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A diary of a Finevion IOL implant
Before deciding on this procedure I had performed a vast amount of research and searched this forum for advice and views. As many post here with problems I have decided to write this diary from day one so others may understand how the progress is made, either good or bad. It is not designed to influence anyone's decision for or against this procedure. Please feel free to comment or add to the thread.


Male, 56 years, West Country of UK. Computer repair technician.

Lens exchange was performed on left (non Dom) eye on morning of Thursday 16th at Circle Bath by consultant Mr Jonathan Luck. A +21 diopter Finevision Micro F lens was implanted  All went as planned with no complications.

Thursday evening apart from a 'bruised' feeling to the eye, there was, and had been, no pain at all all day. No vision testing was done.

Day 1, Fri 17th

Left lens removed from vari focal spectacles and specs worn all day.

First thoughts comparing eyes, the 'new' eye is noticeably lighter and brighter, with perhaps a little less colour contrast and a very slight increase in purple hues. Slight ache, but less than before and nothing really uncomfortable. Focus at 4 metres plus is clear with no ghosting. Reading a letter or newspaper (12 point) at 30cm was fairly comfortable if the overview a little small, but 30 cm is a little too close for holding a paper. At 80cm, computer distance, objects were clear enough with a very slight edge blur, but reading was not possible smaller than 18 point. Text on screen has a soft blurr edge. Night driving home in the dark presented no problems at all with halos from oncoming cars.  Traffic lights have a circular pattern around the light but nothing distracting. Television at 3metres (42" screen) comfortable, with all intros menus and credits readable, if not sharp.

Thoughts for the day

Pleased with initial ability to see objects with this amount of clarity, text will have to improve at all distances to be considered a success.

Phil
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Day 3, Sunday 19th

As it was a day off work I decided to leave my single lensed spectacles off as long as possible to see how things were shaping up. The bruised feeling has subsided greatly to the point of noticing it only if I looked for it. Wandering around the house without specs for the first time in seven years was odd, normally I fail miserably pouring boiling water into the tea pot, let's not go near sharp knives! I could do all breakfast tasks without problems, with the brain using the new eye which could see well, and ignoring much of the information of the blurred image coming in from the untreated eye. I still had binocular vision though, and could judge distance easily. Outdoor tasks of splitting logs (on an electric splitter) and light gardening were easily accomplished and everything was clear and had good focus.

Testing later in the day yielded results of astounding improvements in such a short time. Near focus for Left eye at 35cm, text was readable down to 3 point! The un-corrected  eye at same distance was 36 point and not sharp, binocular was 14 point. Far vision was clear for trees and birds etc from 3 metres to 40 metres. Trees at 100 metres were good, with small branch definition on large Sycamores but leaf canopy on evergreens was blurred (right eye cannot define trunk, much less branches). Intermediate computer work, as against intermediate general vision, is the weakest area. At 80cm, best text for comfortable reading on-screen is 14 point. Smaller than this, I can use a computer, but edges are quite blurred. This is being written on an iPad at 45cm at approx 12 point, slightly blurred, but I want to lessen reliance on corrected right eye.

Thoughts for the day

Pleasantly surprised and pleased with the vast improvement in near focus. If this is the standard of vision with one new and one uncorrected for general intermediate and far vision things are looking really positive.
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Day 7

All bruised feeling now one, even when trying to notice it. Vision continues to improve in the Far field. Near simply cannot get better, it is now at 20/15 j1. Computer use, my daily task, is improving, but unfairly I am using one uncorrected eye along with the new lens. The pair in binocular sight are so far removed from each other in focus I am surprised to be able to see anything in binocular.

Day 8

Time for the second exchange. I have no qualms of having the second eye done. I can then really learn to use them together. The implant went without a problem. By late afternoon there was no bruised feeling, as though it had not been done. Will leave till Saturday to evaluate vision, especially reading on screen.

Thoughts for today

So far all has gone at least to expectations. More work to do with intermediate, but near and far are really good. Everything on the whole looks promising

Phil
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Thank you for this extensive description of your experience with this multifocal lens.  I believe this is the first mention of it on this discussion board.
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I failed to find a 'real life' explanation of what to expect. More disturbingly, in the UK, where there are a range of premium lenses available, little information is offered about them to cataract sufferers. I have spoken to three acquaintances in the last week who have had NHS ( 'free' Social medical care in the UK) cataract lens exchanges and when comparing notes, none had been told of the availability of premium lenses. Two would have paid for the premiums.

The Finevision lens took some finding as far as a surgeon locally who fitted them.

Day 9

Second eye had astigmatism manually removed when the +21 standard lens was fitted so a toric IOL wasn't required.

Eyes are now used binocularly. The difference in ability to see at varying distances (compared to the one IOL and one unaided eye) is so pronounced it is scary.

Driving at night, on rural roads with no street lights, in driving rain, was an experience. Oncoming headlights had a bright circular ring surrounding them producing a small 'spiderweb' pattern. No glare was thrown and I did not feel driving vision was compromised. Shifting vision from dash to road and further to road signs was seamless. If neural the adaption mentioned for the Mplus is needed, it has happened almost instantly.

Reading and writing on an iPad at 35-40cm is really comfortable. Reading a newspaper is easy. Newsprint text or the paper it is printed on is not the highest quality, but I have the ability to read the fine print for conditions of loans etc that advertisers rather you didn't.

I tried my hobby of wood turning on a lathe today, focus at point of tool to wood contact is vital for control and safety. I felt totally in control and found it so much more comfortable than wearing specs which steam up under the face-mask. Depth and field of vision is now excellent.

From first thing in the shower, the ability to read every label on the shampoos etc was the biggest novelty. Sharp focus at 100 yards is not there yet, although I would not be greatly disappointed if it never came, the 12 inch to 40 feet distances are what really matter. Computer use is now clearer with a comfortable reading size of 12 point, but able to see 10 point adequately if a little blurred.

Will post weekly in future to report on focus developments at computer and very long distance.

Thoughts for today.

I think even if things got no better, this has already been a totally worthwhile procedure. I feel my months of research has paid off handsomely and find it unbelievable the FDA drags it's feet and places so many obstacles in the path of these small companies preventing clinical trials and general availability in the U.S.A.
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I'm very glad you're writing this journal, and wish more people would do so.
Let me briefly interfere with a question - I am also in the research phase now, looking for the best option out there... Finevision sure seems interesting, however I also have high astigmatism. Are you familiar perhaps with how the toric version of this iol might be doing?
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Hi

I notice you have cataracts in the early stages, my procedure was elective of the clear lens exchange type, I did not have cataracts. I have used specs from waking to sleeping for seven years and just found them inconvenient, for general life, hobbies and shooting sports.

When presented with my old prescription my eye surgeon initially thought the right eye had sufficient astigmatism to warrant a toric lens. His thoughts were to use standard on the left and toric on the right, and had no reservations in doing this.

However, after the IOL Master diagnostics, it revealed a lesser astigmatism than my usual optician had prescribed for. At -1.2 it was felt he could remove just over half this, leaving 0.5 which was within the scope of the standard lens. Mr Luck errs on the side of caution, but still rates and uses the toric version where all other indicators are showing a positive outcome. Replacing clear lenses puts more pressure on the surgeon to achieve a result at least as good as the patient had before using specs or contacts. This lens ( and the AT Lisa tri) currently offer a very good alternative to vision aided clear lens or cataract surgery.

At your age, if replacement is not required immediately, I would wait to see the results of the new hydro accommodating lenses undergoing trials. Physiol have only released the Finevision Tri in the last couple of years after several years of trials. Who knows what will be available in the next five years. If more immediate action needs to be taken, these seem to be a very viable solution. I can already see myself being glasses free for the rest of my life.

