Eyhance or Tecnis Monofocal?

Eye care
1

I am a 67 year old woman and I am trying to decide between Eyhance or Tecnis monofocal. My last eye glass prescription was -2.00 for the right eye and -2.25 for the left eye, with -.50 cylinder and 130 axis for the left eye. I tried progressives a few times years ago and could never focus with them, so I went with bifocals instead. When I am reading or using the computer at home I always take my glasses off as I find that more comfortable than trying to look through the bifocal portion of my glasses.

I have been reading the posts on this forum and there have been a lot of positives about Eyhance, but also some negatives. Some of those negatives seem to be surgeon “error” among other things, but some seem to be dissatisfaction with the Eyhance. Also, most Eyhance comments/reviews have been days, weeks maybe a few months after surgery. I have seen very few posts a year or more after getting the Eyhance (I realize this could be because of how new the Eyhance is). I am having a hard time deciding if I should go for the Eyhance or play it safe and go with the tried and true Tecnis monofocal.

I would be getting whichever IOL I get set to distance, so I am realistic and realize I will need to wear readers for computer and reading. I also know myself well enough to know getting monovision is just not an option for me. I am also aware there will be a trade-off with whatever I pick.

My worry about the Eyhance is I wonder if it will be the same as progressive glasses and I will end up never being able to focus with them because of their change in power from the outside to the middle. I also wonder how your pupil size will affect your far or intermediate distance with Eyhance. Will my ability to focus on something be constantly changing because your pupil size is changing because of the lighting? I am outside a lot and realize it will be different on a cloudy day compared to a sunny day, but what about those days where it is sunny, but with a lot of clouds passing over the sun.

I have read numerous studies comparing the Eyhance to other IOLs, but there have been no studies that I can find where they go back a year later and retest/re-question the participants about their satisfaction. After getting over how great it is too see clearly again after getting the cataract removed, does that satisfaction continue or after a number of months are they dissatisfied with it. All the studies seem to agree Eyhance gives you a bit better intermediate vision. One study said it was pupil dependent, but did not expand on that.

I have looked at the defocus curves and I appreciate Eyhance does not give you a “huge” intermediate/near advantage over the monofocal, but when you are talking inches in the intermediate/near range those inches can mean the difference between being able to read your cell phone, see your watch, see the person sitting beside you clearly etc. without putting on reading glasses. My husband has monofocals in both eyes and I watch him put on and take off his readers numerous times a day and he can’t go anywhere without them. I am hoping for a bit better glass independence, but not at the cost of picking an IOL that has problems.

I appreciate all eyes and situations are different and my outcome will not be the same as yours, but I would appreciate any knowledge/experience people have about the Eyhance. This is a life changing decision and more knowledge and information can only help us to make the best decision for us.

Thanks.

2

Thanks for posting this as I will be VERY interested in reading the replies. I too am struggling with the choice between Eyhance and Clareon and have to decide soon. One thing that Clareon does have is blue light filtering which Eyhance does not have. I have AMD so that is a consideration for me.

If I get anymore information I will post it but currently I only have vague information and my doctor is pressuring me for a decision!! One person here has had Eyhance for over a year and I have asked him today for information about his experience ....so will let you know!

3

I would suggest it is a hair splitting decision, and you really can't go wrong either way. Both ways are going to require reading glasses. There are pros and cons to each lens. The Tecnis 1 if the correct power is selected will give the best distance vision, but at the price of slightly (0.25 D or so) less depth of focus. The Eyhance will give the slight increase in depth of focus but with a slight drop in distance visual acuity - perhaps from 20/15 down to 20/20. . To get a significant increase in depth of focus you have to set the focal point for one eye closer. Moving the focal point from -0.25 (normal distance target) down to -0.50 with the Tecnis 1 will give you about the same range of focus extension as going with Eyhance. But, this is still not going to get you to eyeglasses free mode. . To be eyeglasses free requires splitting the eye differential down to about -1.25 to -1.50 D. That is what I do, and I very rarely need glasses.

4

Thanks RonAKA and Spring1951. My surgeon has suggested for Eyhance to target -.25 on my left dominant eye and -.50 on my right eye. I know I will need reading glasses and am fine with that because I wear glasses now. I don't want to target my eyes too differently as I know that will not work for me. If my depth perception is off I am worried about falling while doing the different activities I do and just always feeling unbalanced. Good information to know about targeting the Tecnis 1 to -.50, could be the answer if I don't want to go with Eyhance.

