Cataracts - Vivity or Eyhance intraocular lenses

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kkoran

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Anyone have experience with Vivity or Eyhance intraocular lens? I'm trying to decide which lens to get.
 
You don't trust your doctor's recommendation ? You'd rather trust SGOTI?
 
The doctor gave me several options (monofocal, multifocal, and the two I'm asking about). Each has advantages and disadvantages. A lot comes down to personal preference.
 
kkoran said:
Anyone have experience with Vivity or Eyhance intraocular lens? I'm trying to decide which lens to get.
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Both are new products and from what I can tell only approved this year in the US market. You probably won't find many patients who are past the immediate post op period.

What does your surgeon recommend based on what you told him/her about your vision needs/priorities ?
 
I wasn't given a choice. Looking at my paperwork now, looks like I got Johnson & Johnson model DCB00, and J&J appears to make the Eyhance too. I had a complication, but nothing I blame on the lenses.
 
kkoran said:
The doctor gave me several options (monofocal, multifocal, and the two I'm asking about). Each has advantages and disadvantages. A lot comes down to personal preference.
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OK, then, speaking as SGOTI: The article was interesting; The two you are asking about have received FDA approval only in the past few months. From a career in high tech, I have observed that it is the guys out front who have arrows in their chests.

If I were talking about my eyes, I would tell the doc that I was not interested in any lenses that do not have tens or hundreds of thousands of installations and the consequent field experience reports. Better is the enemy of good, and in this case I would absolutely stick with good.
 
Medical devices go through far more vetting than your average consumer tech.
 
I don't know anything about those two brands/types of lenses, but having just had cataract surgery on both eyes, I'll throw in my 2 cents.

Before my initial consultation with the cataract surgeon (but knowing I was almost certain to need both eyes done), I talked to a number of friends who'd had it done, to get their input. Of probably a dozen people, only two had had a multifocal lens implanted, and both had terrible results. One was my brother, who developed an eye infection (which may have had nothing to do with the type of lens), and nearly lost the eye. He claims he "can't see sh*t" with that eye, and that he'll never have the other one done. The other was a friend and neighbor who had to have the surgeon go back in to try and fix something that had not worked right with the implantation; her vision never got better, and she went to a different practice and surgeon to have the other eye done (with the basic lens).

As it turned out, my surgeon said I wasn't a good candidate for the multifocal lens in one eye, due to previous retina surgery, so I stayed with the basic lens for both. I'm happy with my choice -- my vision is now 20/30 or better, uncorrected, in both eyes. I'm currently using reading glasses for close stuff (like typing this), but can read the gauges fine when driving (have'nt tried flying yet). When I get my final prescription (tomorrow, at my 4-week followup on the second eye), I'll have new lenses put in my progressive bifocal sunglasses.

To me, the high-tech lenses carried more risk, and just seemed like too much of an upsell by many cataract surgeons. And I just couldn't see (no pun intended) having one eye set for distance and the other for near vision -- gives me a headache just thinking about it. The one upsell that I went for was something called ORA, which involves precise laser measurement of the innards of your eyeball during surgery, to help choose the best possible lens.
 
Just have a monofocal lens in both eyes aiming slightly myopic say -0.25 to -0.50. You will need reading specs although some people prefer varifocals.
 
I was involved at one time with a company developing high-tech lenses. At this point in my life, approaching 65, I would have nothing but "plane Janes" implanted, and it's possible that I'd even go with something close to my life-long nearsightedness (currently -5.75-ish), rather than "correct" anything. This may change, if some new lens shows promise over the years, but as of now, I don't need any.
 
talk to your AME, the FAA does not like some procedures. most eye docs have no idea what the FAA thinks. maybe one of the good docs will pipe in here.
 
As a general rule, each of these multifocal, focus adjustable or 'presbyopia correcting' lenses are a set of compromises.
My wife is a cataract surgeon. She finds that after discussion of the options, most of her pilot and engineer patients opt for either a monofocal or monofocal toric lenses + readers (or for 'near correction' monofocal + 'driving glasses' for some myopic patients).
 
weilke said:
As a general rule, each of these multifocal, focus adjustable or 'presbyopia correcting' lenses are a set of compromises.
My wife is a cataract surgeon. She finds that after discussion of the options, most of her pilot and engineer patients opt for either a monofocal or monofocal toric lenses + readers (or for 'near correction' monofocal + 'driving glasses' for some myopic patients).
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I wonder if their choice is due to the glare/halo issues with multifocal lenses. That's why I am steering away from the multifocal lenses.

These new extended-focal length lenses are supposed to provide the same distance acutity as monofocal lenses and improved intermediate vision without the glare/halo issues. I would still need readers for close-in reading an fine work.
 
The FAA (after one crash they attribute to it) figures that monovision lenses (i.e. near in one eye, distant in the other) screws up your depth perception too much. Essentially, you get monocular vision without the adaptation that a true monocular vision person gets. If you have monovision due to surgical means (one of the refractive surgeries or implanted lenses) then they figure the brain will adapt as you never "take them out."
 
kkoran said:
I wonder if their choice is due to the glare/halo issues with multifocal lenses. That's why I am steering away from the multifocal lenses.

