CataractCoach 1218: J&J Eyhance compared to the Alcon Vivity IOL

[@hyndry]

I go for image quality... so, monofocal for me. I'm not bothered by wearing reading glasses which I have been doing for decades. I've learned so much from your videos, Dr. Devgan!

[@ckp2ator389]

Did you go for distance in the refractive power of your monofocal lenses? I understand most people opt for this choice. If yes, do your reading glasses take care of intermediate distance (i.e., computer, and other arm's length activities) or are your monofocal lenses good enough for intermediate without glasses?

[@richarddonahue3565]

SUPER info in this video. It really helps clear up a lot for the patient. Another opthalmologist said on their video that you will never get back the vision like you had when you were 20 years old. Thanks for the great info here.

[@miketait1640]

I’ve now had a couple of cataract consultations. One has recommended the Tecnis Eyhance in both eyes and the other recommends implanting an Alcon Vivity in my dominant eye and a standard monofocal in my “lazy” eye. I’ve been struggling to decide which option is best so finding this video has been really helpful. I’m not saying that I understand all the technical stuff displayed on the graphs but I think I get the gist of it. If anyone has any comments please post up. PS. My lazy eye is really really lazy. Not much sight at all.

[@oculusrm]

A remarkable lucid explanation , a wonderful teacher, the thoughts and concepts of science so beautifully explained!🙏✨I think I’ll have my Vivity disinclined patients see this guide! 🙏

[@prashantsharma9858]

So, what was the outcome ? Monofocal (technis 1) or eyehnace or vivity then ? (For patient aged 65) I didn't get it straight , please

[@chaugg1]

I appreciate your fantastic explanation. Most surgeons do not bother to tell patients what lenses they will use. Am I the only one to feel this way? Just wonder.

[@joelseling186]

The color coded side by side by side graph is excellent! Im going for the Eyehance plano in one, -.5 in the other. I'm planning on very good to functional vision down to about 3'. The finite amount of light and how it is dispersed brought everything together for me.

[@Jancass5]

Wow! Terrific description for the general public! So interesting and I understood (most of) it! Thank you so much for making this video. In the end, trusting one’s surgeon is paramount!

[@PhishedOff]

You're just amazing! I love that you explain things so clearly, don't make the lay person feel dumb AND you don't try to sell us a bunch of bunk - you are a straight shooter - thank you!! (I like the marketing tip, you said that so politely)

[@prashantsharma9858]

So, what was the outcome ? Monofocal (technis 1) or eyehnace or vivity then ? (For patient aged 65) I didn't get it straight , please

[@terryv]

You’re kidding, right? This was the worst, most worthless explanatory video I’ve ever seen on KZbin. A complete waste of time. No help whatsoever.

[@carolchristiansen635]

Your explanations on the difference of a patient is brilliant and so true.

[@Dr.Anuj_Satija]

I'm a cataract and refractive fellow from India and I just wanted to say that your is beautiful! Thank you sir!

[@Steve-rc1ug]

I had an Eyehance Toric lens inserted in my left dominant eye in April, then three weeks ago the same in my right eye but my surgeon set the right eye prescription back .5 to give me a little better near vision in my right eye as compared to my left. I do use 1.5x reading glasses now when I use my iPad but in general I see very well with the .5 setback and mono vision and am happy with the Eyehance lens.

[@stevenswann2835]

Hi Steve. How does the Eyehance at .5 handle car instruments? I'm considering swapping out my Vivity for Eyehance set at .5 for a number of reasons, but need to see my car instruments whilst driving.

[@Steve-rc1ug]

@@stevenswann2835 Hi Steve, I have no issues at all with seeing car instruments. Only issue is with reading or using my IPad and so I use my reading glasses there. Very satisfied with the Eyehance lens.

[@stevenswann2835]

@@Steve-rc1ug Thank you. This is exactly what I'm chasing. Happy to use readers for close work, but need to see the car dash whilst driving without glasses. cheers.

[@rhett7716]

@@Steve-rc1ug hi. How come you didnt go -1 or 1.5 to avoid readers?

[@stephenrosenfeld833]

I'll admit that your "Google homework" remark applies to me and made me chuckle. But let me thank you for at least allowing me to get my foot in the door! I have learned a lot from your videos and now have at least a very basic understanding of what's what. I really appreciate the excellent work you have done in getting this information out to both professionals and the general public. I had Vivity lenses implanted in both eyes two months ago, five weeks apart. The vision in the first eye was stupendous, especially considering that I could compare it against the "control eye", even with glasses. One eye saw trees, the other saw the leaves! The vision in the second eye was not quite as clear and vivid, but good enough that, after 60 years, I no longer wear glasses at all. The night vision is interesting. When I look at a star from a very dark country location, I see three points of light in a horizontal plane. With each eye! Each star looks like a UFO! If I tilt my head, the axis of the three points rotates with the tilt. I have yet to have a follow-up with the surgeon, but if you have any idea of why this is, please let me know. Otherwise, no significant halos or starbursts, so I'm more than satisfied with the Vivity lenses. Thanks once again!

[@anassyria5176]

Stephen, hello there! I'm not a professional but here is my understanding! This "UFO-like" effect is quite understandable and even expected with a multi-focal lens. The multi-focal lens takes the light coming, and converts it into several (usually three) images projected on the retina. Each image of the three is focused on a distance : on near, intermediate and far. That's why there is always an overlap of there images at any given time, as your retina has three different images, each with different focus. Would this effect last? Personally as a 31 y/o cataract patient, I don't know, but from a testimony on KZbin (I'll copy the link here next) of a guy with 5-year use of multi-focal lenses, he said that those extra ghost copies fade away more with time, maybe as the brain learns to ignore them and focus on the wanted image with the desired distance in focus. He also mentioned that it took him up to 8 months to reach there (If I'm not mistaken). How's the condition of your vision now in both eyes?

