Vivity vs eyhance TECNIS. PanOptix is the only FDA-approved trifocal IOL in the U. 4-line better distance vision than the Eyhance. hi steven, what issues did you have with vivity and why are you replacing with EMV and not eyhance? i am choosing between these 3. 06 ± 0. The I am a 67 year old woman and I am trying to decide between Eyhance or Tecnis monofocal. 1,3 I googled (without quotes) "defocus curve for Eyhance" and chose the hit that came up on ResearchGate. Methods Sixty eyes of 30 patients who underwent phacoemulsification with bilateral implantation of the ICB00 (15 patients) or ZCB00 (15 patients) IOLs were enrolled. RayOne EMV. 50 D). The TECNIS Eyhance™ IOL is a next-generation intraocular lens that represents a major innovation in the standard treatment of cataracts. I was close to getting a Vivity in my close eye but in the end between myself and the surgeon we decided This patient is a physician from the east coast of the USA (more than 3000 km from my clinic) who has traveled to see me for cataract surgery. Depending on your geographical location and insurance plan, part of the cost may be covered, especially if you are undergoing cataract surgery. These lenses give patients an increased range of vision A recently released study comparing the rotational stability of the two most widely used toric intraocular lenses—the AcrySof (Alcon) and the Tecnis (Johnson & Johnson Vision)—found that the AcrySof lens had significantly better rotational stability than the Tecnis. S. 17 Thus, although the Eyhance provides a more limited range of vision than other IOLs in this review, it provides additional intermediate vision and, with its contrast performance, appears suitable for all patients with Today, we have a wide range of intraocular lenses (IOLs) that cater to distance, intermediate, and near vision needs, wholly or partially. 11 The Vivity is available as a spherical and a toric version, with toric powers compensating for 1. The Mean (±SE) monocular, photopic CDVA for all eyes at 6 months was −0. I considered the Vivity lens for the second eye but have pretty much settled that I will keep it simple and use the standard monofocal for the monovision. Market: Review. 5 diopters more range than the monofocal IOL and the Vivity is 1. The monofocal had 0. At this point in my life, approaching 65, I would have nothing but "plane Janes" implanted, and it's possible that I'd even go with something close to my life-long nearsightedness (currently -5. Johnson & Johnson’s latest monofocal IOL acts like a monofocal-plus, said Dr. 5 to -0. Monofocal IOLs—including the Light Adjustable Lens and enhanced monofocals such as Eyhance and RayOne EMV—are designed to provide the highest quality vision at a single distance. 5 lines in Snellen equivalent); the lower 90% CI of the treatment difference was The enhanced monofocal TECNIS Eyhance IOL is a 1-piece refractive foldable posterior chamber IOL made of SENSAR material that has a higher-order aspheric anterior surface design, with a continuous According to Alcon, the best-corrected distance acuity in eyes which wore Clareon (0. 53 D defocus range IsoPure GF (PhysIOL) Refractive, monofocal, pupil-independent, +1. RayOne EMV versus TECNIS Eyhance. As we become older, that lens becomes cloudy. If patients are happy with the range of vision in their first eye, however, I usually implant the AcrySof IQ Vivity bilaterally. The next most popular option was the Tecnis Eyhance (16 percent). Among them, 62 ZEN00V and 57 The right eye was implanted with a monofocal IOL (Johnson & Johnson Tecnis Eyhance DIB00) while the left eye received an EDOF (extended depth of focus) IOL (Alcon Vivity Clareon CCWET0). Non-diffractive entirely though, rather than the slightly diffractive Symfony or the fully diffractive multifocals like Synergy or Alcon's trifocal Panoptix. DOF2023CT4025 The mean difference in DCIVA was 0. 2,4. Tecnis Eyhance IOL (ICB00) vs. Vivity does suffer from contrast sensitivity loss, and that can be minimized by putting it in only the close eye, with a monofocal in the other. The lenses feature technologies not seen in the United States until now: Vivity is the first non-diffractive EDOF lens, and Eyhance Between June 2021 and August 2022, a total of 120 subjects underwent implantation with ZEN00V (n = 62) or ICB00 (n = 58) IOL in at least one eye at six study sites. 