Talk with a proper surgeon though, not a high street chain, one is led by bottom line, the other by ethics. I will let you work out which is which.

Phil
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It's now more than 3 months since I had my AT trifocal lenses implanted.  The bright circular ring around headlights is still there but it doesn't bother me and, as Phil states, there is no glare.  My near vision is excellent and so is my distance.  My computer use is fine though I have a tendency to lean towards the computer when in fact my vision is better if I sit back.  Just years of habit that I need to change!  The only area of slight difficulty is reading a broadsheet newspaper but this is solved my turning on a bright overhead light (perhaps I should swap to a tabloid!).  A superb result!
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You say, "Talk with a proper surgeon though, not a high street chain, one is led by bottom line, the other by ethics. I will let you work out which is which."

I don't know whether this is entirely fair. My experience has been this:

I decided a few weeks back to pursue IOL surgery, did some research, spoke to my GP and set about speaking to a "proper surgeon" as you put it. I contacted two.

I got through to the PA of the first and explained what I wanted, asking whether the surgeon performed such an operation. She needed to go away and check. When I asked what lenses the surgeon used, she asked me what lenses I'd like! I was told I would need to see my GP for a referral (a chore in itself) and I was not sufficiently impressed with the situation to go to the trouble of doing so.

When calling the second surgeon I was again transferred to his PA. Who was clearly working from home because whilst speaking to me a child was asking for help with his homework. She had slightly less clue than the PA of the first surgeon, but set up a call with the surgeon himself. He proved to be a very helpful chap, and I am sure he would have done a fine job. However I was not sufficiently convinced to book a consultation, mainly because his dialogue came across as a bit of a sales pitch and an attempt to slate his competition.

By contrast, I spoke to the Optical Express and had two free consultations. Each member of staff I met, regardless of their role, knew what the company did, what it offered and what its aims were. They were also extremely careful to ensure that I was entirely happy with their offer. I subsequently had some questions which were answered by phone in a couple of minutes. Later I had more questions and they too were answered quickly (by this time I had paid a deposit). I was told categorically that if I had any further questions, however trivial, that I should call again.

An aside: I was reading an article about lens exchange recently and a leading specialists stated that he won't operate on any patient who asks more than five questions, because they are likely to be "too demanding".

I am also slightly more wary of "non commercial" surgeons for want of a better description than "commercial" ones. Over the years I have been referred to a few, including one or two highly regarded ones (in fact one Prince Charles uses), and I haven't been hugely impressed. I have found that it is quite difficult, too, to gauge accurately their historic performance in order to estimate the probability of future success. Commercial operations, however, live or die by their reputations (and I have used some excellent commercial providers o healthcare).

I have four friends who have had len replacement surgery with Optical Express, all have had Mplus lenses, and all are happy. One requires glasses to read fine print in low light. Two of the four have three friends who have had the same surgery and they are glasses independent.

My concerns about the surgery have been twofold. Firstly, will the outfit concerned look after me and how close are they if something goes wrong? I am as sure as I can be that Optical Express is as safe as possible, furthermore the operation will be conducted about 6 miles from my home, so if I have issues it's not too far to go. They also seem to have diarised extremely frequent return visits for check-ups.

My second concern was about lenses - am I getting the best? This was more difficult to answer. I am aware that new lenses are coming along that will be better than the current ones. I am also aware that the FineVision gets some good reviews. However, the Mplus has a broadly successful history and research suggests that it is more popular with those who want better distance vision. I have also read that the approval rating amongst males is greater than for FineVision. I am therefore, in light of the above, happy to pursue the Mplus route.

I am due for my first eye surgery imminently and I will report back, warts and all, to provide some basis for comparison.


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Hi

Yes, some comparisons would be good. I did not intend to start a big company v small debate, I was put off OE after my consultation in Bristol. The whole examination and testing seemed rushed, with little time to ask questions, then taken to a small untidy office to make an appointment with a surgeon for a £500 deposit. Can I talk at home with the wife? We cannot guarantee the price then, was the answer.  After choosing not to proceed with them, the texts came twice a week upping the offers, firstly a voucher to take £500 off the price quoted, then increasing the free interest period up to two then three years. This is what I refer to as commercial company looking at bottom line. I have two friends who have had theirs done with OE, both were happy with the surgeon and procedure, neither were happy with the aftercare (or lack of it), which was done in a branch that had little knowledge of the procedure.

I paid a premium, both for the chance to have this lens, which none of the major chains use, and to deal at all times with the surgeon performing the procedure. Also like you, location is a big consideration.circle bath is a 15 minute drive away and the consultants at Circle are partners in the medical centre, chosen for their expertise. The consultation was free, and I was sent away to think about it, with the opportunity, and indeed encouragement to ask questions.

The question was asked by a patient who has a known high astigmatism, I would be fearful of pressure to return a profit over telling a prospective client not to proceed, based on the follow up texts to entice my custom. The beast needs feeding. I am sure they have a very large and loyal client base, and as a simple numbers exercise, they will have a higher number of complaints, albeit probably no higher percentage, than a smaller outfit.

The choice of lens was based on the desire for a decent intermediate focus as my work involves working on computer repairs and therefore a separate focal point for this was very attractive.

I believe a diary of yours would also be very useful for others as well. My distance focus, over 10 metres is the weakest point, at the moment I don't know if this is part of the adaption required as I can find no journal to describe progress for the first few months. I don't believe I have a problem, but to have read someone else's progress and seen the results week by week would have been very useful.

Best wishes for you procedure and please do run a diary.

Phil
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I must say when I first spoke to OE, about 18 months ago, they were not doing IOL surgery locally and the branch was uninspiring to say the least. However when they refitted the place to do IOLs I took a second look and was greatly impressed. I have not been aware of any hard sell, but then I didn't need much persuading.

Hopefully your distance vision will come, however at least you have what you needed / desired most immediately.

I will report back with my findings re the Mplus. Thank you for your best wishes.
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Just a friendly note of warning, at Centre For Sight where I had my surgery I believe they no longer implant MPlus lenses as there were too many people dissatisfied with the outcome.
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I have started a similar diary for my Mplus / Optical Express experiences here:

http://www.medhelp.org/posts/Eye-Care/Diary-of-a-Lentis-Mplus-IOL-implant-patient-at-Optical-Express/show/2087264
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Two weeks and one week respectively.

A week of binocular training.

All traces of feelings relating to the surgery are long gone, no numbness or bruised feeling. I know the healing process is far from complete, but there is now no distraction from sight training.

Near vision, this has been the strong point from day one, and has continued to improve in clarity as the week progressed. Black newsprint is not as dark as it used to look, more a dark grey, but with reasonable light, it doesn't present a problem. Minimum text size to read is three point and reading instructions and ingredients on bottles and boxes is easy, as is seeing fine detail on anything at 30-40cm. At work with computer repairs, the very small screws used are fine if they are dark, the bright silver on some reflect off the work light making life a little more fiddly during assembly work. I have improved the workbench lighting at work and in my home workshop, and this has helped tremendously.

Intermediate vision, anything in the same room up to 3 metres, ten feet, is seen well with decent focus, reading across a room, is much the same as with spectacles before. Preparing meals in the kitchen is fine, no issues at all doing any tasks, including using using knives safely. Reading on a computer at 80cm is adequate at 12 point albeit a little soft edged, although not yet as clear or sharp as previous corrected vision. Driving during the day is perfect, with no issues, at night, the bright rings, not halos, appear around all points of bright light but are not a great distraction, get smaller as the light comes closer, and look pretty in a weird sort of way. Strangely, road signs are not as clear as they were a week ago. No rings are evident indoors off any room lights.