[@stephenrosenfeld833]

@@anassyria5176 Hello and thank you for your reply. The Vivity lenses supposedly focus over a continuum, and not at three distinct focal points like the previous generation. I am mightily embarrassed to say that I was so excited by the improvement in my vision that I was hasty in commenting on Dr. Devgan's excellent article here. I had not yet seen my optometrist and it turns out that the problem is a result of some minor astigmatism. So now I wear glasses for night driving and watching tv. What, that's it? Yup. My surgeon is not very communicative (there has been no post-surgery follow-up), but the optometrist told me that the astigmatism may be why my closeup vision is so good. I guess that's the tradeoff versus having astigmatic correction in the IOL. Once again, thanks to Dr. Devgan for providing these excellent articles that allow people in the general public to better understand their situation!

[@anassyria5176]

@@stephenrosenfeld833 Thank you too for the valuable information and experience! My bad I confused the continuum of the Vivity with other lenses. From what you say I understand that there's no noticable overlap/ghosting effect that affects the edges or contrast of fine details (Maybe except for the halos around lights at night).

[@ratherbfishing455]

​@@stephenrosenfeld833 I would ask why there was no post op exam. I have had three visits. Write a review on Google.

[@stephenrosenfeld833]

@@ratherbfishing455 Yeah, good question! Here it is ten months later and still no followup. It was left in the hands of my optometrist. I should create a fake id so I can keep my anonymity in the smallish city I live in. Based on YOUR id, I'll relate that I once gave a bad Google review to a fishing rod company and they afterwards refused to repair the broken tip on my custom fly rod, even after I removed the review like they asked. Like you, I'd rather be fishing than engaging in comment battles. One good thing to note though is that I can see well enough up close with my Vivity lenses that I can tie on a small salmon fly without needing glasses. That was a concern before the operation!

[@vsharmaophth]

Great video, thank you for clarifying it . It will definitely help me in decision making when offering options to my patients.

[@wesleypratt3511]

I've never SEEN a better explanation of lenses and the differences between them / after hours & hours of research / thanks to you - it all makes sense / thanks sooooo much / wtp need more people like you in our journey for the truth 😊😊😊😊

[@prashantsharma9858]

So, what was the outcome ? Monofocal (technis 1) or eyehnace or vivity then ? (For patient aged 65) I didn't get it straight , please

[@sgupta301]

REAL EYE OPENER ! wonderful and very informative

[@p.v.narasimharao7866]

Dear Sir, Very very excellent video, Sharing such a Precious information. This is Narasimharao from India 🇮🇳. We love ❤you soo much for your fantastic videos...

[@highhopesranch2247]

I just wanted to compliment you on the accuracy and understandability of your videos. You're an outstanding teacher and human being and I wish I could Xerox copy you and the world would be a better place.

[@didgeridebi]

Thanks so much ! Best explanation I’ve seen anywhere !

[@rette2901]

Thank you so much for the information. I didn't understand why I could read without glasses now that they say I need cataract surgery.

[@shvn803]

Thank you for putting them into graphs, Dr Uday. I can never get bored with your videos. I've tried a few Eyhance IOLs as well but my patients don't seem to notice any difference for their intermediate/near vision. However I have yet to try Vivity lens. Looking forward to it :) Tq!

[@DoctorKrad]

I really like how you combined the charts. It would be really neat to also overlay the MTF of the natural crystalline lens of, say, an average 30 or 40 year old to compare them with the other IOL's. If charted at scale, it can give patients some good insight. I have some young patients with a healthy phakic eye on one side, and who needed cataract surgery on the contralateral eye for various reasons. It's always interesting to compare their natural lens to the artificial one. Perhaps that can be done in the future. Great video!

[@UdayDevgan]

thank you -- in the video I showed the young crystalline lens with the yellow graph. Accommodation allows the curve to shift at will to provide the widest range.

[@DoctorKrad]

@@UdayDevgan I noticed that on the chart but I didn't assume it was to scale. If so bravo!

[@UdayDevgan]

@@DoctorKrad I am a big fan of your PanOptix vs Synergy videos! thanks for doing them.

[@DoctorKrad]

@@UdayDevgan I appreciate that 🙏🏻, it means a lot coming from you (the OG of cataract surgery education on KZbin!) If these vids help even a few people, they are worth making :)

[@Aakashdeep1313]

​​​@@UdayDevgan how much cost of this 1 lens tecnis eyhance iol

[@Dawnnie473]

Thank you for this video. I feel like I will be able to understand and have a better active roll in the conversation with my doctor in my upcoming cataract surgeries. Your video gave me a better understanding of the limitations of IOLs vs what I was use to with my natural lenses prior to my eye health issues. Again, thank you.

[@UMS9695]

Well explained, Dr Uday Devgan! This video is very helpful in understanding the physics and technology behind these different lenses.

[@rsingh4044]

In the image quality graph of all lens it is reflected that image quality of far distance of J&J Eyehance is better than Alcon vivity and it is almost near to J&J ZCBOO. Alcon vivity has better image quality at near reading distance than J&J eyhance . Kindly let me know whether there is significant difference in distance image quality of J&J eyhance and Alcon vivity . For a pilot which will be better .