5 percent of the surgeons (average number implanted per month: 9; average charge per lens: $3,083). Distance-corrected intermediate acuity was www. If you want to go with an extended focus then the Vivity will give you closer vision, but since your expectations are very modest the Eyhance may be the safer choice. AcrySof IQ PanOptix (Alcon) – The Leading Trifocal IOL. ” However, a European multicenter study reported that patients with bilateral Eyhance IOLs may experience improved intermediate vision compared to the ZCB00 monofocal IOL. Vivity is a non-diffractive lens offering extended range of vision with, according to the company and anecdotal reports from physicians who have implanted it, a low incidence of visual disturbances. In a clinical study of 310 patients (155 per group), Clareon ® and Eyhance^ IOLs offered comparable binocular range of vision 12** The Eyhance intraocular lens and the Eyhance Toric II intraocular lens are made by Johnson & Johnson and are used to replace the cataract during cataract surgery. 75 to -1. Key IOLs in the U. Vivity will give you only a slight EDOF of about . This means that the Eyhance is about 0. 專性厭水性壓克力。 可抗紫外線和有害藍光功能鏡片上有特殊專利標記可以準確地旋轉至精準的軸度，植入方式與無散光鏡片相同，是以注射器植入，但散光有軸度的方向，植入後需將鏡片旋轉至 The Tecnis 1 should give you good distance visual acuity along with maximum contrast sensitivity, while the Eyhance will give good close vision and intermediate vision. The Vivity lens is also available in a toric version to help decrease astigmatism (oval rather than Best eye Lens for Cataract operation. I have surgery booked for 21 August to replace the first of two Vivity lenses with the Rayner EMV. 3 log drop (1 line on the Pelli-Robson chart) compared to mono-focal was only with MONOCULAR (1 eye) testing. 01 logMAR) was identical to best-corrected distance acuity with Eyhance (0. The curves are so close that the difference is insignificant. Tilt and decentration decreased the performance of Eyhance significantly but had minor impact on the performance of Vivity and LuxSmart. 13. 02 logMAR). 30 D One such lens is the AcrySof IQ Vivity (Alcon). So the gain of closer vision and loss of distance acuity is slightly more with the Vivity, What are the pros and cons of j&j eyhance vs alcon vivity? E is a monofocal + , lens for everyone, colors are better than V, vision at night much better, cannot see good both distance and Dr. 0 D should work. . 001), as well as between AcrySof® IQ Vivity™ lenses and Tecnis® Eyhance™ lenses (P = 0. Then I re-labelled the X and Y axis in scales that are easier for me to understand: The Y axis is scaled in logMAR but I relabelled that in 20/20, 20/30, 20/40 terms using the chart in Wikipedia that converts logmar to that more Depending on the difference between the two eyes, people can experience problems with monovision, for example, headaches and loss of binocular vision. One of Eyhance's superiority claims is 30% better contrast sensitivity than the Tecnis monofocal, and I'm guessing it near zero SA is how they get that, and part of that guess is my inferring that the writer is referring to the SA of the total optical system 全新五合一人工水晶體 ★矯正 老花眼及 散光的多焦點非球面人工水晶體(廠牌 Alcon，PhysIOL，J & J ，VSY). 12 logMAR. 3 logarithm of the 2023年5月初，美国一项新的非干预性研究比较了爱尔康 (NYSE：ALC) 旗下Clareon单焦点人工晶体（IOL）和强生全视 (NYSE：JNJ) 的TECNIS Eyhance单焦点IOL在视力范围方面的表现，爱尔康vs强生！单焦点人工晶体，嘉峪检测网，检测资讯 Additionally, significant differences were noted in comparisons between Vivity lenses and PhysiOL® IsoPure 123™ lenses (P = 0. Eyhance ( J & J ) versus Vivity ( Alcon ). 00 D defocus range Tecnis Eyhance (Johnson & Johnson Vision) Refractive, monofocal, pupil-dependent, +1. That is a 15" Quote is from a 2021 Review of Opthalmology "Necomers" article comparing Vivity, Eyhance and Rayone EMV. 10 It has also been reported that bilateral implantation with other monofocal IOLs can provide some intermediate vision. surgical). Adler says Vivity “gives excellent range of vision for post And the reality is that the difference between the Clareon and Eyhance is marginal to the point of being insignificant. “I like the clarity of the lens, the ease of delivery and the fact that it gives some Following the Vivity was the PanOptix toric version, chosen by 30 percent of surgeons, who implant an average of 5. 3%, 96. 75-ish), rather than "correct" anything. 01 logMAR (Snellen 20/19) in the enhanced monofocal IOL group, compared with −0. Pricing for premium IOLs like AcrySof IQ Vivity and Tecnis Eyhance can vary widely, typically ranging from \$2,000 to \$3,500 per eye in many U. the Eyhance (e. -based practices. 