There is a difference between seeing well generally and good computer use, I can do the first, and the second is work in progress.

Long distance, faces at 10 metres are soft and fuzzy, and with me being not good with faces anyways, I have trouble identifying people until they get a lot closer, down to 5 metres. Similarly, outside in the high street, hanging signs and shop signs beyond 10 metres are quite blurred. Probably as a result of too much information reaching the brain from all the rings in the lens and me not filtering out the info not required. Getting around outside is comfortable, with no great issues despite far focus not being particularly brilliant at present.

It is early days and I do not feel there is a problem, just a learning curve.

Unless anything untoward happens, will report again in a week.

Phil
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Sounds like you're doing fine.

Now that you have had both implants done I think it's a question of just enjoying the ride, making friends with any limitations and letting your brain get on with adjusting to a new way of seeing.
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Weeks tree and two respectively

All tasks now performed bifocaly and everything about day to day life is at least comfortable.

Near vision, up to 70cm, is now at least as good as my previous vision with spectacles, with an improvement in very fine detail. Reading magazines and newspapers in usual lighting is problem free. Writing this on an iPad at 40cm not zoomed in is quite comparable. I can now read hallmarks on gold rings including the symbols and carat rating. I couldn't see the hallmark detail before even with glasses.

Intermediate. Everything up to 4 to 5 metres indoors and out has good definition and vibrant colours, fuzzy edges on everyday objects are a thing of the past already. Most notably, whites are brighter than I remember them. TV at 4-5 metres is extremely clear and all text on screen perfectly sharp. Computer use at 80cm is still work in progress, pictures and icons are clear, text is still the weak point with soft edges and no hard edge definition. Even so using a computer all day is still achievable.

Mid range, 5 to 15 metres. Less fuzzy, but a way to go yet. Faces are now clearer from 6 metres but beyond that start to loose definition. Driving during the day presents no problems, although road signs are readable but not sharp at a distance.of 20 metres. Light ring during night driving are thee, and I think this is a 'feature' of this lens and will always be there, although not an intrusive phenomenon.

Far distance. A good level of detail can now be seen. Building edges are sharp, trees show a decent level of branch detail. At the extremes, star clusters can be defined to individual stars in the main constellations. The seven individual stars of the Pleiades can be seen.

In summary, very pleased with the total freedom from glasses and all is progressing well considering the time since implant. Areas still to improve are reading on screen at computer distance, more so onscreen text at laptop distance of 60cm. Focal range of 6-20 metres is the least detailed as far as edge definition, but very gradually focus is extending outwards.

Next report in a week after my one month checkup.

Phil
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Good to hear you are making progress and clearly adapting well to the lenses.
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Thanks for sharing.

Dr. O.
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Hi Phil,
Nice to read your diary.
We communicate personally about those changes, so all in the normality.

Let me share these thoughts below with you and your friends.

Right now I am at 7 months and 10 days since the surgery with PhysIOL Finevision.

I'm 49 years old.

Before the cataract in August 2011 I had Laser PRK to correct Hyperomy (I had +1.75 in one eye and +2.25 in the other)

The surgery didn't succeed and in May 2012 had to be done a second time.
Second time was better BUT I got cataract because of the extensive use of Cortisone and Desametazone, so my vision was spoiled.

So at the end of June 2013 I did the cataract surgery using PhysIOL Finevision trifocal lenses. (The first eye was done on June 29th and the second on July 1st - done close because I did it in Italy and live in another Country)

My surgeon wanted to place the M-plus bifocal since he had more data on those (he placed them in over 2000 eyes) while when I asked for the Finevision he had done in only 7 eyes.

He said that the Finevision seemed better than the M-plus, giving better light in dark places and better intermediate vision due to the third ring but because of lack of data on long term results he wanted to wait before proposing it to his patients.

The same day that I had my surgery using the FINEVISION few other people had theirs done by the same surgeon but they all put M-plus.

At the first visit my vision was way better than all the other people. One had problem seeing close, one could read a J3.
I was the only one able to read perfectly and without effort a J1 for close (wonderful feeling for someone who had Hyperomy).

After 7 months this is the situation:

My vision for close is still perfect as day 1 (still J1 without efforts)

My vision for intermediate is superb (PC - TV - Phone etc.) and it surpasses my former vision with specs

My vision for far is almost as good as it was when I had Hyperomy and I could see sharp for far distances.

I test myself from time to time. I can read a car plate from 80 meters with effort, but it is sharp at 60 meters.

Overall, this surgery was a success beyond my best hopes.

The eyes are working perfectly and the brain is adapting in clearing all the data that is coming from three different rings.
The rings are visible only at night when I see a light over 100 meters away
(in the beginning almost every light
even small and close had rings).

I was told by my surgeon to give it more time and in another 6 months - 1 year also those last rings that I see at night from far should disappear.

For Vizard (who put the M-plus) I hope all went well for you.
Also the M-plus are very good but I did many researches before switching my decision from M-plus that was suggested by my surgeon to Finevision (that I insisted).
Today I'm very happy I insisted on Finevision.

I read in several tests results that while overall 90% are satisfied with M-plus, the ones satisfied with Finevision are above 96%.

Just for a reference, after my surgery results started to become more clear, my surgeon told me: QUOTE " this means that when it will be my time to do the cataract, I'm going to use these lenses" END QUOTE

Also his assistant said he wants these lenses instead of the M-plus.
Finally, Bauch + Lömb were so impressed by these lenses that they started to brand them as theirs and took several lenses of PhysIOL:

Here one of the articles on that:
http://www.prnewswire.com/news-releases/bausch--lomb-to-distribute-physiol-trifocal-diffractive-and-toric-intraocular-lenses-in-key-asian-european-and-middle-eastern-markets-205598121.html

Just write Bauch-Lömb Finevision on Google and you get more.

I think that says a lot.

This doesn't mean that M-plus is not good. For some people could fit even better than the Finevision

But with the Finevision I think for many is better.
You get about 7 % more light (that helps you to read even in the dark), you get a INTERMEDIATE vision for PC - TV and have more probability to have a "FINEVISION" :-)

Well that is my opinion and of course when all went well is normal to be happy. However every person and every eye is different, so listen to your doctor and trust him only.

Even me, I was happy when my surgeon agreed that the Finevision could in fact be better than M-plus for me, so we went ahead. If HE would have said "no, that lens is not good for you" I would have listened him and use the M-plus.

Well, I hope all who had surgery can be happy with whichever lens.

Have a nice day you all.


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Weeks three and four respectively.

On waking, the eyes can take fifteen to twenty minutes to function properly. They feel a little 'tight' most mornings and extreme close focus is not possible. A shower and cup of tea and everything then starts to function as it should.

One month checkup at Circle Bath with the consultant surgeon Jonathan Luck.

Standard sight test gave a result of 6-4.5 or 20/15 at 6 metres. A result that I could not match with spectacles before. A very slight infection was noticed in both eyes, and whilst not a cause of concern, a further course of drops was prescribed.

Playing pool, I have played the best games for the last four years, not looking over the specs whilst playing is so good. General vision in all lighting conditions indoors is excellent, regardless of light levels. I am getting used to what I can and can't expect to be able to do. I have set up three static test areas at work so I can better judge improvements for the 5-15 metre range.

Near vision, no change, absolutely perfect, all detailed work with circuit boards easy, sometimes with a work light employed. A superb light is the Ikea Tertial at only £8.50. I have put three of these in the workshop. Reading at 35-40cm is excellent at 8 point and can easily read down to 3 point.