[@yashkansal3718]

Very informative based of factual data which I have not across with others on u tube

[@CT-mo5cs]

Your videos are excellent.

[@dr.subhashprasad315]

Very informative.Clears lot of doubts.Thanks👌🏻

[@bharathimegur4664]

Sir Thank u for this insightful video Does having one eye Eyehance and the second eye Vivity should work and give a good range for distant vision and near vision. The graph u have shown seems to be suggesting the same Your comments (Keeping aside the insurance issues)

[@onlyawareness4608]

I have the J&J Eyehance in one eye and was considering the Alcon Vivity in the other as against another Eyehance in the second eye, too. Nice video. My doc was suggesting a 0.5D myopia in the second lens. I learned that this may be needed for the Vivity too since the first lens has been focused for distance. The Eyehance is great ... sharp and crisp.

[@showers0416]

Did you get two different lenses? I like this idea

[@utube26able]

I suggest the same lens in both eyes. If you are happy with sharp and crisp vision in the first eye, why would you compromise that in the other eye? If anything aim maybe -0.5 in non dominant eye. Or just wear readers when needed. Quality quality quality

[@roger-1981-wimb]

@@utube26able i got an Eyehance in the other eye as well and am very happy. Almost a year ago! However, i feel there is some loss of sharpness over time.

[@Sipu79]

@@roger-1981-wimb do you have an idea why that is?

[@TitanyumDioksit]

alcon vivity edof lens de ise uv ve mavi ışık koruma var bunun için yorumunuz nedir daha iyi değil mi yani ? belki biraz kontrast kaybı olur ama göz sağlığına etkisi daha fazla olacaktır sanırım

[@cosmicpalm4404]

Gem of a video by Uday sir.

[@SuperEye2eye]

Great job. Nice summary!

[@scottwelker]

I wish I had found this video before I had my cataract surgery. My surgeon recommended and used the Vivity lens. I am now three months post surgery and my vision is still worse than when I began. I have had several follow-up visits with my doctor who sent me to a retina specialist (no issues found) and then recommended a neurologist-opthmologist (difficult to get an appointment). I am now scheduled to have "test" contact lenses in order to see if that corrects my blurry vision (near, mid and distance). If yes, she will perform a laser "tweak". I'm at my witts end.

[@utube26able]

If your refraction is off then the quality of vision from any lens will be off without glasses. If your problem is you aren’t plano then glasses or contact would help. If it’s contrast or quality of vision issues then consider exchanging the iols.

[@michaellahood6157]

Good video, as usual. Comment: The difference in usable optic area between J&J IOLs with the rounded anterior OptiEdge and Alcon IOLs which have squared off anterior and posterior edges is a moot issue, because many (most?) cataract surgeons prefer to overlap the IOL optic edge with the CCC, thus eliminating - as a usable refracting surface - the peripheral area in question. You advocate in your videos sizing the CCC so that it overlaps the IOL edge. So, your thoughts please re: the practical significance of the difference in “clear” area between the two brands/manufacturer’s IOL designs.

[@UdayDevgan]

I disagree. The capsule is clear, isn’t it? Even now, you are phakic and you are looking at the world through your anterior lens capsule, right?

[@thalesvilhenagiacchetta7644]

I agree with dr UD, and you can also polish anterior capsule, if you want.

[@AndrewHigdon-l5e]

I am a 73 year old man. My consuming passion is playing pool with a cue stick. The most important thing is the ability to visualize fractional angles on both the white cue ball and the point of contact angle on the object ball that you are aiming to shoot into the pocket. This means it is imperative to be able to see the crisp outline of the object ball in order to contact the ball in the right spot or angle. Also - it is very important to be able to have eye focus clarity and crispness up to a distance of 10 feet and also at arms length or about 3 feet. Of course this discipline or game does not involve reading at all. But it does require being able to see the extreme edge of the spherical round balls which are 2 and 1/4" in diameter. Sometimes the angle for cutting the ball into the pocket can involve feathering g the extreme edge of the object ball. I have taken pains to emphasize how important this exercise is to being expert at pocketing balls. So my question is whether or not I should opt for monofocal toric iol and cataract removal? Or should I opt for toric iol vivity with cataract removal. I am not so much concerned about halo or glare or dim light situations with losz of depth perception and contrast because I can control the environment where I choose to play pool by not going to pool venues which have poor lighting However - I am very concerned with how much depth of field, contrast and sharp crisp focus from 3 to 10 feet that I might lose with vivity toric iol as opposed to monofocal torc iol If this was your personal choice - which iol toric option would you choose? Thank you.

[@miketait1640]

Disappointed that you didn’t get any comments to your post. Do you have an update on your lens choice. I’m in UK and play lots of snooker on 12 foot table. I’m faced with the choice of Eyhance or Vivity and really can’t find any information which will help me decide. It looks to me like it’s a flip of a coin and cross your fingers that things work out ok. Best regards.

[@AndrewHigdon-l5e]

@miketait1640 I had the surgery. Chose vivity multifocal in toric version. Very satisfied. Can see edge of both cue ball and object ball with sharpness and crispness. Now able to execute very thin cut shots at 90° angle. Also able to execute feather shots or rub off object ball without moving g the object ball a quarter inch. Very helpful in defensive shots in game des ribed as one pocket where cue ball ru s off object ball and travels to the rail to trap opponent

[@miketait1640]

@@AndrewHigdon-l5e Thx for replying. Just the type of information I’ve been seeking. Good luck with your game. Mike.