6 D which converts to 25". This is the minimum amount required to call the lens an extended depth of focus or EDOF. AcrySof IQ Vivity (Alcon) Refractive, monofocal, pupil-independent, +1. The Eyhance extends the depth of focus by about 0. Comparison of new monofocal innovative and standard monofocal intraocular lens after phacoemulsification. Dr. My Vivity somehow gave me 20/20 far, middle, and close-up, and I don't need glasses. EyeOC. Richard Wieder, It gives dramatically more near than the Vivity, Eyhance, and RayOne EMV, so it gives patients that extra near that they want, and it doesn’t compromise distance. 03 logMAR of the Eyhance Group (p > 0. The difference is more when considering Vivity. 45 D of corneal cylinder. I have an Eyhance and also have worn monofocal contacts for years I'm (late 60s M) getting Vivity tomorrow in my (mostly) non-dominant L and nothing for now in my (sometimes still) dominant R. The Eyhance is not all that different from the Vivity. Tecnis Eyhance. click below for the full video about my opinion of the J&J Tecnis Eyhance IOL: Share this: Click to share on X (Opens in new window) X; Pennsylvania last week. The lens material is a hydrophobic Vivity. Between the other time points there was no significant difference in The Vivity lens has an additional, new, wavefront-shaping technology which allows a wider range of focused image than with a monofocal lens, helping decrease the need for glasses. 0 Multifocal Lenses: A The mean difference in DCIVA was 0. 5 D extra) over the Eyhance (0. 5D, this will basically give you 1 additional line on an eye chart for intermittent and close vision. 5 D. 05 with non-inferiority margin of 0. The Eyhance Toric II will be launching in Europe and Canada later this year. thanks. and remains one of the most popular premium IOL choices. A Vivity EDOF gives about a 0. The patient had a great recovery Yes, to put some numbers on the difference between Eyhance and Vivity lets assume that comparing apples to apples, Eyhance gets you down to -1. The increased depth of focus is seen clearly in the MTF and Defocus curves above. How to choose Best Lens for cataract surgery among Eyhance (J & J)and Vivity For someone that's having cataract surgery at See Clearly Vision, they'll have the opportunity to choose from two brand new, top-of-the-line premium IOLs: the Eyhance IOL and the Synergy IOL. The Eyhance IOL (intraocular lens implant) was approved as a monofocal intraocular lens by the Federal Drug Administration Both the AcrySof IQ Vivity and Tecnis Eyhance IOLs had excellent distant and intermediate visual acuity, while the former had more satisfactory near vision outcomes with greater spectacle independence rate. The Eyhance lens has been available in Europe since February 2019 and became available in Latin America and Canada in the summer of 2020. Purpose: To assess the depth of focus of four latest non-diffractive extended range of vision IOLs on the optical bench. He took a memo pad and wrote “Uday Devgan MD” and told me to look at your pages. 00 for but vivity makes the edof requirements but has a ring type center. Omid Kermani, Ärztlicher Leiter und Vorstand der Augenklinik am Neumarkt in Köln Was berichten Ihre Vivity-Patienten über ihr Sehvermögen im Alltag? O. That is a very significant difference of about 3x as much with the Vivity (1. 00 to 2. Like a multifocal iol, it provides a wide range of clear vision, but with smoother transition between ranges. That is why our ophthalmologists at Oracle Eye Physicians & Surgeons in Tucson, AZ, offer Eyhance and Vivity premium lenses for individuals interested in their best corrected vision after cataract surgery. The Vivity functions as an EDOF IOL, with continuous vision from infinity to approximately 26 in (+1. 03 ± 0. An Eyhance will give you a very modest gain with a Vivity giving you a little more. tecnis has a diffractive edof called symfony which has many rings. Both the AcrySof IQ Vivity and Tecnis Eyhance IOLs had excellent distant and intermediate visual acuity, while the former had more satisfactory near vision outcomes with greater spectacle independence rate. com 👈Cataract surgery or refractive lens exchange requires careful IOL selection to g Price Ranges and Coverage Options. Ligabue noted that there was no significant difference observed in the range of vision between Clareon and the TECNIS Eyhance monofocal IOL. Therefore, it is essential that prospective patients be fully informed of this risk before giving their consent for implantation of the Clareon ® Vivity™ IOL. And if you have a look at this article, Figure 1, you can see the difference between a Clareon monofocal compared to the so called enhanced Eyhance monofocal. 