Hello - Age 25 - In both eyes have been implanted a Acrysof IQ Vivity IOL Femtolaser assisted - Surgery is 8 Months ago - Good Day vision, need reading glasses to see food sharp - Terrible Night Vision + Contrast Sensitivity - Glare, Starburst, Halos, - Lightstreaks from street lights going from top to bottom - Tried Pilocarpine drops - No Effect I don't know what to do, my surgeon almost yelled at me when I talked about monofocals and driving back then saying "YOU CAN'T DRIVE WITH MONOFOCALS YOU WON'T EVEN SEE THE DASHBOARD" S****y Situation and I wish I could turn back the time and actually chose monofocals and went with progressive glasses, multifocal contacts or whatever. Night Driving is possible as it was possible to drive for me when I had -15 Dioptrien when my cataracts formed and I still managed to go to places more or less safely. But the Joy is definitely GONE. And driving was my number 1 Hobby. Like my absolute number 1. My plans were to buy nice cars in the future and to just drive and enjoy driving. But now I feel like 50 percent of it is gone. Night driving is so much more fun so ofc it's nice to see well at daytime, but I don't want to miss night driving for the rest of my life. I've read people with monofocals also experience contrast and glare problems, so I I'm not sure what to do. I was thinking if an explanation could maybe fix this problem, because I'd happily have the inconvience of using different glasses for everything, when I can see at night again crystal clear. And the dark spots won't turn into pure black making me think is there a person crossing the road or not. I do have PCO forming on both eyes, but the night vision problems we're there from day 1 of the surgery, so I don't think it's that causing my problems. What can I do at this moment? TL;DR - Unhappy with vision at night from EDOF IOLs, what are the options? help
Hi Mister,
Sorry to hear you are having issues with your Vivity IOL. I watched a webinar this week on the Vivity IOL run by Alcon and some ophthamologists and they talked about how amazing the IOL is and how everyone has such amazing vision and it’s the same as a monofocal in terms of negative side effects. It’s all marketing. You can’t trust anything you read by these manufacturers or ophthamologists (most not all) unfortunately. Cataract surgery is a big money maker and their goal is to get you to buy these premium IOLs.
Now I will say there are issues with monofocals. I have both a monofocal (put in 4.5 weeks ago) and a multifocal (Symfony 5 years ago). I’m experiencing side effects with my monofocal as well. I went with the monofocal because I thought there would be very little negative side effects and that hasn’t been the case.
So with that said, you really need to see if you can find out whats causing all of your negative side effects. Removing the Vivity and switching to a monofocal will definitely help with the contrast / low light issues but it’s not going to solve it 100%. But the PCO could be causing glare, starbursts etc. You may also still get the glare, starbursts etc with a monofocal as well. And removing IOL’s is not an easy surgery unfortunately. It would be nice if it was and we could just switch IOL’s easily until we found one we liked.
Have you tried glasses recently? Did they not help?
Sorry to hear about your outcome.
If an explant / exchange is possible you should probably go with Mono (Acrysof or Tecnics) but the J&J Eyhance might be an option. Gives slightly more usable near vision range than a regular aspheric Mono but with no contrast loss.
I'm surprised to hear about your visual disturbances. Two different trials both found that the visual disturbance profile of Vivity to be virtually identical to a Mono. But everyone's outcome is different and no lens can claim 0% visual disturbances. You may have that with Mono as well.
Do you think the night driving issues you're having are more due to the dysphotopsias or due to the low light CS loss? Or both? I'm considering Vivity but nervous about the trial findings of CS loss in low light.
mister84231 First of all, I've tried to contact you, but you haven't replied to my post (don't know why). I'm in a similiar situation and wanted to discuss it with you as I also live in Europe. Anyway: 1. As far as I remember, you had your lenses replaced by Prof.T.Kohnen in Frankfurt, am I right? Did you do your surgeries at Goethe-University Hospital or EuroEyes? 2. I think there's little hope for us, except exchange. I'm pretty sure it's gonna stay that way for the rest of our lives (at best) if it's not for IOL exchange. 3. Your surgeon wasn't right, it's still possible to see a dashboard of your car with a monofocal lens. I can see it. You won't see your smartphone's screen, though. 4. We should find together the best surgeon in the EU in terms of IOL exchanges. I'm also interested in it. Again, if you want to contact me, send me a private message or leave your email address here.
Hi - sorry your iols are causing do many visual disturbances. if you are considering an exchange i am not sure edof lenses are the way to go. Likely cause just as many visual disturbances as your current IOLs.
A good monofocal in your dominant eye targeted for distance may help the situation considerably and you may not need to do an exchange in the other eye.
Your age too may be a contributing factor as your pupils dilate far more than a person who is of usual cataract age. That might be source of night vision issues.
ideally you should seek put a few opinions - it does take a surgeon with more experience to do an exchange. Find someone who has that skill and experience.