[@davidlarson4422]

When are the fluid vision and juvene lenses coming to market?

[@Harjeet_Singh_M]

Dear @UdayDevgan, I tried to understand every word you said, it was great explanation video. Just want to know by what percentage the quality of distance vision in Vivity is compromised over monofocal lens. And is it worth compromising distance vision.

[@letranger5]

"J&J Eyhance compared to the Alcon Vivity IOL"? Forget both, and choose J&J SYNERGY, as I did on March 22, 2023. Magical!

[@JK-rv9tp]

is it fair to say that getting a monofocal for distance, and say bifocal readers for mid/close, provides the best possible image quality at all distances? This is a strong argument for monofocal.

[@allison447]

how about eyhance +.25 and then the vivity at -.5. Excellent far depth and good inter, with some reading w/o contacts. Then the prescription could "piggyback" the near for excellent far and near and good inter. Would probably be good to discuss the glittering that an Alcon lens is guaranteed to get later on, which could inhibit night vision a great deal in many patients. The HEMA lens seems superior over time, so J&J seems to be the lens of choice, although I haven't researched the LAL, which would probably be an excellent to pair in the non-dom eye.

[@badbadley]

Your description of "mini" mono vision using the Eyhance lenses is brilliant. Taylor Gibson (below) reported having one eye done at Plano and the other set to minus one D. But he/she was presbyopic, apparently whereas I am severely myopic. I can see perfectly at about 2 inches (optimized for fly tieing). My eyes are currently corrected to 20/25 and 20/30, so I'm thinking mini mono vision won't be a big difference at distance (perhaps yielding 20/20 and 20/25?) but I want to keep them as close together as possible. My goal? Ideally I'd like to be able to read the car speedometer and read screen on my iPhone Pro Max it it rings while I'm in Safeway without glasses. Looking at your chart, I'm tempted to ask for either -1d in my second eye or even -.75. But could I get enough clarity at -.75 to read my phone at 16" that way or do I need to stick with -1 or -1.25? I have always had to use glasses to read a book or magazine and plan to continue that. It is easy to keep the glasses by my bedside for reading, but I probably won't have them on me at Safeway. Thanks for being there for us!

[@prashantsharma9858]

So, what was the outcome ? Monofocal (technis 1) or eyehnace or vivity then ? (For patient aged 65) I didn't get it straight , please

[@rhett7716]

Hi what did u do?

[@badbadley]

​@@rhett7716 I went with Eyhance lenses, which for some reason (maybe Medicare?) did not cost extra, but did require an additional "AURA" refraction measurement to be done ($300 total per eye) during surgery after the old lens came out. But before he selected the final lens to implant. I asked my surgeon to do the non-dominant eye mini-monovision at minus .75. He reluctantly agreed after I showed him a screen shot of the mini-imonovision chart Dr. Devgan used in his video. He said he couldn't be that precise, so I would end up with one eye somewhere between minus .50 and 1.00. He didn't want to go beyond 1.00. I'm now three weeks post surgery and my vision is still changing (getting better nearer) but I have around 20/25 distance vision with both eyes and can see not only the speedometer in the car, but I also see clearly the buttons and switches on the steering wheel! My wife, who got regular single vision lens implanted, cannot read even the speedometer without glasses. I can also read my iPhone if I hold it out to about where my watchband sits. And can send texts and emails without glasses. I can't really tell any difference between the Plano eye and the minimonovision eye if I alternate between them. Distance and near vision seem the same. But I get terrific vision at both near and far distance with BOTH eyes open (again, from my watchband distance and beyond). I bought a set of 1.75 Walmart glasses to be able to see what I'm eating, and I'm using a 2.25 pair as readers. Only problem for me, a 78-year-old who had been myopic since seventh grade, is that I really miss the near vision I used to have about 2" to 3" in front of my face. Next week I get my new prescription for glasses, and plan to order a near vision pair for reading (I read two hours a day) and a separate pair for my computer distance. You can get $10 grams and $50 plastic lenses at Walmart. But I'll also get one pair of progressive glasses to wear around the house. Bottom line is between the "slightly extended" vision I got with Eyhance lens and putting the low-end (somewhere around .75) minimonovision Eyhance in one eye, I'm good to drive, go to Walmart, check my iPhone and even send replies on it. But in a restaurant or around home I'll still need glasses to be comfortable. Especially for reading. But you aren't going to believe the colors! The day after surgery I stood in the mustard/ketchup aisle at Safeway and marveled at the colors! And I had to wear sunglasses at home for a week after surgery because the light was so bright!

[@badbadley]