Intermediate, very little change in focus but an improvement in the overall clarity. Computer use is good at 80cm, but text at 12pt still has a slight blur, fortunately I know computers well and don't rely entirely on what I can read. I now run my monitor display setting at 110% and find this makes life more comfortable. The tendency is to lean into the screen and I am trying to pull back 20 cm to fully use the intermediate zone of the lens.  All objects though in everyday situations are perfect with no edge blur through a wide focal depth of 0.5 to 5 metres.  In a darkened room of an evening, illuminated by two wall up lighters, looking round, the furniture all has excellent definition.

Near distance, again little change in focus but an improvement in general clarity. Facial recognition at 7 to 15 metres is not particularly good as they appear very soft. Reading the large road signs is ok, street name signs are good from 8 metres, so room for improvement there. Driving still good. Light rings are less noticeable on the smaller lights and are prominent only on new traffic lights and cars with LED headlights.

Far focus. No issues, not pin sharp, but perfectly good, and not really concerned whether this distance improves, although I have been led to believe it will.

Seeing my life is mainly lived in the range 0.5 to 20 metres I can cope perfectly adequately as is, but believe there will be improvements in time.  The benefit of not needing specs to do any of it, is a superb outcome already, although some areas could do with improvement. Mr Luck offered a tweak to the long focus at a future date if I wanted it, but I am really happy with progress at present and wouldn't even consider anything for 8 months. I believe the lenses will work perfectly, when I learn how to use them.

Will update in a couple of weeks.
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Very nice Phil. Please be RELIGIOUSLY serious in not missing to use your drops at the appointed time every day.
If you miss even once you risk to get your eyes too dry or an infection.
Also be careful with WIND. It's very bad after this surgery.
You will not ruin the results but might slower a lot the full healing.
I remember I kept using the tears until the end of the fourth month. After that I stop all kind of medication and now I'm fine.
For intermediate vision, I had the same situation as you after 4 weeks.
I was eager to get to see sharply my 40" TV but from 3 meters it was not sharp yet.
It became sharp at the 9th - 10th week, but it keeps getting sharper and after 7 months is so sharp that you wonder how could it improve so much when on week 10 it seemed already very fine.

Enjoy your vision and your day,
Roberto
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Thank you Alberto for the insight into the progress still to be made. It really is unbelievable that there can be so much more improvement still to come. Still on an exciting journey.

Regards

Phil.
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Interesting that we are experiencing different things, but have some challenges in common. My PC monitor is back where it was pre-op and I am now finding that most comfortable. Not perfect but getting better.

I concur with Roberto's comments about wind and would actually go a stage further; I am finding it wise to avoid any situation where air is being moved around, which includes car heater and fan heaters in my office.
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Now a month of bilateral vision and all fast change has settled.

The differences now are more subtle, but things are still in flux.

It is interesting to see the way the Oculentis Mplus that Vizard is documenting here http://www.medhelp.org/posts/Eye-Care/Diary-of-a-Lentos-Mplus-IOL-implant-patient-at-Optical-Express/show/2087264 and the Finevision are progressing in different ways in similar situations, due to their different design.

With my Finevision, I find there is no difference in vision whether in sunlight, a bright room or very low light levels, with very little adverse photo effects. The sharp images are always sharp. But, what is in focus between the two lenses is very different. Whilst Vizard has good long and extra long focus, I have yet to achieve this.

As post operative healing has finished, time and neural adaption will be the only way progress is made. I will now rate my experience with the lens monthly, based on two criteria at four distances. The criteria used are general vision and focusing ability, which are not necessarily the same, at distances of 35cm, 80cm to 3 metres, 10metres and 20 metres+

Currently in good and lowlight conditions:

35cm, everything clear with excellent definition, objects and text both sharp 9/10

80cm to 3 metres, object vision really good, PC screen text still feather edged
8/10

10 metres, vision is good, good enough to see everything going on around, but faces are not in focus. 7/10

20metres+, good general vision, but road signs, as used at approach to roundabouts are readable but not sharp at this distance. 7/10

Despite the failings, I am totally glasses free and looking forward to neural adaption achieving an improvement in focus at mid and long distances.
Overall 7.5/10

Phil
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It will be interesting to see how this pans out, Phil, over the next six
months or so.

One article I read suggested that the Mplus has a track record of delivering good distance vision, with variable results in intermediate and near. Conversely that the Finevision offers good near and intermediate with a question mark over distance. You mentioned that near and intermediate are most important for you, so assuming the above holds true then you've chosen the right lenses, even if there is a bit of adaptation to do yet.



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Hi Vizard

Yes, I have always thought there was going to be a trade off.

If either of the main two players had cracked the 'all round perfect' the other could not compete. You seem to do more driving than me,so perhaps the longer distance is advantageous to you, I only live half a mile from work, then am confined to the workshop all day (bit like a mouse on a wheel most days), so near to 10 metres are by far the most important. At least spectacle independence is now a reality for both of us, and that was always the aim. I certainly hope for improvement yet, as I feel the long distance is too compromised to be called a final outcome.

This is the first true unbiased and honest comparison, without vested interests that I have come across, and with a few more months of progress reported from both, could become a very informative source of research and reassurance for prospective candidates in the UK.

Watching your progress with equal interest.

Phil
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Phil and Vizard,
As I read your comments I see a little tone of disappointment among your nice words due to some small doubts, so I would like to put your both minds at ease.

As I see how your progress is going I can promise that you will both improve very much and be very satisfied.
I confirm what Vizard said, the Finevision offer better near and intermediate than far vision, instead Mplus offer better far vision, good near vision and decent (in most cases) intermediate.
The facts are however that you both will see very well IN DUE TIME.
Don't be too impatient. Your brain has seen the whole life only one picture on your retina. That picture was give from your natural lens. To see close or far was the work of the eye to squeeze the lens as needed.

Now you have lenses with 2 (Vizard close & far) or 3 (Phil close, intermediate & far) main rings in addition to several smaller rings for all other distance in scale.
This means that in your retinas you have so many pictures and your brain see well all those pictures but ALL in the same time.

In fact the reality is that you already see perfectly almost at all distances, however your brain is learning how to choose only the best picture to process.

To understand how it work, if you have one eye that see perfectly at 50 cm. and the other is slightly blurry at the same distance, opening both eyes the picture will be sharp because your brain knows to filter the bad data received from the weaker eye and keeps only the good one.
Now, try to do it with all the rings you have in your eyes giving all those pictures you get.... That's a big job and your brain is learning how to do it. It will take months for your brain to master this task (usually between 8 to 12 and for some people even 18)

I'm sure you are still in a phase where if you look from few meters a strong light at night you can see vividly the main rings and all the other rings around doing a "Christmas ball" effect - am I right?
Well, that is because the brain cannot process the strong images from the lights and shows them all.

As month will pass, you will see the rings disappearing. Right now after 8 months, during the day I don't see those light any more, while at night I see them if they are 50 meters or more far. In few months when my brain will be mastering better the task, they should disappear for good

I notice that with my Finevision I could see every day better giving an improvement of about 2 - 3 meters per month looking far.

Now I can see sharply and read plates of the cars at 35 meters in ALL conditions and 70 - 80 meters in good light (I got Finevision).

I guess that if your surgeon did a good job in 1) calculating the needed strength of the lenses and 2) inserting the lenses professional in the center of your eyes, then you both will have an amazing vision because both lenses are top of the line.

Phil, as from the beginning you could see probably a J1 (smallest letters used sometimes in the medicine descriptions) you will see it always as that is the final result. But your brain will keep adjusting for far vision and you should be able like me in few months to forget that you even had surgery when you will drive your car.  
It will not be perfect but around 90% or more of what it used to be (for me is now about 90% and I'm still healing on my 8th month).