Wishing you well.
hey the problems I have night are due CS loss and glare mostly. Since the distance just seems so blurry at night like I wish i could just put on glass like pre catarct when i had -2 dioptren and when i put on glasses i had 4k full hd 3d vision and could see every single bit. every dark shadow moving thats 500m away.
but now i have -0.25 dioptren on both eyes and using glasses maybe change 1%. at daytime i dont notice the difference at night time i think i notice 1% or its just a feeling since you look through clear glass. nethertheless its not enough.
so im downtown 9pm its night at the traffic light. street lights illuminating the street. up to 50-70m everything is mostly clear. some glare and starbursts from traffic lights. but every car or traffic light streetlight after 50m becomes less visible and blurrier. like darker and their headlights form a big glare starburst so what im seeing in the distance is a light sources and pure black/grey inbetween which is the road usually. im just seing either black grey and light sources with a huge diameter or blurry things where i can't tell what it is. sometimes i even get irritated because i see lights from windows but not the house even tho its not pure darkness.
even at dawn 6pm when I leave the house for work my distance vision ready is reduced by like 40% and everything seems darker the headlights more intense and blurring everything.
somehow my left eye has less glare starburst, but less is definitely definitely definitely not enough. a car comes ahead i have to FOCUS BE CAUTIOUS whats behind it.(even at dawn) i feel so old because sometimes i drive like a snail, my confidence at night driving is definitely greatly reduced. ive used to own fast cars and it was no problem for me to catch the spots where i could accelerate for a bit without endagering anyone. but now I feel like i could hit a jaywalker even tho im driving normally.
also i dont see this young pupil theory working on me since using these eyedrops literally cause more glare and not less.
my wishes would be:
sharper vision for the distance since the world at night feels so small suddenly due my 70-100m vision. being able to tell whats in the distance. so that's low CS I assume.
less glare starburst and these lightstreaks are pretty annoying.
not feeling like the world is so dark anymore, needing to use flashlight to walk on steps which i could see WELL before.
hope that could help, my doc said i could have glare with monofocals too but they for sure didnt say contrast vision will be reduced i remeber just seing it on the paper to sign AFTER the surgeon left the room. anyway they will get their place in hell enough anger for those ppl.
SO IF YOU WANT TO PLAY IT SAFE TAKE A MONOFOCAL. They say my lense has low probability for glare and visual disturbances. okay but still the risk is there and its higher than on monofocals. its like with stocks high risk high reward when you risk taking premium lenses. low risk is monofocals.
You can always fix distances with glasses, but you cant fix WORSE vision quality.
To give a better illustration on how my vision is now and how it feels like it used to be before surgery. (ignore the lines from the streetlights they were already in that pic) this pic is mainly showing the darker and blurrier world im seeing
Sorry to hear your outcome with Vivity. It should be a low risk option for those effects, but I guess you never know. The clinical trial data does show some issues with a very few people. It is unfortunate to be one of the ones that did not get really good results. . I currently have a monofocal, and I certainly can see the dashboard very clearly. I suspect I could read at the steering wheel distance. In general vision starts to go at about 0.5 meters and closer. . My other eye has the natural lens and a mild cataract. I wear a contact to give me monovision. When I drive at night, I do see some slight amount of flare from headlights and street lights. The natural eye with the contact is worse, but neither is an issue for driving.
mister84231 I don't understand why you keep ignoring my replies. It seems you don't care at all and you're not interested in helping each other. Ok, whatever.
hey i didnt ignore your message. i sent you private message check your inbox
Hey, ok, I'm really sorry, I didn't notice it. My fault! I'll reply asap.
what iol did you get and where from?
Hey my friend, I'm 32yo, also got vivity implanted in my dominant eye. It's been 6 months since my surgery and its still so difficult to drive at night. I wish I saw your post before my surgery. I'm considering an exchange to a monofocal. All the joy of night driving is gone here too. Luckly my other eye is still good.
My opinion is that Vivity should not be used in both eyes. If a monofocal like the Clareon is used in the other eye, it helps to offset the loss in contrast sensitivity of the Vivity.
ron you feel the same about eyhance?
Yes, if one was to use an Eyhance I think it would make good sense to just use it in the near eye, and use a true monofocal in the distance eye.
I have the same problem I am 49 and got a Vivity for the first surgery non dominant and the night driving is bad but also the reading letters have slight blur halos too. The free monofocals my dr uses I think are Alcon Sof IQ or something (there is no Eyehance option) and that is what I will do next month I think? Because your post reminds me of my situation like I was just driving before sunrise and it is ridiculous it's like before surgery. It may be like this with a monofocal too but maybe I should save the other $3,000 and just use glasses.
You should ask if your doctor has the new Clareon monofocal. It is essentially identical to the AcrySof IQ but is made from the new and improved material. I have one of each. There might be a small cost for the Clareon over the AcrySof IQ but I think it is worth it to get the newer material. They are both made by Alcon.
At this stage she should get a Sofport Silicon IOL or hydrophilic one, not any Clareon or whatever as long as Positive Dysphotopsia is the reason (no matter multifocal or mono). It's not wise to change for the same material in such a case.
Halos and reduced contrast sensitivity are caused by the optics of the Vivity lens, not the material. It is hard to find surgeons who still use silicone lenses.