@@prashantsharma9858 I went with Eyhance lenses, which for some reason (maybe Medicare?) did not cost extra, but did require an additional "AURA" refraction measurement to be done ($300 total per eye) during surgery after the old lens came out. But before he selected the final lens to implant. I asked my surgeon to do the non-dominant eye mini-monovision at minus .75. He reluctantly agreed after I showed him a screen shot of the mini-imonovision chart Dr. Devgan used in his video. He said he couldn't be that precise, so I would end up with one eye somewhere between minus .50 and 1.00. He didn't want to go beyond 1.00. I'm now three weeks post surgery and my vision is still changing (getting better nearer) but I have around 20/25 distance vision with both eyes and can see not only the speedometer in the car, but I also see clearly the buttons and switches on the steering wheel! My wife, who got regular single vision lens implanted, cannot read even the speedometer without glasses. I can also read my iPhone if I hold it out to about where my watchband sits. And can send texts and emails without glasses. I can't really tell any difference between the Plano eye and the minimonovision eye if I alternate between them. Distance and near vision seem the same. But I get terrific vision at both near and far distance with BOTH eyes open (again, from my watchband distance and beyond). I bought a set of 1.75 Walmart glasses to be able to see what I'm eating, and I'm using a 2.25 pair as readers. Only problem for me, a 78-year-old who had been myopic since seventh grade, is that I really miss the near vision I used to have about 2" to 3" in front of my face. Next week I get my new prescription for glasses, and plan to order a near vision pair for reading (I read two hours a day) and a separate pair for my computer distance. You can get $10 grams and $50 plastic lenses at Walmart. But I'll also get one pair of progressive glasses to wear around the house. Bottom line is between the "slightly extended" vision I got with Eyhance lens and putting the low-end (somewhere around .75) minimonovision Eyhance in one eye, I'm good to drive, go to Walmart, check my iPhone and even send replies on it. But in a restaurant or around home I'll still need glasses to be comfortable. Especially for reading. But you aren't going to believe the colors! The day after surgery I stood in the mustard/ketchup aisle at Safeway and marveled at the colors! And I had to wear sunglasses at home for a week after surgery because the light was so bright!

[@fp6889]

I'm making a decision between the Vivity and the Synergy any chance you'll have a comparison similar to this on these two? BTW your videos and docs are fantastic and are responsible for 80% of my education on IOLs. So thanks!

[@prashantsharma9858]

So, what was the outcome ? Monofocal (technis 1) or eyehnace or vivity then ? (For patient aged 65) I didn't get it straight , please

[@DCTORARD]

Great Lecture and amazing explanation skills. Thanks Dr , I really enjoyed it.

[@dgpretzel]

After viewing the video above a few more times, and doing some more information gathering on the internet, I think I would rephrase my question below along the lines of asking for a video similar to this, but comparing the RayONE EMV lens to the Vivity lens. Perhaps, the RayONe EMV would permit something similar to the "micro-monovision" that the Vivity makes possible. (?)

[@sureshhanumanthaiah6154]

We are using Rayone EMV iol and results are very encouraging.

[@ValeriiRaiu-s7c]

Dear Dr. Devgan, could you compare the LuxSmrt G&G and Rayner BVI with the other premium EDoF IOLs. Thanks in advance!

[@torinwalker]

I'd ask my local surgeons, but sorry to say, they're too busy selling new services to have time enough to explain these things in the level of detail I need (the level of detail you offer), hence my question to you. If you don't mind; these questions are about distance resolution between the two lenses. You say a reduction in contrast at distance (particularly at night), buw what is the compromise at distance between the Eyhance and Vivity lenses expressed in terms that make sense to the layman?For example, being able to resolve lines (e.g. read characters at distance not unlike an eyechart) I have implants scheduled for later this month and still haven't decided on which lens (and which clinic) to attend. I have 20/20 (r) and 20/21 (l) with uncorrected astigmatism and though I can resolve the letters, it's more shape recognition than reading because at that distance the characters are still a little blurry. You say any lens is better than cataracts, so can I expect an increase in image quality no matter which lens I choose? Interpreting your graphi: If some of the light at distance is shunted to nearer focal planes (compared to monofocal lenses), does this cause the eye to open the pupil and therefore decrease the depth of field? (in this case, does a higher point on the graph corerspond to a smaller pupil (aperture) and therefore a greater depth of field? Does this mean also that the Alcon lens lets in even less light at distance resulting in less depth of field? You described the two lenses and the distance of focus up close while reading a cell phone (67cm vs ~50cm), but what is the difference at distance between these two lenses? I can always wear glasses up close, but at distance, I want the razor-sharp vision. This makes me lean toward the Eyhance, but others have said "20/20" with the Vivity.

[@motta4100]

Hi Doctor! Fantastic video! I am 40 Years old and have an Eyhance in the left eye. I see halos when it is very dark at night, and maybe it is due to the "dead zone" that You mentioned (5mm real diameter). I am going to Vivity in the right eye, Waht do You think about this combination (one eye with Eyhance and the other with Vivity)?

[@qratedfilms]

Dr Devgan, what are your thoughts on the new LALs? They seem to also achieve some depth of focus. My opthamologist said there's no compromise on visual quality for the range which I just cannot seem to understand given the physics of how many photons enters the eye staying constant as you pointed out. I am trying to figure out if it is just a marketing push since they would be >$5K per eye!

[@goosygoose5462]

Thank you for such for so much detailed info

[@AS-tt8ui]

I chose monofocal lens. Sharpest distance and highest contrast and super night vision. Wearing readers for just small print is no big deal. You give up more than think with multifocal lens. You can't go wrong with monofocal lens.

[@CC-uh8gl]

But doesn’t it depend on how bad your eyesight is to begin with? If you have presbyopia before surgery?

[@uwejanssen7555]

I will be getting the Tecnis Eyhance in both eyes soon. I have asked for monovision. My doctor suggested to aim at -0.48D for my dominant eye, -0.63D for the non-dominant one. I am a little concerned how it will affect my far vision. Thoughts anybody?

[@briansun6336]

That’s around -0.5D of nearsightedness, it’s fine. You might still see 20/20 or 20/25 binocularly.

