The Alcon Vivity lens is used to improve range of vision via cataract surgery, although what is the catch? The monofocal lens is the most common lens implanted during cataract surgery and there is no risk of this changing in the near future. It does lack the ability to alter focus and for this reason there will always be a demand for emerging lens technology that can reduce dependence on glasses. A common description for a lens that offers multifocality is a “premium lens”. Admittingly this term is more common in the United States as the term “premium” reflects the higher cost of these lenses. Unlike our American counterparts the cost of the lens is covered by Australian insurance companies. We therefore have the luxury of avoiding terms like “premium”, as I feel this carries a negative connotation towards the standard monofocal lens.
Alcon is a company with a long history of lens production who are attempting to bridge the gap between the monofocal and multifocal lens. Many patients avoid a multifocal lens based on the risk of developing visual phenomenon such as glare and haloes around light sources. With this in mind, Alcon have developed the “Vivity” lens which has the aim of delivering a range of vision coupled with the low side effect profile of a monofocal lens. The biggest question is whether or not they have achieved this?
Before recommending a lens for a patient, I will always analyse the studies that led to this lens being approved for use in the general population. The American data through the FDA is often an excellent resource. In this study 220 patients either received a Vivity lens or a standard monofocal lens. This allowed a direct comparison between both options. The results included the following:
- The Acrysof IQ Vivity lens achieved a better range of vision over distance, intermediate and near compared to the monofocal lens.
The data suggests that most patients will achieve distance and intermediate vision without glasses and likely require reading glasses for near.
- Contrast sensitivity, an important measure of visual function, is the ability to distinguish objects from their background, especially in dim lighting. In the Vivity clinical study, contrast sensitivity in dim lighting was reduced in patients who received the AcrySof IQ Vivity IOL compared to those who received the Monofocal IOL. The loss of contrast is likely a trade off in an effort to improve the range of vision.
- The rate of visual disturbances was similar among both groups. This is an extremely positive outcome as many lenses which improve a patients range of vision often are accompanied by a higher rate of these visual disturbances.
Positives:
- A patient implanted with a Vivity lens will likely benefit from an increased range of vision.
- There is a low risk of visual phenomenon with this lens design.
Negatives:
- A patient wanting to be completely glasses free is not a candidate for this lens. It does not seem to achieve adequate near vision without glasses.
- The reduced contrast may be an issue for some patients particularly anyone suffering from glaucoma.
Summary:
The Alcon Vivity lens does improve range of vision over the monofocal lens with minimal side effects. It does not replace a multifocal lens which achieves a superior level of glasses independence. It is a safer option for patients concerned about the visual phenomenon associated with multifocal lenses.
*I have no financial interest in this lens. Each patient should do their own research prior to choosing a lens implant and this should be discussed with their surgeon.