1,2 Furthermore, 88. 4 D while Vivity gets you to -1. The existing literature also describes that no statistically significant difference was observed in any spatial frequencies regarding the contrast sensitivity of monofocal and Eyhance IOLs. But as the Vivity stretches EDOF more the risk is elevated for optical side The Eyhance has a visual disturbance profile that is similar to that of a standard monofocal IOL and a contrast sensitivity profile similar that of an aspheric IOL. Results: RayOne EMV was very robust against misalignment but had considerable deterioration of modulation transfer function (MTF) for large aperture with USAF images seriously blurred. 1 The retrospective study re­viewed 1,273 eyes treated by two surgeons from the same practice, The mean difference in DCIVA was 0. For monocular CDVA, with 55 subjects in each lens group, there is 99% power to conclude non-inferiority in visual acuity between the ZEN00V and ICB00 lens groups at one-sided alpha of 0. a monofocal. For 4. Clinical studies confirm those results and show a If the patient notices the dysphotopsias and is significantly bothered by them, I’ll combine this with a monofocal or EDOF lens in the dominant eye—for example, a PanOptix in the non-dominant eye and an EDOF lens (such as the Vivity or Synergy) or monofocal plus distance lens in the dominant eye, targeted for distance (such as the Eyhance or the Rayner EMV). However, a European multicenter study reported that patients with bilateral Eyhance IOLs may experience improved intermediate vision compared to the ZCB00 monofocal IOL. friction between the lens haptic surface and 12. We would like to show you a description here but the site won’t allow us. 25 D. The Eyhance and Vivity premium lenses are two of the state-of-the-art IOLs that provide patients with significantly improved vision. My last eye glass prescription was -2. In the Alcon world, a Clareon at plano in dominant eye, and Vivity at -0. There is a lif In such situations, I prefer to implant an AcrySof IQ Vivity (Alcon) in the dominant eye and, if the patient requires more near vision, a PanOptix in the nondominant eye. I should add it is important to realize, Vivity also comes with Contrast Sensitivity loss. Symfony. Methods: We assessed and compared the through focus modulation transfer function (MTF) of the following novel IOLs with a nominal power of 22 D: Acrysof Vivity, LuxSmart Crystal, RayOne EMV and Tecnis Eyhance. 10 It has also been reported that bilateral implantation Some even claim the Eyhance is a monofocal. The other The Vivity lens is an extended depth of focus (EDOF) IOL. Tecnis monofocal 1-piece IOL Optical bench testing shows the PureSee has a flatter defocus curve from distance to near compared to the Tecnis Eyhance enhanced monofocal or the Tecnis monofocal IOL. Given that our study of 310 patients (620 eyes) did not find a clinically significant difference between Clareon and Eyhance IOLs in terms of intermediate vision, The Clareon Vivity IOL is the only available non-diffractive IOL that has received this FDA EDOF designation—offering patients excellent distance, This means that the Eyhance is about 0. That translates into 28" for a close distance for the Eyhance, and to 25" for the Vivity. com/doctorkrad/Within a healthy eye is a clear lens. 08 logMAR for „Vivity liefert einen kontinuierlich erweiterten Sehbereich und hohe Sehqualität“ Im Experteninterview: Dr. Tecnis Monofocal. 24 April 2023. Food and Drug Administration this year. Will report back here once the first eye has settled. comhttps://www. I think there is a significant opportunity to add this lens to your portfolio. At the Hospital San Rafael in Madrid, 22 eyes of 11 patients were implanted with RayOne EMV and 70 eyes of 35 patients implanted with TECNIS Eyhance Between surgery and the early post operative period (P1), rotation was more likely in the clockwise direction than anti clockwise (Clareon/Eyhance: 76/87% v 21/0%, p<0. The Alcon Vivity is a non-diffractive EDOF IOL that delivers monofocal-quality distance vision and has improved acuities at intermediate ranges. 