[@uwejanssen7555]

@@briansun6336Thank you.👍

[@johndileo7202]

Thank you for the great video. My question regards dry macular degeneration and IOLs. My Mac Degen is worse in my left eye, but present in both. I am R eye dominant and my retirement gig-retired anesthesiologist- is as a photographer. My brain handles my vision well as things now stand. I really don't notice anything from the Mac degen unless I close my dominant eye and do an amsler grid or the like. My question is, after IOL (planned Eyhance) how much of a risk will I have, because of better vision, noticing the Mac Degen more? Is that a risk and is it a reasonable concern? Thanks again and looking forward to your response.

[@carmelotreviso]

Can you talk about LAL by RxSight. I'm halfway through one eye and I'm on the fence for the second eye. I've had two UV treatments but still have double vision up close and distance now after 2nd UV treatment. I'm a bit concerned after 2nd treatment.

[@anassyria5176]

Good luck! How do you feel the results are now?

[@carmelotreviso]

@@anassyria5176 completed second eye. August was right eye and October left eye and still healing. Just had one month followup after left eye. Was told that left eye might need YAG procedure but will hold off and see how things are once my next followup is done in three months.

[@anassyria5176]

@@carmelotreviso Thanks for sharing! Wish you the best results when these followups are done! 🙏

[@carmelotreviso]

@@anassyria5176 Thank you!

[@phadnis94583]

Thank you for a very informative video. Is the Vivity lens available without the blue light filter? I am considering a Eyhans and Vivity combination and my ophthalmologist said that the Vivity only comes in the yellow tint while the Eyhance is clear which would lead to a mismatch.

[@MariaP574]

Regarding the "deadzone" - is this also the case for the new PureSee from J&J? Does it only have a 5 mm zone where it actually focuses light?

[@Janhoy723]

I don’t think I was a good candidate for the Vivity multifocal lens that I got in my left eye in 2021. I ended up with a floater shorty after. My night vision got worse I see starburst and halos and can’t drive on the freeway anymore. I’m now afraid to have cataract surgery in my right eye. Wish you were my Ophthalmologist. Thank you.🙏🏽

[@UdayDevgan]

Come to Los Angeles and I can help you. Call us DevganEye.com

[@uwejanssen7555]

@bojankozomara9559 I will be getting the Tecnis Eyhance in both eyes soon. I have asked for monovision. My doctor suggested to aim at -0.48D for my dominant eye, -0.63D for the non-dominant one. I am a little concerned how it will affect my far vision. What do you think please?

[@domwash]

Thank you Uday. Do you have access to the Rayner RayOne EMV IOL? It's relatively new where I am practicing and am starting to use it. Very interesting lens and promising for depth of focus. I'd like to see a video comparing this Rayner lens to the Alcon Vivity.

[@jakerogan2472]

If you're Interested in either of these lenses...do yourself a favour and look into the RayOne EMV from Rayner. With mini-monovision it will offer the best of both for Binocular uncorrected vision.

[@acidophulus]

did you use Rayner. To get best and get smallest print vison?? don't you have you have to do about atleast 1.50 bet eyes. If do -.50 or so how much more vision do you get. I never had mono vision contact lens so no way of trying out . -1 more or less gets you maybe 18? inches to see near??? I would want under -1 difference. What experience did you have and what did they set eyes at?? Thanks

[@vanithabagade3746]

Namaste Dr. Uday Devgan I am 43 years old and Lasik was performed on both eyes in 2001 May and got 20/20 vision... Last year 2021 July Clareon monofocal lens was implanted in my right eye...can you please suggest if I can go for Technis Eye Hance lens in left eye (considering Lasik in 2001) or Clareon monofocal as implanted in right eye... please do advise doctoz eagerly waiting for your reply

[@KidsEduTainment76]

Can we have the same comparison, after including Alcon clarion, is alcon clarion equivalent to J&J Eyhance or Alcon SN60WF

[@drj6418]

I understand that some colleagues are now using the Tecnis Eyhance as their go-to monofocal. Do you agree with this or is your go-to monofocal IOL ZCBOO or some other for "routine" cases? Thank you.

[@UdayDevgan]

I use the full spectrum of IOLs. The Eyhance is a good lens but it fails to provide sufficient intermediate or near vision. For patients who want the absolute best distance vision, the J&J Tecnis ZCB00, the Alcon Clareon CNA0T0, or the B&L EnVista are likely better options. Plus, in my humble opinion, J&J has done a poor job of pricing the IOL: more than double the price for such a small incremental change.

[@sunilmoonasar117]

Can you compare Alcon Vivity vs BVI/Physiol Isopure

[@toddlichtenwalter2012]

If I were to get the Vivity, for driving, I could make up the lost distance with glasses or contacts, correct? I am considering getting Toric Vivity with mini-monofocal, anyone have experiences with this, if so, please share.

