Hi everyone! I had cataract surgery on 10/24/22. i got the vivity implant. im experiencing ghosting. worse at near vision. pre surgery my near vision was 20/70, post surgery im 20/200. far vision is 20/20 lost surgery so thats great. the monocular double vision or ghosting is so bad up close that everything is very blurry and nauseating to look at from 0-10'. had me retina looked at, eye remeasured, refractory retested everything looks text book good. No remaining inflammation, and iol is hooked perfect. i still have to get my other eye done but am waiting to correct the current issue with the implant. im 39, was born with cataracts and also have had a lazy eye muscle when I was young. Any input would be appreciated.
I wouldn’t expect anyone to see much from 0" to 10" with a Vivity lens set at emmetropia (plano).
Indy G
Indy, I think he mentioned 10 feet not 10 inches.
BTW, I have a Vivity with a -0.75 refraction suprise and my vision get sharp at about 22".
Hi Luigi,
See my post (“Vivity … progress after 3-4 weeks”) about taking me about 4 weeks before things really settled with my Vivity.
Unlike you, I didn’t see 20/20 distance at any time and I am unlikely to in the future due to a -0.75 refractive surprise. For the first 2-3 weeks post surgery, nothing looked sharp, near, intermediate, or distance.
I don’t know if it’s correlated, but things started to get better after I finished the course of eye drops.
Today, I, with effort, I can read my Apple watch or iPhone (with larger fonts) but it’s fuzzy. I begin to see clearly at 22" of distance but, unfortunately, it gets blurry again at distance (e.g. TV.) So I think you got the better outcome :-).
Check out my post, I think it will make you feel a bit better!
I have a few comments. First is that you are only 2 weeks post surgery. Recovery takes a minimum of 3 weeks, and up to 6 weeks. Don’t consider doing the second eye until after you get your vision refraction tested at 6 weeks. You have lost your near vision because you have traded your 39 year old natural eye that still had lots of accommodation (ability to change shape to focus close) for a plastic lens that has no accommodation. Last I think that the Vivity lens should ideally only be used in one eye. To minimize the ghosting it may be worth considering a monofocal like the Clareon in the other eye. It will improve contrast sensitivity and perhaps allow you to ignore the ghosting from the Vivity. But, it is only two weeks. I would expect vision to improve by 6 weeks.
will do thank you for the info. the ghosting is driving me nuts. my friend had both eyes done with vivty, and is seeing great 4 weeks out. 20/20 far and 20/40 near. even a person is blurry to me at 5 feet.
what is causing the ghosting? this result wasnt expected by me, my doctor, or by two friends who have gotten vivity.
i had my retna checked, a refractory test, and eye measurement the other day. doctor said everything looked perfect. the doctor thinks my brain is having trouble focusing my eye and believes I need time to train it to focus. i e had cataracts since birth so not sure if thats the issue.
when i look through a pin hole with the surgical eye, the ghosting is gone.
hopefully it clears up. as of now ive had zero improvement with ghosting and near vision. i remain 20/200near post op. so discouraged right now. wishing i went with panoptix at this point.
i cancelled my 11/21 surgery and postponed until 12/18. also have a second lined up for 12/10 at MA eye and ear. just want to see good again. my other eye is almost completely fog at this point.
The Vivity is an extended depth of focus lens. The lens surface had a raised area which has a slightly different power than the rest of the lens. While this increases the distance over which you can focus, it essentially creates two images to look at, as best as I can figure it out. The concept seems to depend on the brain being able to choose the image that is in best focus and ignore the other. If the brain does not ignore it then it possibly shows up as a halo around the sharper image. The hope would be that over time the brain will learn to ignore the out of focus image.
I agree with Ron about waiting till you are off the steroid/anti-inflammatory drops to see if the ghosting disappears.
If the ghosting stays around, two of the possible problems include astigmatism and something akin to a cataract on your capsular bag (PCO) where the IOL was implanted. If astigmatism is the problem, I would have thought it would have been found in a refraction at your 1/2 week post-op appointment. But I would also think if there was any problem with your capsular bag, they would have found it as well.
I had lots of ghosting when looking through my now-replaced posterior subcapsular cataract lens. I could see 20/30 through pinholes and multiple ghost images in an optometrist’s office but was maybe 20/200 outside.
Since you were born with a cataract your eye/brain may have adapted to pinhole vision available through the cataract and may take longer to adapt to the new cataract-free IOL that your brain is completely unfamiliar with. You might look into vision therapy to see if there might be ways to speed up this adaptation.
I also have a Vivity and it took me a good 4 weeks before things became satisfactorily clear.
Luigi, did your doctor mention a “refractive surprise?”
wishing i went with panoptix at this point.
Perhaps. But you might have experienced another set of problems.
There is a difference between good decisions and good outcomes.
The Vivity was a good decision, you just have (for now) a not-good outcome.
So don’t beat yourself up too much (like we all tend to do, me included) and give it more time.
This forum is an awesome source of information—and a special hat-tip to RonAKA who really knows his stuff!
I suspect it is possible to distinguish between “ghosting” caused by astigmatism from that caused by the EDOF lens effects. I certainly have ghosting from astigmatism in an eye that has a monofocal lens. I call it a drop shadow as it is located to the bottom right of the main sharp image. I don’t have any halo effect, but I suspect if the ghosting is uniformly around the whole sharp image than that is most likely to be due to the EDOF design of the lens.
ghosting is around the entire image. i can also see the edge of the implant in the right side of my eye
One of the likely issues to cause this is your age. Younger people, yes 39 is much younger than most of us with cataracts, will have larger pupil diameters. In some cases the pupils can open up large enough that you can see the edge of the IOL. Looking through a pin hole sharpens the image and counters the large pupil issue.
could my lens be corrected somehow for this? should my doctor have ordered a lens to accommodate this?
i will redo my surgery with a new lens if I have to. whatever it takes. the ghosting is making it hard ti do most of the tasks i need to do.
Unfortunately virtually all lenses are 6 mm in effective diameter. As for the ghosting I think I would wait for 6 weeks post surgery before making any decision. One option may be to get a straight monofocal like the Clareon in your second eye. It should give you a sharper distance image, and may allow you to ignore the halo effect on the other eye.
With my small amount of astigmatism, I’ve noticed that if I cover the other eye with an envelope and look at a ghosted object (lighted letters on far-away buildings at night) then move the envelope very slowly towards the other eye, the ghost of the image will go away just before I cover both eyes. At that point, the image is sharp. Evidently, the envelope is cutting off the light that ends up creating the ghosted image.
You might play with covering your eye slowly from all directions to see if you can get rid of the ghosted image. Might help diagnose the problem.
thank you for that, I will try it tonight
thank for the info. im going to wait until after Christmas. i might have this lens removed and go with clareon in both eyes.
do you think i would have a better result with panoptix over vivity as far as ghosting goes? would live to get my range of vision back if possible.
I think PanOptix would be worse than Vivity for ghosting. Google this and have a look at the halo simulation image down near the bottom of the page. The Clareon should be the same as the AcrySof IQ lens. It is just a newer material with basically the same monofocal design.
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MiVision Shaping the Wave: The Evolution of Extended Depth of Focus Intraocular Lenses