health and in our cases vision we aren't as accepting of limitations vs selecting a mobile device.

Soks the pupil size does affect one's outcome significantly more and my hope is for those in that situation like you there will be a lens that addresses that. Especially as cataracts are affecting more and more people at a younger age. Myself I wonder if the sun plays a role in aging our eyes. I know it affects skin. I had surgery for skin cancer 10 years ago (thankfully I haven't had more as my dermatologist said I had 50% case of seeing more within 2 years of my surgery. I still go in for skin exams and my dermatologist say she has patients with skin cancer in their 20s now!

Thanks again Christian for all your input - very helpful. I still read articles on cataracts and surgical procedures and lenses - admittedly some of the lingo goes over my head so really appreciate your taking the time to simplify the science and unravel the science behind the lenses. All we can do is make best choice of what there is at the time.

symfony / lara are 20/20 at 66 cm. eyhance is being called significantly better than monofocal at 66 cm. so i understand it is manufacturer word play but what is significantly better. 4 inch over monofocal would not be that great.

now if lara was 4 inch better than symfony that woukd be significant because the uncorrected range remaining for symfony is very small.

I don´t think there is any noticeable difference in Symfony and Lara, I really don´t.

And if there is, the difference is so small that hitting the target refraction will give you a much bigger difference, I think other variables are much bigger factors than choosing Lara or Symfony.

If the monofocal gives you usable vision from far distance to 100cm, you will get far distance to 90cm with Eyhance, this is what you get from the added 0,3 on the defocus curve.

At 66cm, with Eyhance in one eye only, you should have about 20/50 vision at 66cm.

With Eyhance on both eyes set for plano, you get a bonus, two eyes normally gives you one more line, that means 20/40 vision at 66cm.

20/40 is quite usable, although 20/32 is consideret what we want to feel we have sufficient vision.

A standart monofocal is about one line lower according to defocus curve in midrange.

So one standart monofocal give you 20/63 at 66cm, two monofocals give you 20/50 at 66cm.

Because of the different shapes of the defocus curves of the standart monofocal and the Eyhance, you can create almost any scenario you like to prove a specific point at a specific distance.

For a mathematic nerd it is not that hard to calculate and manipulate the numbers, and show the result you would like to show.

But no matter what, the Eyhance is a monofocal with a slightly wider range than standart monofocal, but also a little bit reduced vision at the top, you will loose at least halv a line in an eye test with the Eyhance where your vision is the absolute best, this is the price you are paying for the slightly wider range.

Your surgeon can use the wider range to suit your needs when planning monovision, but he can make almost the same with a standart monofocal. The Eyhance is not a big game changer, but a welcome improvement in the segment of monofocals.

Using the Eyhance for plano in both eyes, would be very much like using the standart monofocal for plano in both eye, not that much difference there.

If you see the text about the Eyhance, at some point they are mentioning that the Eyhance is making it easier to walk on uneven surface - I think this says a lot, this very far from what we (us premium patiens) demands from our lenses and vision 😃

my thoughts exactly. and with Symfony in just one eye the natural eye does tone down the Symfony artifacts. these same artifacts are toned down with miotic eyedrops so people with small pupils may not be experiencing this and thus have no need for it. It appears that Symfony / Lara would give a vision of a 40-45 year old (2 feet) while Eyhance would give the vision of a 50-55 year old (3.5 feet).

PEOPLE who experience nighttime issues with EDOF want to seriously consider monofocal. So for us this is a game changer if this gives us something midway between monofocal and edof. At this point spectacle independence is really out of the window for us. So we seek both FOR and AGAINST opinions on a promising new product.

"I don´t think there is any noticeable difference in Symfony and Lara, I really don´t." - Dr. Romesh Angunawela from Moorsfield UK told me the same thing based on his experience. However, don't you think JnJ would object to such claims coz this would eat up their european market.

For hitting target I had the eye measured by 5 doctors and opted for ORA intraoperatively. Asked to see the ORA recommendation during the surgery and also made a choice on how much farsighted I wanted to be. Saw the IOL calculations from all 5 doctors myself. I knew I was going with 16.5D or 17D days before the surgery and used Barrett II method recommendations although i had measurements from 5 other methods (holladay, haigis etc.,). So i considered myself sufficiently well versed on hitting target. surgery induced astigmatism of -0.5 is not OK for me and i wear glasses for it. correcting it with glasses or with lasik makes near worse. i was not aware of this before the surgeries.

"If the monofocal gives you usable vision from far distance to 100cm, you will get far distance to 90cm with Eyhanhance on both eyes set for plano, you get a bonus, two eyes normally gives you one more line, that means 20/40 vision at 66cm." -- THIS IS THE challenging part. These distances are different for different people. SO how would you know what an individual is going to end up with?

"20/40 is quite usable, although 20/32 is consideret what we want to feel we have sufficient vision." AGREED. 20/32 binocular vision with Eyehance at 66cm and I am SOLD on the lens. With Symfony and Eyhance I might be even better.

