Which IOL is best for you? | Explained | Dr Dylan Joseph

[@-myal-8691]

The music playing in the background while you are talking is very distracting and annoying. It makes it more difficult to focus on your words. Otherwise, your video was on point and helpful.

[@gigistax]

Thanks Dr Joseph, this video is extremely helpful 🙂

[@MegaCoolFaisal]

Annoying Music

[@mukulsharma5877]

Thank you Dr Joseph I am 68 years old my right eye operated with TriFocal lens now can I be operated my Left eye with Vivity EDOF lens please reply soon Thank you

[@যমদূত]

Hi doc,
I have cataract, glaucoma and until recently uveitis. Because of uveitis the cataract surgery was delayed for quite a while, while uveitis was treated with steroid tablets (prednisolone) and drops initially and then steroid drops for quite a long time. My doctor opined against any surgery before uveitis is controlled. Now uveitis is almost gone / quiet I'm told and that I should proceed with the surgery asap!
My current eye diagnosis is as follows:
1. S/P LPI (both eyes) -- [Status Post Laser Peripheral Iridotomy??],
2. 360 PS (right eye), -- [360-degree Peripheral Synechiae??]
3. Complicated Cataract (both eyes),
4. PACG (both eyes) . -- [Primary Angle-Closure Glaucoma??]
5. Arthritis
6. H/O CKD.
..........................
The "complaint" section says: Visual Acuity: Aided. Right Eye: 6/18 p +2.50. Left Eye: 6/9 Plano Add +2.50.
Anterior chamber: OD Quiet. OS: Quiet.
IOP: OD: 18 mm Hg (NCT). OS: 20 mm Hg (NCT).
Iris: OD: 350PS.
Lens: OD: lental opacity. OS: Early lental opacity.
Fundus: OD: Looks normal. OS: Looks normal.
---------------------------
"Surgery Order" says: "1. Phaco with PCIOL (right eye) local anesthesia with Synachiolysis+ iris hook under oral steroid coverage".
---------------------------
I was hoping to use "Clareon Vivity IOL" (EDOF) because I work with _computers and near and intermediate vision related work mostly,_ but my doctor says premium/multifocal IOLs are not advisable in my case since (to the best of my understanding of what he said!) if "Synachiolysis+ iris hook" unravels sometime after the surgery or in future, multifocal IOL will become totally useless, even detrimental. Which is a very undesirable situation. He recommends standard monofocal.
*MY QUESTIONS ARE:*
1. Is Alcon "Clareon Vivity IOL" a "multifocal" IOL really? My understanding was that it's something different due to new technologies although it covers some of the multifocussing benefits of a "multifocal" lens. Vivity/Clareon is VERY new in my country and I suspect my doctor may not be familiar with it and thinks it is "multifocal". I checked last year and it was not available in my country at that time, but it's now available (probably except Clareon though).
*_So my questions are again:_*
*1.* Is Alcon "Clareon Vivity IOL" a "multifocal" IOL ? Is it appropriate in my condition in your opinion, especially in case of ""Synachiolysis+ iris hook"? If you think it's okay, then what can I say to my doctor to explain / query this?
*2.* What would you recommend as safe & most suitable in my case from the following (available from my Eye hosp): Monofocal Aspheric (Zeiss/Alcon/J&J/Hoya) / Monofocal Plus (Alcon/J&J/BVI/RAYNER). Also: Alcon Vivity (it looks like Clareon Vivity may still not be available here, it's probablly mostly Vivity AcrySof IQ/Restor/SP/Toric/Sert).
*3.* What's your view on a Monofocal Plus or Enhanced in my condition if Clareon Vivity is not suitable or available?
Please help!

[@musicastro9743]

Dr I have my cataract surgery last year in my both eyes I am not happy at all I need glass for reading before I don’t need to reading glass now I can’t read without glass it’s so annoying now I am a reader so how can I solve my problem Is it possible to change implanted lenses please let me know & if possible which lenses will be good for me far & near site cause I don’t like glass at all specially for reading.

[@mortalstorm]

Thank you for your excellent presentation. I am one of those who spends most their time indoors and typically focus on objects of distances of approximately 2m or less. Since I wear my near vision glasses most of the time, do you think that I would be better served by opting to chose a monofocal iol to correct for near vision? I currently use my distance glasses only for outdoor activities which is much less than indoors. A required characteristics of the iol would have to have low positive dysphotopsias as I now experience extreme light disturbances which prevent me from driving at night. Is what I am requesting even possible, or should I just accept whatever my surgeon suggests? Unfortunately I have read about (and personally encountered) patients with dissatisfaction with their post cataract surgical outcomes. Thank you for any advice you can offer.