Vizard, your vision will improve and will be close to the one of Phil looking close objects when you will be completely healed. Probably you will see a J1 if all went perfectly, but if not you should see at least a J2, while a J3 is the letters used in newspaper you should be able to read even smaller, so don't worry if your near vision is not so good now. Probably you will see a 100% good vision for far

When I'm visited by my doctor and read the letters on the wall I have perfect vision with both eyes for far (better than 20/20 for close and far), but in reality he said that the final result for the very far distance with the Finevision will be like being 0,5 myopic (that's nothing).

So Phil when you say "I certainly hope for improvement yet" be sure that you will see the biggest changes for far by day 100. You will be driving and realize "Wow! I can see the plate on that car so far and is so sharp!"

Just look at my post I wrote after 20 days after my surgery when I was so worry because I could not see far: http://www.medhelp.org/posts/Eye-Care/Post-Surgery-Myopic-Astigmatism/show/1978066#post_9299455

But now all is perfect and sharp, so Phil don't worry please.

So guys, keep your journal (is very important for people who will do the same surgery in the future) but be patient and be happy for the new vision you enjoy already right now and the marvelous final result that you both will enjoy in few months. Roberto
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Hi Roberto

Indeed it is your experience and comments I refer to when I mentioned 'led to believe things will improve' I am a very positive person and truly believe the end result will be superb. The neural adaption taking months to master is quite an alien concept, but your simple example as used in mini mono is a very good analogy.

Disappointment I think can be read as impatience and unknowing, but your comments, as always, are so reassuring, and many thanks for them. The frustration of wanting/expecting full range focus immediately when things just don't work like that is probably felt by many having multi focal IOL's. because this has not been documented before in such a detailed fashion, so there is nothing to reference progress. This makes your comments at this time so much more relevant and welcome.

With best wishes to you

Phil
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Now nine weeks since implantation

Vision at all distances is improving, but strangely not gradually.

One day computer monitor is in a position it has been used in for eight weeks and the next day it is moved back 6 inches to its original pre op position and made finer. Almost as instantly, 8 metre vision is extended to ten metres. No gradual increase, just a jump to the next focus level. All eye drops have ceased and no specs or any other sight aid is used at all. my conclusions so far.

Results in daylight, good artificial and lowlight conditions:

35cm, everything clear with excellent definition, objects and text are both sharp in all lighting conditions. 9/10

80cm to 3 metres, object vision really good, PC screen has been reverted to pre-op position and screen zoom set back to 100% from 110%, feather edge on text has now gone even at this finer resolution. Black on white keyboard is better though than white letters on black keys. Vision indoors at night, whether in the pub or at home is superb with no loss of vision depth or focus. 8.5/10

10 metres, vision is good, good enough to see everything going on around, faces are now in focus. A rat was shot dead from 13 metres with no scope sights. Before, I couldn't even see a rat at that distance without a scope. 8/10

20metres+, good general vision, road signs, as used at approach to roundabouts are very readable and quite sharp at this distance. Distant fields and hedgerows are easily definable, Star constellation are easily identified to individual stars. 8/10

Not now classed as failings, merely a learning curve, I am still totally glasses free and happy that even now I can manage all tasks easily with no enhancements. The slight reduction in contrast is no great issue. I cant see how things improve, but judging by the last month it appears that advances will just happen as and when.

Next report in a month or so.

Overall 8.5/10

Phil
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Now fourteen weeks since implantation

Vision at longer distances is still improving gradually.

No sudden surprises this month, at to be truthful I have really stopped trying to learn anything new with the vision. However my test area set up at work is there, so after another month I did the testing.

Results in daylight, good artificial and lowlight conditions:

35cm, little change, everything clear with excellent definition, objects and text are both sharp in all lighting conditions. Tiny bright screws into tiny bright thread holes are the only challenging task at work, but a task light eliminates the problem. 9.5/10

80cm to 3 metres, object vision extremely good with very sharp edge and colour definition. 42" TV at 3 metres is pin sharp. Computer use, a daily task as I run a computer repair business and therefore a vital part of my vision requirements, has again shown increases in sharpness of the text on screen. Computer screen is still the weakest area of my vision, although is in itself focus is very good, it is the slight lack of contrast that is the more challenging aspect, although not a real problem, just the one that has taken longer to adjust to fully.  9.5/10

10 metres up to 15 metres, vision is now overy good, faces are now in focus up to 15 metres, so this is certainly an area that is still improving, without necessarily noticing a change on a daily basis. Birds at 15 metres are easily recognised by breed and colour in the fruit trees in the garden. A real improvement here. 9.5/10

20metres+, very good general vision, road signs, as used at approach to roundabouts are perfectly readable and very sharp at this distance. Car number plates are a good test and I can now read them at 20+ metres. 9/10

The learning curve continues, but now it is very much a sub-conscious one. So much of daily routine is now as good as pre implantation when I used multifocal specs, that I am almost starting to take good unaided vision for granted again, as I am now (and hopefully always will be) totally glasses free for all tasks. I am extremely pleased and very fortunate to have been able to achieve this level of improvement in such a short time. My frustration of the first couple of months has now been replaced with extreme confidence in the procedure. For some reason I had assumed the lenses would just 'work' once they were implanted and the scar had healed. This procedure really is a journey and not merely an operation, and should be approached as such.

Again, I await to see if there is any improvement left to be made.

Next report in a month or so.

Overall now 9/10

Phil
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"This procedure really is a journey"  
That is a valuable insight, and should be noted by anyone planning on cataract surgery, or any other vision repair.
Thanks for the continuing updates.
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Thank you so much for the detailed and thoughtful commentary on your experience with this IOL.  It's great to read that you seem to be benefiting from the 'trifocal' design of this lens.  

It's also good to hear that the initial vision after the implantation can improve as your brain learns to adapt to the new information profile coming from the operated eye and the IOL.  

Thank you again for taking time to provide others with your experience and thoughts; it's very much appreciated.
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Dear Phil... I'm so glad to be able to say "I told you so" without being mean :-)
I remember the enormous stress I had the first two month after my surgery when I could not see and I was really worried that something went wrong because I was told that I should be able to see well in few weeks time, while I could not. Unless the Doctor himself had the same lenses he cannot know that these require much longer.
After that period, when I started to see better I thought that no one should go through that despair and that's why I tried to encourage you as much as possible to be positive and patient and now I can see that all is going well as predicted and as it was for me as well.
What is amazing is that now after 10 months since my surgery with these lenses I still see small improvements. For instance there was a large road sign at about 200 meters from where I have to take a turn and I could not read it (it was too far at 200 meters and the letters were not sharp enough), even after 5 months from my surgery, despite I had a good vision I could not read the sign. The sign is still there but now I can read it and every week is sharper and sharper.
After 5 months I still had problem to see sharp in distance in the evening, while now I see perfectly.
Right now after 10 moths I don't see anymore the "Christmas tree balls" effects when I drive at night, but I see sharp normal lights (Hurra!!!) Just the lights over 200 meters are still showing some circles but they will go as well, I'm sure.
What about you? How do you feel playing pool now without the need of adjusting your progressive glasses? Isn't that great?
Keep up the diary for future use so that people who will get these lenses implanted may have reasonable exceptions about the time needed to heal and see properly. I think that more and more people will get these lenses once there will be long term use results available.

My vision right now is: close always perfect - I can read J1 (the smallest possible printing used in some small medicine bottles) at 35 cm. distance very sharp, even in the evening... Up to 15 - 20 meters super sharp outside, and super sharp about 5 to 10 meters inside depends on light. Between 20 and 50 meters outside sharp. Between 50 and 80 meters I see but depending on light it could be blurry. At 100 meters I am still able to read car plates with good light, otherwise is blurry and I can't.