[@juliehoskins9255]

I have been recommended ICB00 lens implants to correct my sight. Please can you tell me if there is any chance that my sight will deteriorate after the implants have been done? Will I still be affected by age degeneration? Would there be any fuzzy/non focussed areas or should the sight be perfect? Many thanks

[@alexandertheiler2501]

Hallo and thanks for this wonderfull video! Which lens do you prefer in my case: I’m 50 and don't have a cataract but astigmatism and i only see 40% in one eye and 100-120% in the other. I have + 6,5 dpt. I am looking for the best possible quality of vision from the distance to the computer distance of 60cm (100% if possible). I can wear glasses underneath. I thought of Eyhance, symphony, Vivity or Luxsmart. Thank you and best regards. Alex

[@prashantsharma9858]

So, what was the outcome ? Monofocal (technis 1) or eyehnace or vivity then ? (For patient aged 65)

[@maxsmith6251]

like your videos i am thinking of premium lens implant vivity or panoptixs i live in oklahoma not sure who good doctors any ideals

[@dgpretzel]

Thank you for you comparison. Would you consider doing a video comparing the Eyhance with the RayOne EMV lenses, please? Then, the follow up would be the "winner" of that comparison compared to Vivity. I'm wondering about lens options that avoid diffraction issues (night vision), while doing as much as currently possible for distant and intermediate vision, while also minimizing reduction in contrast. (That is, looking for having as much of my cake as possible, while eating it too! It may be that monofocals [e.g. Eyhance or RayONE] coupled with glasses, might "beat out" a pure presbyopic-solving lens [e.g., Vivity, or even Synergy]). I like what I have seen about Synergy, but... diffraction. I also recognize that I can't decide anything without consulting an actual surgeon, and am in the process of arranging that. But, I would like to accumulate some background info. Also, where I live (Alaska) cataract surgeries are backed up for many months. So I have time to research. Thank you for any comments. BTW, has COVID caused your cataract surgery schedule to get backed up?

[@teresitaang2759]

Doc im a pt. Im a follower. Bausch and Lomb lens was put on me and I have left eye near and right eye far(mono) My vision is blurry when I look around and feels dry so I have to put eye drops.I was told I will have laser on my left eye.What can u advice .Thanks

[@patrickmouton2179]

Dr. Devgan, I'm going to have my right eye (panoptix) lens exchanged for Vivity or Eyhance. I have trouble focus/blurred vision far and intermediate. So I will have a panoptix in my left eye and Vivity or Eyhance in my dominate right eye. Which one should I exchange it for Vivity or Eyhance. I don't know witch one to pick.

[@rachanait3889]

عندي panopthix ولا ارى بوضوح الان عن قرب صار لي اربعين يوم

[@mnayak9348]

Can I get standard distance glass in one eye and vivity in other eye. I have family history of AMD so should I go for just monofocal standard distance lense and forget about enhance or vivity. I don’t have AMD but have history and age 78

[@janinedierks8711]

I just wanted to check all of you examples are talking about monofocals or are the Vivity and Enhance multifocal? I am looking for multifocal and have read there is a reduced risk of Halos and star bursts with the vivity and so I am not sure if there is an equivalent in the J&J range? I already wear multifocal contacts i.e. I don't have cataract, but am keen not to have issues when driving at night. Any insight you can provide will be gratefully received!!

[@tameemahmed7076]

What about PhysIOL ISOPURE lens which is enhanced monofocal IOL comes with ISOFOCAL technology and same category of Vivity and Eyehance ?!

[@chemlabgal7564]

Could you comment on the contrast sensitivity of the Vivity lenses compared to Synergy?

[@Y4XKB]

I also would like to know more about contrast sensitivity regarding the Vivity and Eyhance. I have read that night driving is more challenging with the Vivity IOL.

[@mostafahanout]

This video is brilliant 👏

[@NicoTineman]

Isn't it true that the amount of light entering an eye with a cloudy, opaque cataract is only a fraction of the light - so replacing the cataract with a crystal clear IOL is a huge gain of light. So, when the light is split by multifocal lenses, the patient is not likely to have a problem with the amount of light entering their eye. It is ironic that they sell eye drops to improve vision.. by constricting the pupil to be smaller - like pinhole glasses - which give clearer vision at the cost of blocking out a lot of light. Also.. wouldn't it be a good idea to wear blu-blocker sunglasses and/or UV blocking sunglasses so that the pupils dilate and do not constrict? In that way... the patient would get more of the GOOD light by having their pupils allowing the good light in, without constricting as a response to the unwanted frequencies of light?

[@myobmyob2215]

Unsure why but wearing very yellow tinted sunglasses is the only thing that helps with cat symptoms

[@4ndrew4w44]

How are these both compare to SAV-IOL Lucidis that come with 3 diopter depth?

[@DeannaAllison]

Wery well explained, thank you.

[@user-pu6sg7ih8r]

I am having to have my first cataract Surgery at 44 and I cannot for the life of me decide between Vivity or PanOptix for my right eye?! I've never needed glasses before, and nighttime vision is important to me. Two of the most frustrating of the symptoms of cataract has been glare around windows, and halos/starbursts at night. However, cell phone and computer use is very important to me. Which would you ultimately recommend as a result? Ty in advance!

[@aarr2603]

Did you get your surgery done I’m 41 and have a cataract on my left eye never needed glasses it’s been so hard trying to decide I’m on the fence between a Toric mono or the vivity. what did you end up getting and how is your vision now?

[@mostafaelsherbeny152]

Please, I have cataracts in both eyes The question now, are Eyhanse lenses?better than acrysof Alcon or not Quality "good look "materials

[@My_Life21]

I have too

[@santiagoblandon3022]

How about the Juvene lens?

[@fjdkfdfjdf33]

Can you direct me to the fountain of youth?