These new extended-focal length lenses are supposed to provide the same distance acutity as monofocal lenses and improved intermediate vision without the glare/halo issues. I would still need readers for close-in reading an fine work.
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Glare/halo are one issue, less than maximal visual acuity in distance another.

Yes, the manufacturers and their sponsored investigators claim that those two new lenses dont have any of those drawbacks. This is achieved using an optical concept callled 'magic'. Those lenses haven't been in the US market for any length of time, so there is less of a consensus on whether these claims hold up when those lenses are used outside of the study environment.

The boss just spent a few days at the conference of the association of cataract and refractive surgeons. I'll ask her what the word on the street is.
 
My wife's on the training side of ophthalmic implants. It takes years and years to develop these lenses and get approval. Usually some small company develops them, and then raises a bunch of cash along the way. As they get closer to approval, one of the big dogs buys them out...hence my wife being a lot better off than I will ever be....

And the joke above about one of each? Actually, doctors do that from time to time.
 
weilke said:
Glare/halo are one issue, less than maximal visual acuity in distance another.

Yes, the manufacturers and their sponsored investigators claim that those two new lenses dont have any of those drawbacks. This is achieved using an optical concept callled 'magic'. Those lenses haven't been in the US market for any length of time, so there is less of a consensus on whether these claims hold up when those lenses are used outside of the study environment.

The boss just spent a few days at the conference of the association of cataract and refractive surgeons. I'll ask her what the word on the street is.
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The booths were empty of docs in Vegas, only about half of the registered showed up, and those that did spent their time in the Casino. My wife was very disappointed in the conference this year.
 
I would explore now with glasses to see if you like mono vision - one eye nearsighted for reading, one eye far sighted for distance. Me? Cannot do that.

I wear one contact in left eye (which is nearsighted) to put both eyes equal in distance vision, and I use progressive bifocal eye glasses for close.

Yep - I wear a contact in left eye to get distance vision at the expense of reading up close, and wear glasses over that contact to provide me up close vision vis progressive bifocal.

Its that bad for me to go mono vision.
 
WDD said:
I would explore now with glasses to see if you like mono vision - one eye nearsighted for reading, one eye far sighted for distance. Me? Cannot do that.
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Two weeks between getting eye 1 and eye 2 fixed. Nu-uh. Not gonna happen. Both eyes are set for distance. Life is good.
 
Follow up question. Does anyone here have intraocular lenses in a minimonovision (.5 -.75 diopter difference) configuration?
 
I got vivity in both eyes. I’m delighted with my vision during the day. Distance vision is perfect, intermediate is perfect, and I can read although it’s a bit blurry. For anything more than a few sentences I use readers. The change from distance to near is natural, there is no zone where it’s clear and the rest blurry like with multi focal lenses. I suffered terribly from glare and now it doesn’t bother me at all. Night vision is where the compromise comes in. It’s harder to see in the pitch black dark than I’d like. A nightlight in the bathroom is essential. Maybe it’s age, maybe it’s a loss of contrast sensitivity. I see halos around tiny coloured lights. No halos around street lights or car headlights, but a small halo around the red yellow and green traffic lights. It bothered me at first but I’m getting used to it. I figure I use my day vision the most, so the trade off is worth it. Also, if I squint the halos disappear, so it must be related to pupil size. I would think differently if I saw halos around all lights. For me that would justify replacing the lens. My doc did not recommend eyehance. He said the near vision would be blurry. I do think he oversold the vivity, especially since I had rejected multifocals because I was concerned about night vision and did not want halos. I will admit I was disappointed at first but by now it’s been six months and I’m content. I really do have fantastic vision during the day. And I’m super happy I don’t have to constantly put readers on and off. I hope this helps.
 
I'm still pretty conservative about these. The eye can only tolerate so much with regard to re-opening and going back in. These products do not have a track record as of yet.....
 
As a side note, Peter La Haye, made millions developing implantable lenses for cataract patients. He was killed, along with my pilot mentor, Don Slipper..............descending in his Westwind into Teterboro.
https://archive.seattletimes.com/archive/?date=19991213&slug=3001311

The week before their maintenance facility at Boeing Field did a service bulletin on the jackscrew in the tail. It was later determined that the SB was not even needed due to the SN# of the airplane.

They were on their way to pick up a brand new Falcon 50.
 
I am trying to make a decision on using Vivity. I am more concerned about halo's than anything else. I fly a lot at night and not sure about the new technology. I would like to hear from more pilots on this issue.
 
I don't fly at night, but I drive a lot. I had terrible halos with my cataracts, now thankfully none. I went with the classic lenses, because I knew others who had problems with the high-tech options. I'm glad I chose what I did.

I use readers for close work (like phone or laptop), but can read speedometer, GPS, etc. without. Haven't tried flying yet, but will likely wear bifocal sunglasses (basically plain on top, readers on bottom).
 
If your a pilot go with a monofocal lens. Every multi focal has reduced contrast sensitivity.
 
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