To read at the necessary distance phone, tablet, computer, TV between 40cm. up to 5 meters SUPER SHARP - NO PROBLEM with any of them.

At the last visit to the Optician I had 14/10 in DX and 12/10 in SX (Notice: 8/10 is a little weak and 10/10 is considered perfect vision, so 12/10 and 14/10 surpasses that and is considered a vision better than average good).

I asked the optician if he thinks I might need eventually some kind of glasses in the night for the driving and he started to laugh and said: "your days with the glasses are over, except for the sunglasses if you like them. You have a vision so good that if you apply to become a airplane pilot, you will pass the vision test with no problem. Enjoy your new vision".  

So Phil, as I understand for a complete healing it takes 12 to 24 months, you (and I) will still see improvement... too bad we are old to become pilots otherwise I would have liked that :-) Nice day to all,
Roberto
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Now six months since implantation, and surprisingly (for me) the journey continues.

Message to Roberto, yep, you told me so, and certainly no offence taken.  I think more reports need to be made available from all IOL patients to give prospective clients a fighting chance of making an informed decision.

As time passes, the novelty of being able to see well at all distances unaided wears off and things again, like much in life, get taken for granted.

Keeping an objective mind on the diary, I still  have the test area at work, it will always be there now I guess, but moreover, the intricacies of normal life are more relevant. With the vision already having been learned to more than satisfactory at all distances it may be better to concentrate on what could perhaps be considered less than perfect.

Very fine close up work, say at 30 cm is perfect except when a shiny object is involved. A very tiny screw in black into a screw-hole is no problem, change the screw to shiny silver and it is still possible, but with a little misalignment sometimes. Two fine wires at 20 cm sometimes ghost over each other even when they are coloured cable. For these tasks I use a 10 inch magnifying light.

Computer reading and writing is good, but some websites especially chose some difficult colour combinations. White text on black tends to ghost, yellow text can also require more concentration. The sweet spot to read a screen is increasing to the point I have two very small defocus distances where text becomes slightly fuzzy. These are at 25-29 inches for computer and 16 to 18 inches for printed text or ipad type tablet. A simple lean in or out re-focuses so doesn’t present a problem, and the defocus areas are shrinking, as they used to be 10 to 12 inches and 6 to 8 inches deep as against 2-4 inches now.

There are no real issues with any mid or long distance focus now, the edge blur on shop signs even at 200 yards has diminished to the point of being there but negligible.

Low light vision indoors and out, is as good as my sight has ever been pre spectacles, with no adverse photo effects at all. As Roberto stated, still very slight improvements are happening as the brain just gets on with the adaption.

My opinion of these lenses, and the surgeon who performed the operation is absolutely superb, and rate my vision now at 95%+

I have no regrets in having the procedure done using the Finevision lenses, but realise they are not the solution for everybody.

Phil
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I have been asked two questions,

are you still really glad you did it ? and Any regrets?

A little background as to my situation, reasoning, and therefore my conclusions.

At 56 I am not ready for pipe and slippers. I work with computers as a self employed repair technician, play pool at league level, work on a wood lathe for a hobby in an unheated shed, and shoot clay targets with a shotgun. Working with monitors all day had made my eyesight bad at near and intermediate vision, and that gradually got worse to the point I wore glasses from waking in the morning to back to bed at night. From reading bottles in the shower to shooting and woodworking, I could do nothing without spectacles. I tried contact lenses, but as I was wearing vari-focals, contacts just weren't an option as a replacement. Vision was fine, the pain was the misting in a cold shed, fogging up when wearing a safety face mask at the lathe, looking over the specs playing pool. Forget shooting if it was cold or raining, the safety glasses (a range requirement) just fog up when worn in conjunction with spectacles, so vision was good, just too many hassles. I opted for Clear Lens Replacement after a friend had replacements for cataracts. She went to Optimax and had RE-Zoom bi focal lenses fitted at a cost of £8000. Research on these did not inspire much confidence, but she seemed happy most of the time, except computer work. Masses of research and I found the AT Lisa Tri and the FineVision Tri. Lots of reading and I felt that if I wanted rid of then glasses I would have at some point go for CLE with one of these. It was certainly a gamble, but I wasn't happy with what I had, my eyes were tired at night to the point of rubbing them to keep them open. The strain of watching TV at least made me fussy about what  I watched as it was a pain.

You've read the diary so you know the progress, as documented in a methodical way.

Now to the questions.

are you still really glad you did it ?

The very fact that I can do every thing, every day without visual aids is a massive improvement. I am writing this on a computer screen at normal distance, at normal size. That said the slowest vision to come good was the computer distance. With tri-focal lenses, the ring arrangement give something like thirty different images to the retina at three focal lenghts. The eye effectively sees everything with all focal ranges, so not only does it see everything in focus, it sees everything out of focus at her same time. For example a vase of flowers at three feet is seen with the long distance and close up rings plus the proper intermediate rings. The trick is ignoring the out of focus, and only 'seeing' the 'in focus' image. There is no 'art' or 'way' of doing this, it just happens, eventually. So straight from surgery the lenses don't actually work fully immediately. You do have to take this into account that you will have to adjust monitor position and text size initially for computer use and adapt as the vision improves over the months.

So am I still glad I did it, it must be an emphatic YES.

I chose the best lenses that are available now, (I'm sure in the future there may be better, but how long do you wait just to have something even better in another couple of years).

The chain clinics don't use trifocal lenses, and I still believe the extra focal point is a justified extra expense. As stated Circle Bath, Head consultant Mr Luck charges £2400 per eye for the Finevision, but moreover, I had him do all the tests and follow up not a trainee in a branch.

Regrets? NO, none at all. I don't regret having the procedure and moreover I don't regret the extra expense over Optical Express, it felt so production line there, and it was never stated that their 'multi focal' lenses were in fact Bi-Focal with limited mid range capability.

With no knowledge of anyones current visual situation or indeed the  main requirement for their lifestyle, it is impossible to advise on suitability, that is up to the specialists. They have that knowledge, but very few eye surgeons have had the lenses exchanged so cant give a first hand account, but please don't enter into this thinking you will have the eyes of a twenty year old, you won't.

With tri focal they focus perfectly at approx. 30cm, 70cm and 15 metres to infinity. The focus at in between distances is made up from other images so whilst it is good, even really good nearly all the time, it is not perfect. The natural lens accommodates by constriction to keep everything in focus, an artificial one does not (at the moment) so very occasionally there is a need to adjust your position and due to the slightly reduced contrast you may need task lighting for especially demanding work, needlework, modelling etc.

A long winded answer, but I don't believe a Yes/No would have been very helpful.

Would I recommend it? An emphatic yes IF you are not expecting perfection, you wont get it, and if you choose a well practiced surgeon and try not to treat your eyes to bargain basement treatment.

The procedure doesn't restore your sight to perfection, but it's a very acceptable balance with excellent all round vision and total spectacle independence alleviating all the old hassles.

Phil
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Phil

A good write up. I think however I'd like to add some balance:

You chose the best lenses available now FOR YOUR REQUIREMENT, specifically a lot of close work. There are studies that show the Finevision to be less effective than the Mplus for distance and with a lower approval rating than Mplus where the subject values distance vision.

I don't recall ever having been misled by OE regarding what the Mplus lenses are, and to be fair to them despite an admittedly production line experience the care has been absolutely top notch.

You mentioned that you got an infection in both eyes shortly after surgery. This may have been picked up quicker by OE because their aftercare is so intensive.