[@yassertamer7416]

How long it takes for the eye to get used to the AcrySof IQ Vivity lenses. It was implanted in my eye since 4 days and still have blury cloudy vision

[@rachanait3889]

سلام وعليكم هل استطعت الان الرؤية لاني زرعت panopthix acryso f ومازال عندي ضبابية وحتى لا استطيع قراءة صار لي اربعين يوم

[@yassertamer7416]

@@rachanait3889 الحمد لله. استطيع الرؤية الآن بشكل افضل. المشاكل التي كانت عندي انه كانت هناك أجزاء باقية في محفظة العين من العدسة الأصلية واكتشفت بعد فترة وصلت الى ستة أسابيع واضطررت للخضوغ لعملية اخرى لتنظيف المحفظة. سبب هذا التهابا في القرنية وانتفاخا. تلقيت بعدها قطرات مختلفة لمدة شهرين ثم تعافت عيني تدريجيا. وأصبحت قادرا على الرؤية بها بشكل جيد. لكنها لم تصل للمستوى الذي توقعته والتي تروج له الإعلانات

[@rachanait3889]

@@yassertamer7416 نفس شي قال لي طبيب عن تنظيف العدسة لم التجا اليها بعد لان صار لي فقط ستة اسابيع اما بالنسبة لقراءة عن قرب لا استطيع بعد ضبابية ولكن حسب ماقرات ان متل هده عدسات تستطيع رؤيا بها عن قرب لدالك زرعتها الحمد لله على سلامتك رغم ان طبيب اكد ان الليزر لن يسبب المضاعفات ومن خلال كلامك كانت مضاعفات

[@yassertamer7416]

@@rachanait3889 تنظيف العدسة شيئ لا نحتاج اليه قبل عدة سنوات. خلي الدكتور يكشف اذا كانت المحفظة نظيفة من بقايا العدسة الطبيعية.

[@rachanait3889]

الطبيب هو اللدي اكد ان تحتاج الى تنظيف ودالك بعد اربعين يوم ولكن لن يعملها حتى تمر تلاتة اشهر بسبب ضبابية رؤيا ولا استطيع قراءة

[@darylmorse]

What happened to so-called accommodating IOLs?

[@anassyria5176]

There are the Crystalens, Trulign Toric and the new upcoming technology (wish it would come soon) TrueVision liquid lens. In principle the accommodating lenses are way superior and closer to to the natural eye mechanism

[@Pkilla80]

amazing info. thank you

[@Coffeeismyhappyplace]

What do u think of the acry sof.

[@UdayDevgan]

AcrySof is the family of IOLs from Alcon that includes SN60WF, Vivity, and PanOptix.

[@mohdhaseeb89-l1j]

@@UdayDevganis acrysof IQ good? and cost of surgery with this lens in india?

[@lorihimes1786]

Excellent!

[@dranil18]

Its better to be YOUNG 🙏🏼

[@martywilliard]

HAA HAA. Funny!

[@ravikumarts8845]

My right eye cataract operated and fitted with Eyhance Johnson & Johnson IOL. For my left eye can I opt for Alcon Vivity IOL. Can any one clarify my doubt.

[@4ndrew4w44]

Yes, you can.

[@katkat1194]

I'm doing the same. Had left eye (non dominant) Vivity and will have Eyhance in the right in 2 weeks! looking forward to see if I can be spec free :)

[@ravikumarts8845]

@@katkat1194 No Sir. Eyhance lens is a monofocal lens and you may need glasses while reading. I am fitted with Eyhance IOL in both eyes still I need glasses for reading purpose.

[@acidophulus]

@@ravikumarts8845 what distance can you see Without glasses. Did you do mini monovision. Can you see GOOD intermediate and see computer at about 24-26 inches clear? Thanks

[@ravikumarts8845]

@@acidophulus only for reading I need glass. For intermediate and distance I don't need glasses.

[@hepaticapropria]

👏🏼👏🏼👏🏼👏🏼 this is great information also for young ophthalmologists 😂

[@heelerjustheeler879]

Would one get the overall best *quality* of vision, then, with monofocal lenses plus glasses (for intermediate and near distance)? If you are an artist who is concerned about having the best quality of vision (versus best range of vision) and you are OK with wearing glasses to achieve that, is a monofocal lens + glasses the best option?

[@mark9118]

I would like to know the same thing. I believe that a monofocal lens plus glasses is the best for me also, but would like to hear what the Dr says. My current Rx is +5.0 -1.50@90 +2.50 which is strong hyperopia. Like you, I don't mind wearing glasses after the cataract surgery since I am skeptical that any IOL could give me optimal vision without glasses at all distances with my Rx, and I have worn glasses since I was about 5 years old. I tam thinking that the J&J TECNIS Toric II IOL would be best for me since it has a much higher abbe value (freedom from chromatic aberration) than AcrySof lenses from Alcon, although I heard that Alcon has a new IOL material called Clareon just made available in the USA.

[@1taylorgibson]

Nobody answers this. I happen to know many opthalmologists. They all choose monofocal lenses for their own eyes. And wear glass3s for near vision.

[@My_Life21]

​@@1taylorgibsontrue

[@Microvisc]

Vivity is not preload, is made out of the old Acrysof material with super high glistening! Also the element in the center do halo. And the price for EDOF is super high 👎🏼

[@giano6343]

Yes, but clareon version will fix glistening. Also there is xact mono edof and Rayner emw

[@ukna-gi1dk]

Eyhance is best

[@gary24752]

All find and good except when the doctor does not want to take the time to explain it.

[@CATownsend777]

Ok, make me young again. 🤪

[@timmccarthy5782]

So great.

[@JTDIYM]

What am I watching

[@nobilismaximus]

An accommodating implant would give you young vision. And they are working on that now.

[@joanchepon6793]

This was so confusing 😕!!

[@thomasrzepka2590]

I am waiting for the rapture (1Thes4:16-17).