"Because of the different shapes of the defocus curves of the standart monofocal and the Eyhance, you can create almost any scenario you like to prove a specific point at a specific distance. For a mathematic nerd it is not that hard to calculate and manipulate the numbers, and show the result you would like to show." -- WHAT do you mean? Are you saying they are manipulating numbers?

"If you see the text about the Eyhance, at some point they are mentioning that the Eyhance is making it easier to walk on uneven surface - I think this says a lot, this very far from what we (us premium patiens) demands from our lenses and vision 😃" - HA HA..THAT IS indeed drastic. BUT NOONE WITH MONOFOCAL is complaining about walking on uneven surfaces.

I see what you mean, my hole point is that Eyhance is not that different than standart monofocal, only very little. And some would even not choose the Eyhance I think, because it will have a lower peak.

And yes, it varies from person to, everything does, in theory you need +1,5 to see at 80cm, and +3 to see at 40 cm, but yes, this varies, I only used the mean numbers to put things in perspective.

I know several people with monofocals and monovision, they often target +1.5/+1.75 on the second eye, and this is because of the profile of the monofocal.

The monofocal lens set for far gives you 20/32 at +1, and at this point the second monofocal already have started taking over, giving you advantage of binocular vision in the overlap.

The second monofocal will then peak at +1.5/1.75 and tapers off again giving you 20/32 at approx +2.5 (mean 55cm)

This is mean numbers, that will vary, but it shows that if you have two healthy eyes, you can be covered quite well from far to +2.5 with standart monofocals and monovision, and it will bring you well into midrange with good vision, and maybe even give you a little bit reading vision as well.

Some of my friends have this setup, and it works quite well, one of them never brings glasses with him, he can read as well, monofocals with monovision can work really well if both eyes works fine.

Manipulating numbers - sure they are, most numbers you see are corrected numbers, so everything is right on target, and not the little bit off they always are.

Have you ever been able to get the same gas mileage on your car as the manufacturer states?

If I was payed to make a statistic look a specific way, it is not hard to look at numbers from a group of 100 people, and choose the 25 people that have the right numbers I need for my statistics.

And then choose some distances or diopters where it is especially good for that specific statistic.

So are you thinking bilateral Eyehance with plano target dominant eye and -0.50 or -0.75 target in non-dominant eye?

Thank you for mentioning the pupil issue! I've got large pupils causing me a lot of trouble/dysphotopsia with two trifocal ZEISS LISA toric implants. Do you know how this will affect the Vivity? There is no diffractive optic. I therefore consider the Vivity as a real alternative after explantation. To achieve as much spectacle independence as possible is also important for me. Another plus compared to Eyhance.

My thoughts: Large pupils are probably avoiding too much contrast loss which is supposed to be a drawback of the Vivity IOL. Am I right or maybe mistaken because it's not that easy? Many people are very happy with the Vivity without suffering from contrast loss. I wonder why. Mabye it's related to pupil size.

My thoughts: Large pupils are probably avoiding too much contrast loss which is supposed to be a drawback of the Vivity IOL. Am I right or maybe mistaken because it's not that easy? Many people are very happy with the Vivity without suffering from contrast loss. I wonder why. Mabye it's related to pupil size.

Large pupil lets in more light but implies that you're in a low light scenario to start with. So maybe there's not enough light no matter how big your pupil gets? Vision is a complex thing with many variables though. Contrast is just one. My understanding about pupil size is a big pupil increases the effect of corneal aspherical aberration. So more light is getting in but the light that's getting in is less focused and can make halos worse. Small pupil lets in a lot less light and I assume that would lessen contrast BUT the light it's letting in is very focused.

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As for contrast and Vivity... I've done a ton of research on that (too much) and my conclusion is that all but the most particular patients will be very happy with Vivity. You may notice some contrast loss in low light but it's subtle. With Eyhance you'd probably notice some contrast GAIN compared to what you have now (depending on age and how bad the cataracts are). So you might be blown away by Eyhance quality... but there's a higher chance of needing glasses for your watch / phone.

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Also the Vivity 0.3 log drop (1 line on the Pelli-Robson chart) compared to mono-focal was only with MONOCULAR (1 eye) testing. Using both eyes, the difference compared to mono-focal is minimal (their own mono-focal in this case not Eyhance which is theoretically a little better in dim light according to bench data). And with glare in clinical contrast test I think the Eyhance doesn't perform that much better. It preforms clinically much better without glare than Vivity but again... I'm starting to think that I'm really splitting hairs here. I think the vast majority of Vivity patients will be very happy.

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For a really excellent presentation to put all this contrast sensitivity stuff into perspective I HIGHLY recommend finding a YouTube video by searching on "Presbyopic IOLs in Glaucoma Patients!?". Watch from the 11:30 mark to about the 25 minute mark. It's explained very well and Brian specifically talks about Vivity and it's 0.3 log drop in clinical monocular mesopic contrast testing.

Really appreciate your explanations about Vivity. Thank you.