During cataract surgery, the eye’s clouded natural lens is removed and replaced with an artificial one called an intraocular lens (IOL). In recent years, advancements in IOL technology have provided patients with options that can also correct refractive errors like presbyopia, the age-related loss of near focusing ability.
The Alcon AcrySof IQ Vivity lens is a new generation of IOL designed to provide an extended range of vision. It is an option for individuals undergoing cataract surgery who wish to decrease their dependence on glasses for many daily activities. This lens utilizes a novel technological approach to broaden the scope of clear vision, distinguishing it from other presbyopia-correcting lenses available.
How the Vivity Lens Works
The Vivity IOL is the first and only non-diffractive Extended Depth of Focus (EDOF) intraocular lens. Instead of splitting light into multiple distinct focal points like traditional multifocal lenses, the Vivity lens uses a proprietary technology called X-WAVE™ to create a continuous, stretched focal range. This approach allows for a seamless transition between different visual distances.
The X-WAVE™ technology incorporates two smooth surface transition elements on the front of the lens. The first is a slightly elevated plateau that stretches the wavefront of light entering the eye. A second, small change in the lens curvature then shifts this stretched wavefront. This combined action of stretching and shifting light extends the depth of focus without the light-splitting process inherent in diffractive multifocal IOLs.
Because the Vivity lens does not split light, it utilizes almost all of the light energy that passes through it, similar to a standard monofocal lens. This is a departure from multifocal lenses, which divide light to create separate focal points for near, intermediate, and distance vision. The non-diffractive design is intended to provide a broad range of vision while minimizing the potential for visual disturbances.
Vision After Vivity Lens Implantation
Following surgery with the Vivity lens, patients can typically expect excellent vision for tasks at a distance and arm’s length. Clinical data shows that distance vision is comparable to that achieved with a standard monofocal IOL, with patients achieving mean uncorrected distance visual acuity of 20/20.
The lens also provides strong intermediate vision, which is useful for a variety of common tasks. This includes activities like working on a computer, seeing the dashboard in a car, cooking, or reading price tags at the store. Studies have demonstrated that patients can achieve an average uncorrected intermediate visual acuity of better than 20/25. This performance at arm’s length significantly reduces the need for glasses for many daily routines.
Near vision with the Vivity lens is described as “functional.” This means it is often sufficient for short-term, casual near tasks like reading a text message on a phone or seeing a menu in a well-lit restaurant. However, for prolonged reading, fine print on medication bottles, or other detailed close-up work, most patients will find that they still require the assistance of reading glasses.
Potential Visual Disturbances and Limitations
A primary advantage of the Vivity lens’s non-diffractive design is its visual disturbance profile, which is comparable to that of a monofocal IOL. While all IOLs carry some risk of visual side effects, the Vivity lens is associated with a lower incidence of severe glare, halos, and starbursts compared to traditional multifocal lenses. In one study, over 90% of patients reported no halos, glare, or starbursts. However, a small percentage of individuals may still notice these effects, particularly when driving at night.
This trade-off is a direct result of the lens’s design, which prioritizes a high-quality, continuous range of vision with minimal disturbances over sharp focus at very close distances.
Ideal Candidates for the Vivity Lens
The ideal candidate for the Vivity lens is a patient undergoing cataract surgery who desires a broad range of vision and wants to reduce their dependence on glasses for most daily activities. They typically prioritize clear distance and intermediate vision for things like driving and computer use. A person who is particularly concerned about the potential for halos and glare often associated with multifocal lenses may find the Vivity lens to be a suitable option.
This lens can also be an appropriate choice for a wider range of patients, including some who may not be candidates for diffractive multifocal IOLs. Ophthalmologists have reported successful outcomes in patients with certain other eye conditions, such as glaucoma or mild macular degeneration. The lens is also available in a toric model to correct pre-existing astigmatism at the time of cataract surgery.
A thorough discussion with an ophthalmologist about lifestyle, visual priorities, and expectations is necessary to determine if the Vivity lens is the right choice.