I must also point out that your comment about trainees doing follow-up appointments is a little silly, unless you call fully qualified optometrists "trainees". I am sure they would take issue with your description! I don't think I've ever seen a trainee in any role at OE much less anyone in a key position.

As you know, I have done a write-up elsewhere on OE and Mplus. I am a bit behind you on the timeline but will do a final write up after 12 months. However what I can say at this point is that I experienced first class service and care at OE and my eyesight is 95% perfect at all distances including intermediate. The 5% being the slight extra effort I need to put in, the requirement for some task lighting and a +1 prescription I still have in one eye.

Would any of these things have been different with Finevision / XYZ consultant? Doubtful. IOLs aren't 100% at the moment and any surgeon / patient can experience a slightly suboptimal result for a number of reasons. I could have the +1 corrected with laser but probably won't bother because it is in my non-dominant eye and it is having little effect upon my vision.

The reasons I chose OE have proved to be valid. I wanted a tried and tested lens, which the Mplus is. I wanted swift support in close proximity, which I have had. I also wanted my vision to be as natural as possible, which it is. Aside from some haziness in low light during the adaptation period I have experienced few of the challenges that you've reported with Finevision, for example problems viewing fine wires or bright screws.

The reports I have read about the Finevision, including yours, suggest that I might be less happy with Finevision than I am with Mplus. But, unlike you, close work is less important than good vision at all distances.

I should emphasise that I have no allegiance to Optical Express and have been quite frank about their strengths and weaknesses. But they have done for me what they said they would and it is unlikely I would have had a better result by taking any other route.



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Wow What an absolutely wonderful write up. Thank you so much for taking the time to let us follow your experiences. I too have been researching and feel that the Finevision lens would be best for me. I have hyperopia and now that presbyopia has taken a good hold I am very rarely spectacle free. My hobbies and work mean that intermediate distance is most important to me too. I just want to be rid of these nuisance glasses for the main part and don't mind not being able to read very small print or even still wear glasses for driving. I do not have cataracts and have a consultation lined up for the end of January wih a highly rated surgeon. I am just praying that they do not consider me too young at 46 for lens exchange. Are you aware of a minimum age limit?
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re: "Are you aware of a minimum age limit?"

I suspect most surgeons wouldn't have trouble with the idea of someone presbyopic considering lens exchange as long as they understood the risks and tradeoffs. Ultimately it is up to you since I'm sure if one surgeon objects you can easily find others who will have no problem operating.  

Since you are in the UK you have more choice of IOLs than many who post on this site from here in the US. Another option you might consider is the Symfony lens that I had implanted after cataract surgery (which I had to travel to Europe due to the US not approving new lenses, like the trifocals and the Symfony).  if you search the site you'll see my posts about it, and there is info on the net about a few places in the UK that provide it. The tradeoff is that it seems likely to provide better intermediate than the trifocals and better contrast sensitivity for night vision, but has more of a risk of needing reading glasses.

You do need to remember there are potential side effects and complications, I'm not sure if I would have considered lens implants if I hadn't had a cataract.  I have an apparently uncommon side effect (flickering) that should be expected to  go away within a few weeks, the odds are you won't have any issues but there are still risks.  
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Thanks for the reply Software Developer. The symfony does sound good but due to it being new I haven't seen too many reviews on it. My main priority has been to find a really reputable surgeon. I have done so and probably wouldn't want to trust my eyes to anyone else.
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I researched top doctors elsewhere in Europe as candidates to use, but I didn't explore options  in the UK after a quick check on prices since it tends to be more expensive than elsewhere in Europe. I figured if I need to travel to get there I may as well use a lower cost country. However I do know there were a few newspaper articles in the UK about the Symfony, and the surgeons mentioned seemed to be at these clinics (though I hadn't evaluated their quality, they seem credible enough to look into at first glance):

http://www.londoneyehospital.com/treatments/symfony-lens/
http://www.optimax.co.uk/intraocular_lenses/symfony_lens.aspx
http://www.ultralase.com/vites/symfony-lens/
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Thanks SoftwareDeveloper. I am prepared to travel for an excellent surgeon and am not using price at all in my decision making, and am not wanting to use any companies with multiple branches as I cannot guarantee the surgeon I would get. On the symfony discussion, not being an eye expert, I am unsure whether ageing and further weakening of the eye ciliary muscles in future years could decrease the effectiveness of an accommodating lens. Ideally I would like the best chance of never needing reading glasses again. Are you aware of any implications with ciliary muscles?
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The Symfony isn't an accommodating lens, its an extended depth of focus lens. It is the Synchrony (somewhat similar name) which is an accommodating lens. The Synchrony seems to be not being pushed these days from what I hear due to mixed results, many people have good results but a decent fraction don't see much if any accommodation.  I decided I didn't want to bet on an accommodating lens, so I didn't check too much into what might happen in the future regarding muscles.

I do recall it sounding like the elderly who hadn't used accommodation much for years might struggle to regain it with an accommodating lens, but it sounded like they could. Though   I'm not sure what the statistics are and whether or not that might degrade in the future if you got the lens when young. Another issue was whether the eye healing around the lens over the decades might inhibit the movement of an accommodating lens, but they haven't been around long enough for that to be assessed. I don't know offhand what they think about the likelihood of that happening or if it was more just speculation on the part of some that it might be a concern but not a major worry.

re: "never needing reading glasses again"

No lens is perfect, so you do need to prioritize goals. The trifocals (or bifocals) seem the best bet for never needing reading glasses again. In my case I figured I valued I preferred higher odds of excellent intermediate vision was worth a bit of risk I'd need reading glasses. Visual acuity in multifocals is a bit lower between the focal points. Had you done a multifocal contact lens trial? I used multifocal contacts and had no trouble with them so I was willing to go with that option, but I did notice a bit more struggle in lower lighting levels, and the Symfony has better contrast sensitivity than multifocals.

Even with the eye clinics with multiple branches you can still ask for a particular surgeon and evaluate them.

Since you are in the UK  and not concerned about price, there are many good surgeons there and in the Europe (or New Zealand or Asia even). You could try asking non-surgeon eye doctors there who they'd recommend.

One clue I figured was useful to look at when considering surgeons was to look for those who were involved in implanting lenses for clinical trials for IOLs. I figured that lens companies wish to see results for their lenses that aren't impacted by flawed surgical techniques, though I hadn't confirmed how those doctors were chosen to be sure my speculation was justified, I figured they had to be at least considered competent. At the least it indicated the surgeons were keeping up with their field, which not everyone does. In addition I looked for surgeons that seemed to be respected by their colleagues, e.g. if they were on panels at conferences or invited speakers, or asked for their opinions in publications like:
http://bmctoday.net/crstodayeurope/
Cataract and Refractive Surgery Today, Europe to see

Of course having their opinion respected is separate from assessing   their surgical skill which is why I figured lens trials might at least give some clue, in addition to being able to assess the results of their studies to see how the patients did. Overall however cataract surgery isn't like complex brain surgery, it is very common and straightforward, so you needn't find the very best doctor. Complications of course can arise even in simple surgery so it does make sense if you have a choice to get a very good one though.



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After finding this article and so many others on this forum invaluable when making my decisions regarding RLE I thought I would just give an update following my procedure.

I am a UK 46 year old female, without cataracts, who has been farsighted since a child but always made do without using glasses. As presbyopia set in I found I needed to wear them for both reading and distance and progressively began to keep my readers on permanently around the house for watching TV, using iPad, cooking and eating. Over the last few years I have had consultations regarding laser and that later Supracor when that came out but I wasn't suitable for either. So after realising my only option was lens exchange I spent the last couple of years looking at which lenses would best suit my personal needs and finding a very reputable surgeon with the latest technology to perform the procedure.