0% of patients reported that they never, rarely, or sometimes experienced halos, starbursts and Close behind is the Vivity toric, used by 37. 28 Patients with the TECNIS Eyhance IOL had That is the kind of information needed to evaluate the lens compared to the Vivity and a monofocal lens. Such comparison had not been done before. instagram. 50 D difference is the sweet spot for most people. , Dr. The J&J Tecnis Eyhance is a monofocal IOL which slightly extends the intermediate range (67 cm) as compared to the J&J Tecnis ZCB00. Here are sample defocus curves for 4 multifocal IOLs (Symfony, Vivity, PanOptix, and Synergy) that are superimposed, although defocus curves often vary between studies. Kermani: Bislang haben wir etwa 40 Augen mit Vivity versorgt und unser The first enhanced monofocal IOL was the TECNIS Eyhance IOL (Johnson & Johnson The Vivity Extended Range of Vision IOL vs the PanOptix Trifocal, ReStor 2. No differences were obtained between two IOLs in terms of patient satisfaction and visual dis Background To compare clinical outcomes and optical performance of a new monofocal with enhanced intermediate function intraocular lenses (IOLs) with that of conventional monofocal IOLs. 👉 Better vision options after cataract surgery 👉 https://IOL-adviser. Shafer, in that it provides functional interme­diate vision and excellent distance visual acuity. Can give both good distance and intermediate. 11,13 However, it was reported that the AcrySof IQ Vivity IOL reduced contrast sensitivity more than the monofocal IOL at high spatial frequencies, although the difference was not Statistically, there was no difference between the TECNIS Pure-See™ IOL and the TECNIS Eyhance™ IOL in terms of bothersome symptoms. 14,15 There is minimal data directly comparing visual outcomes The Alcon Vivity EDOF IOL splits the difference, giving about 50% more visual range than the monofocal while avoiding the nighttime glare/halo/rings of the diffractive PanOptix. 6 D at the 0. DOF2023CT4028 – Simulated VA of the TECNIS PureSee™ IOL compared to Vivity. The Tecnis Eyhance lens implant, by Johnson & Johnson Surgical Vision (JJSV), utilizes extended depth of focus (EDOF) technology to deliver similar distance vision and better intermediate vision compared to a standard monofocal lens. 5 mm, MITF values for Eyhance and particularly for RayOne EMV dropped For Vivity and LuxSmart, only the peak for the secondary focus decreased Conclusion: Vivity and LuxSmart showed a larger depth of focus for our measuring conditions than Eyhance and RayOne EMV. I was involved at one time with a company developing high-tech lenses. 05 logMAR between the Eyhance and Clareon IOLs which was significant Eyhance and Vivity produced a considerable increase of negative Z 4–0. What sets the Vivity IOL apart from other EDOF models is the unique technology The MTF bench test bar graph with 3mm and 5mm model eyes from that "The Opthamologist" PDF would indicate that Eyhance has double the contrast sensitivity of Vivity. net for Tecnis Eyhance vs. 05 ± 0. These are only some of the many intraocular lenses that the practice offers to patients, like toric lenses, multifocal lenses, accommodative lenses, and more. 5 Active Focus and ReStor 3. Vivity seems to be Alcon's EDOF competitor to Symfony. 5 diopters more range than the monofocal IOL. acon has the panoptix which is a trifocal. 1 logMAR non-inferiority margin. 5 mm aperture www. 75 D with either the Vivity or Eyhance. EDOF lenses such as the Symfony OptiBlue and the non-diffractive Vivity create one elongated focal point to enhance a patient’s range of vision. 05). 07 ± 0. 05 logMAR between the Eyhance and Clareon IOLs which was significant (p < 0. I developed dry eye, and on Restasis, and that is improving, but some nights I get double vision in the Vivity eye, but not the monovision eye. There is a shift of some of the distance Vivity is a novel, non-diffractive extended-depth-of-focus intraocular lens with a 6-mm biconvex, aspheric, wavefront-shaping optic that uses Alcon’s proprietary X-Wave technology. 03 logMAR compared to 0. But because it does drop off at the near range, the Eyhance does not meet the criteria to be con­sidered an EDOF or multifocal lens, he said. 1 Building on the proven TECNIS® IOL platform, the TECNIS Eyhance™ IOL was the first lens designed to extend the depth of focus, as measured by bench testing, as well as provide 20/20 distance vision. Vivity. 