[@dylanjoseph3830]

Hi there. What I would suggest you do is a Vivior trial-please see one of my videos discussing Vivior. It is a visual behaviour monitor that determines your visual lifestyle and then tailors a lens for you to best suit your visual needs. Once this is done we get a better understanding of what ranges are what lighting conditions are important. We can then discuss the pros and cons of the different IOL's.

[@yallascholarship7441]

Dear doctor
If i am a medical student and I had cataract in only one eye. Is trifocal is the best for me ? Especially alcon vivity? And for my future work, will this implanted lense in my left eye affects my whole vision?

[@haqsach4147]

What is your age?

[@hectorrivera4347]

I get premiun Alcon vivity IQ Toric UV 1 year ego , OrlandoFlorida after insurance I paid about 5,300 out of my pocket My vision are day time night distance closed computer reading perfect not halo on night but my complait is my eye are sensitive to the heavy sun light or computer high light , I used the sun glasses Maui Jim grey color or blue ,the lazer make that also my eye are dry so I used out of the counter drop like thera extra dry or systene complete pm but I like more thera because help with it itche , this vivity lens are amazing, I not used not more glasses

[@peterdaniel66]

Hi Dr. what do you think about mini mono vision lenses

[@user-lw8cg8uv9f]

Thanks a lot for this video and your videos about LBV (laser blended vision). I'm thinking about getting LBV - if I'm not happy with the results, will it be possible to get an IOL with trifocal lenses later in life? If this is possible, would I have to "reset" the LBV?

[@parton_me789]

The music is very distracting while I'm trying to listen to you.

[@pauls3423]

You discuss "blended vision" with an EDOF IOL. Can you get "blended vision" or monovision for a myopia cataract patient with a basic monofocal IOL?

[@Frenchy_The_Isle]

Thank you Paul for your comment. Dr Joseph will answer to your question soon.

[@dylanjoseph3830]

Hi Paul. You cannot get true blended vision with a standard monofocal as you will miss the intermediate range(desktop) vision.

[@evaobermeier3554]

Kind would Like to ASK you, im 47 years old have cateract will need soon sugery , have -2 -0,25 right, -2 -1,25 left, use my handy at 35cm, laptop 55 cm, computer 65 cm.
Im active with my dog, bike also to Work morning night Anne in free time also Drive Car, v das night, hiking,
Would like to have good near,+intermediar seeing, working at Computer, want to have good normal contast, nice colours and want no or little halos at night.
Whats the best choose for me ?
Zeiss Lara, or Acunex vario, or vivity, or visiotis ?
Thank you very much

[@davidlarson4422]

When are juvene and liquid vision coming for use?

[@Frenchy_The_Isle]

That's an interesting question... ;)

[@dylanjoseph3830]

Hi David. I cannot answer that-it certainly is not available at present.

[@amogh2k]

Glistening alcon?

[@amogh2k]

any reply

[@davidfwilliams1960]

depends on material if acrysof or clareon. I have acrysof and a year later don't notice a problem but most certainly the lens is affected. (Vivity Toric in both eyes)

[@ramjet4025]

What you call a primitive presentation. Most of these lens mentioned are not permitted for pilots.

[@remycallie]

I don't know where you practice Dr. Joseph, but you should know that Americans have no idea what a rugby ball looks like. A quick google reveals that it's basically a football, but if you said football, then the rest of the world would think it was something round. Maybe you could find some fruit of something to compare it to?. :)

[@mypluto1234]

Hmmm is rugby ball round?🤔.... or the ball is the shape of an olive. (Size 5 - Length 285mm, Girth 585mm)😅

[@dylanjoseph3830]

Hi Nancy. How about Yoda's eye from Star Trek? That is pretty Universal...

[@remycallie]

@@dylanjoseph3830LOL I think you mean Star Wars. Probably better just to refer to it as a prolated spheroid. :) (Or somewhat more practically, "rugby ball or American football.")

[@Stevethesearcher]

This guy is not with the program. The next generation is coming fast. Already in America they are inplanting the IC-8 lens but even better lenses are coming such as LensGen. I would hate to have this guy operating on me. He is one of those guys who says I can set your vision for near or set your vision for far. What do you want? The completely wrong approach!