5

How would you compare Eyhance with Clareon in light of trying to be eyeglass free?

6

Do you have astigmatism? If so, do you know many diopeters?

7

My thoughts are that without any offsets there would be an almost insignificant difference. But, yes in theory the Eyhance does give about 0.3 D more depth of focus. My thoughts are that it is not going to make much difference in needing reading glasses.

8

Ok. Thanks. I do like Clareon better from everything I have read.

9

I have a very small astigmatism in my right eye according to my surgeon and not enough to get corrected, .3 I believe. In my left eye he said it is 1.14. Not sure if that is diopeters, but it will need a toric lens.

10

Well, the Eyhance toric seems to perform quite well. Since your dr recommends the Eyhance I assume he has had good results with it. If your astigmatism is corrected with a toric, you should have no problem if you wear progressives. RonAKA often suggests the mini-monovision approach to be essentially eyeglasses-free. There are many variables in cataract surgery. Your own ocular pathology, the surgeon's skill, the IOL, and well, just plain luck or chance, But considering that two million cataract operations are done in the USA every year, I am surprised this forum doesn't have many more posts, with questions or complaints. Presumably most surgeries go quite well. It's just that now patients have more choices than ever before, and in the coming years, there will be even more choices with IOLs. The odds are that you will be fine.

11

0.3 D is not enough astigmatism to correct with a toric lens. But 1.1 is enough. You would probably need a toric lens with 1.5 D cylinder.

12

I joined an older group called Eyhance Review on this site which I found on google. Here is a post I found.

"My first days seemed okay too. A year out my vision is terrible. I cannot read or knit for more than a half hour. Everyone should know that these IOLs were developed as a medium price point. It was for those that did not want to pay for state-of-the-art multi-focals. I learned this one operation too late. My vision is not good enough to go without glasses and glasses are not compatible with the IOLs. Unusual blurred spots in my field of vision. It is on the table to have them taken out. My new ophthalmologist clinic does not have Eyhance on their approved list.

It is not right that a patient ends up with such a bad outcome and the only recourse is leaving bad reviews. I did contact J&J about their misleading brochure. No one in the brochure is wearing glasses. What did they want patients to think? Also it is not in the brochure that it is a mediocre lens for people looking for a cheap way out, which I was not".

13

I can't say that I am a big fan of Eyhance, but I certainly cannot agree with that comment that Eyhance is a budget IOL and is compromised due to the price, and are for those that did not want to pay for state of the art multi-focals. I would think the person that said this that is unhappy with the Eyhance is much more likely to be dissatisfied with "state of the art multi-focals". I would suggest this is an example of the very misleading information one can find on social media. . I do agree that when targeted for distance the Eyhance is highly unlikely to give you an eyeglass free full range of vision. I have not seen any J&J Eyhance claims that it does though. The Clareon lens is not going to give you a full range either, unless you target different distances for each eye.

14

The Eyhance is not a "mediocre lens." It is being used world-wide by cataract surgeons. I would not take that review seriously.

15

I never wear glasses so it will not be something I relish and I probably will shun them anyway if I can!

16

I don't question the poster's honesty, but there is not enough difference in the design of the Tecnis 1 and Eyhance to attribute the poster's difficulty to the IOL rather than an unfortunate result or individual condition. That said, my opinion would change were there widespread reports of such results connected to something distinctive about the Eyhance.

I confess not understanding the point of the price point reference. At least when introduced in the U.S., it cost surgeons a modest amount more than a conventional monofocal. But in most (nearly all?) cases the difference can't be passed on to patients because of Medicare rules and surgeons' agreements with health insurers.

17

It is hard to know what to believe but I like hearing all sides but I was surprised to read this?

18

Good to know there were there no widespread reports of such results connected to something distinctive about the Eyhance. I didn't know if there were and don't have a vast knowledge on the subject matter.

19

My wife is the same. I think she would do well with monovision, but can't as she only has functional vision in one eye.

20

my pre-cataract prescription is similar to yours. do you need glasses for reading or do you do well just taking off the glasses for near vision?

if i started this process all over again i would go with one of the following two scenarios:

  1. eyhance set for -0.5. depending on how much near i get with that i would play with + power contacts in the operated eye a month after the surgery. depending on what i feel comfortable reading at 16-18 inches, i would set the other eyhance as -1 oe -1.25.

  2. i would get clareon panoptix in one eye and BnL sofport monofocal set for -0.5 in the other eye.

good luck.