01 ± 0. Ease of Use. You can kind of pick your poison. 12 With similar mesopic contrast level compared toTECNIS Eyhance TM IOL 9 . 36/month at a price of $2,763. 12 logMAR for AcrySof IQ Vivity compared to 0. In addition, the Vivity IOL was superior to the monofocal IOL for monocular photopic distance-corrected near VA, resulted in statistically significant more eyes with monocular distance-corrected near VA of 0. 02 logMAR (0. 10 logMAR, assuming no difference between the IOLs and a standard deviation of 0. Tencis Eyhance is a Premium Refractive IOL which is supposed to provide a little bit of EDOF with the same overall results of a standard monofocal. 2 LogMar value of "good vision". No differences were obtained between two IOLs in terms of patient satisfaction and visual disturbances such as halo and glare. Vivity was FDA approved in February 2020 and began a commercial rollout later in the year. 6 D improvement or down to -1. 001, Fisher exact). Are you saying you think there will be more more visual side effects with Vivity vs. The first trifocal IOL was introduced in 2010 For the Clareon ® Vivity™ IOL, most patients implanted with the Vivity™ IOL are likely to experience significant loss of contrast sensitivity as compared to a monofocal IOL. 01), but within the 0. Keep reading Vivity falls into the NEW category of Premium Monofocals, which also includes Eyhance and RayOne EMV. 000) at intermediate distances with correction. 5 D extra). Lahners pointed out that Eyhance, a monofocal IOL with some additional intermediate vision and a little near vision, does not have presbyopia-correcting status from the FDA, whereas Vivity does, with more powerful near vision The Eyhance achieved a statistically significant, 1. En esta ocasión vamos a comentar acerca de dos lentes intraoculares que se están destacando y posicionando mundialmente, se trata del lente AcrySof IQ Vivity® de Alcon y el TECNIS Eyhance® de Johnson & reduced MITF and with maxima differently located. Citing a recent study by Micheletti et al. No significant difference in range of vision was observed between Clareon ® and Eyhance^ monofocals . Eyhance, in addition to the lower contrast with the Vivity? Are you talking about headlight glare? Why would this be, since both lenses are not diffractive? And I wonder if there are other risk factors for the Vivity vs. You can relax that back to targeting -0. I am quite sure this must be how they get this stated difference at 66cm, because one Eyhance set for plano will never cover that distance, Also the Vivity 0. comparable tecnis Unique positive spherical aberration design provides a smoother transition between distance and near eyes. I told him I was doing internet research and considering the Eyhance or Vivity. Eyhance. 1-line improvement in monocular and binocular intermediate vision at six months vs. steven64823 aspen88. This was a non-interventional, examiner masked comparative study (n=155 per group) on binocular visual acuities at distance and intermediate. 7%, and 100. RayOne EMV is an emerging non-diffractive EDOF option that could offer a middle ground between Vivity and Eyhance. g. 02 ± 0. In fact, it very commonly improves distance. 1. 3 D, while the Vivity extends it by 0. And on this eye you do not have to be aggressive in getting real close to plano vision by targeting -0. There is a shift of some V is an EDOF extended depth of focus, pricier usually, some anatomy of your eye may discourage it so it's not for everyone, may have issues at night and in dim conditions, must be centered properly. 35 D. The Vivity extends the depth of focus by a bit more than 0. The lens has one focal point, but utilizes light-manipulating technology to elongate it. Some studies and individuals suggest that a 1. Mean CDVA of the Clareon group was 0. T he Acrysof IQ Vivity (Alcon), Tecnis Eyhance (Johnson & Johnson Vision) and Rayner RayOne (a recent addition that was approved at press time) intraocular lenses were approved by the U. Unsal U, Sabur H. The Eyhance falls a little short of that with a depth of focus extension of about 0. In comparison to another non-diffractive EDF IOL (AcrySof IQ Vivity, Alcon Inc, USA), the mean binocular UDVA was 0. 01 logMAR (Snellen 20/17) in the standard monofocal IOL group, resulting in a difference of −0. aqpad cxtns xause oat kroiz bvsyx eiyhuzmv wwyw zdnw ermbp iwmyjjzk qbfajl tmq kdkvwg payr