Although I live 300 miles away I decided on Mr Data at the Centre for Sight. I couldn't be happier with my decision as the thoroughness, professionalism, expertise and friendliness of the whole team there was outstanding.

On Monday 9th Feb 2015 I had my non dominant left eye fitted with a trifocal  +28D Finevision Toric (as I had astigmatism also). I was amazed how pain free I found the procedure and after removing the patch less than 24 hours later, there was no bruising, pain nor bloodshot eye. I could tell my eye already had improved vision, although a little blurry to begin with. The following day (Wednesday 11th Feb) I had a +28.5D Finevision topic out in the right eye.

On the Thursday I went again for my eyes to be checked. Already all of the different distance readings ha've improved and I expect as my brain becomes used to them, the sharpness of images will increase.


Having asked, I am told my results are as follow:
Distance - preoperative 6/15, now 20/20
Reading (40cm) - preoperative 20/63, now 20/25
Intermediate (60cm) - preoperative 20/100, now 20/20
Long distance reading (80cm) - now 20/16

I can see my iPad, tv, read a newspaper all comfortably without glasses. I can read number plates further away than I've ever been able to without glasses.

I am delighted!!!!! But if I have to look for any downsides, it would be that still within the week of surgery I occasionally see a few flickers at the sides of my eyes. Although not glares, there are a lot of rings around headlights and brake lights at night so I wouldn't feel happy if I was wanting to drive at night. Also there is a strict drops regime to follow. To begin with its hree lots four times a day, keeping eyes closed for 5 minutes between each drop. The drops will need to continue for about a month.

I go back for a six week check up and will let you know how I get on.
I hope anyone reading this has found it as useful as some of the other posts on here I read, in helping make a decision.
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Hi and welcome to the journey, as that is what you will now find you are on.  Please do keep up the progress reports, these provide a valuable resourse for people looking for non biased accounts of the pros and cons of the procedure, lenses and possible outcomes.

Mine is now 13 months post op and I think the adaption is pretty much, if not entirely, complete. I have not required glasses of any kind since implantation. The longest by far to come good was the long distance, this is now crystal clear from 20 yards to infinity. Cars, trees, birds and even the details on the full moon are all clear and in focus. The light rings, like very fine spider webs have diminished to near non existence and only appear surrounding the brightest white LED lights. Candles, incandescent and head lights now have no webs.

Aside from the two very small de focus zones, perfection. I would class unaided vision overall as in excess of 95% perfect even in extremely low light.

If I can go 13 months glases free, I believe I may never need them.

Phil
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Just back from my six week checkup after having the fine vision toric lens in each eye performed by Mr Daya at Centre for Sight.
I am ecstatic. All distances are at least 20/20 with intermediate and long distance reading (80cm) even better at 20/10.
I really wasn't expecting to get such fantastic results, I was just hoping for an improvement on my rubbish farsightedness and hopefully reduce my need for reading glasses.
No more glasses at all. Rings around bright lights at night are there still, but somewhat less and I feel totally comfortable whilst driving. They neither glare nor distract me.
All drops have finished now. I'm just left to really enjoy my new freedom from glasses. I am extremely pleased that I worked up the courage and was accepted to go ahead with the surgery!
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I'm hoping to get some more follow up from the OP. I hope Woodvillewomble will just send another update after  2 years.
I'm just wondering, I have the same implants, but when I look to rooftops (black rooftops) with a sky background, I see the white reflected on the top of the roofs, so the black doesn't look black but white/black, at least at the edges. These double vision becomes more noticable for rooftops far away.
Also, when I see the street lines and signs, I mean the signs printed on the streets, I see them double (with the second one, the ghost I would say, much less noticable. And as I approach these signs they become one. Did Woodvillewomble also experience these side effects.
I'm now 8 weeks post operation. I'm pretty satisfied, but I'd love to know if these effects will go away after time.
I hope Woodvillewomble still get's the emails and keeps coming back to this website.

Thanks for all info all on this matter.

Kurt
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Back for an update.

But firstly to Kurr, as per my diary, the long distance was the slowest to come good without the effects you describe. These do go altogether, but if you read through, and the update below the full perfect long distance without ghosting (looking at a lamp post in our park and I could see two, slightly overlapping) took best part of 20 months to come good. Too soon surprisingly, to get a final picture. I too thought 'lenses replaced, just use them' but it just isn't like that.

It is now three years since implantation 10 January 2014, of the Finevision IOL.by Mr Jonathan Luck, at The Circle, Bath. A private clinic. The cost was £4804 for both eyes.

Since the implantation I have not used any visual aids for all normal day or night time activities. I shoot clays, keep bees, lathe wood-work along with all usual daily activities. Near vision there is nothing that cant be read, even to the minute writing on bottles like Vicks Sinex (pop in to Boots and try it, the writing is tiny, but totally readable). For circuit board repairs I still use the magnified light as I always did even when wearing specs.

Computer use, still my daily employment, is all but perfect.  I say all but, as there is, and always will be a very small defocus zone at a set distance of approx. 20 inches (50cm) where the edges of small print on screen slightly blurs, still readable but not pin sharp. Move in or out 3inches and either the near or intermediate focal points is used and text is perfectly sharp edged. Transition between the focal points is beyond my control, it just happens, keyboard use at normal comfortable position is perfect. I do find though, that a white keyboard with black letters is better than a black keyboard with white letters. They are still available, but mainly from Ebay and the like.

Driving and long distance is now perfect in every way. No visual aberrations of any description, no ghosting, no double vision, no halos or webs around light sources. I'd honestly say these lenses do not truly become as perfect as they are now for 20+ months. The little niggles, webs around lights etc. are no longer there, I try to look for them once in a while and they just don't exist.

I do get the odd floater, a tiny grey dot which drifts across my peripheral vision if looking at a white screen. Nothing to worry about, happens once a week that I notice for about two seconds whilst it passes across the edge of my field of view.  

I almost went for the M plus X, a new version of the M plus, they have now been dropped by Optical Express and a class action against the lens is now in progress. I think I dodged a bullet on those.

In summary, I am totally satisfied I made the right choice in both make of lens and my chosen surgeon. I don't regret a penny of the money spent.

Phil
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thanks for the update. Good to hear and informative
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re: the "M plus X" issue and dodging a bullet. Although I'd suggest people research the issue themselves if they are considering the lens, my impression is that the class action suit is bogus (though I hadn't researched in detail to confirm it).  As you know, no IOL is perfect, and a  certain % of people experience problems with any IOL, although obviously the risk of problematic visual artifacts is higher with multifocals. I'm sure the right ambulance chasing attorney could round up unsatisfied patients of any lens to try a similar class action lawsuit. That said, I don't know how much of the issue might be more that  Optical Express didn't  appropriately caution people about the risks rather than really the IOL itself.

I get the impression that overall for most people there are likely better choices than the Mplus X, but  if its a possible match for people's needs I wouldn't rule it out based on the existence of the lawsuit, it'd merely suggest caution and further research.

For most people though I suspect one of the trifocals is a a better bet if they need really good close up vision, or the Symfony I went with if intermediate is a higher priority (it was really a close call for me which to go with, though I think for my needs I made the right choice). The poster above had great results and only noticed a slight drop at intermediate, for some others it may be   more noticeable. He also doesn't have problems with night vision artifacts (most people don't have night vision issues with any IOL) , but the risks of that, and of reduced low light vision, seem to be slightly higher with a trifocal.

[for any US patients reading this and confused, the Finevision and other trifocals and Mplus X aren't approved by the FDA so they aren't available in the US].
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