Aa
Symfony IOL resuls
Surgery on my right eye was yesterday. Vision was blurry for about 6 hours and then cleared. But movement was very disorienting. It is less disorienting today. The vision in the eye is very good for everything except for very close. I had a hard time pitting my eye drops in, but am slowly adjusting.
My contact lenses prescription was -10 and -11, so this is amazing for me. I can't wait for the second eye which is scheduled for April 13. The anatomy of my eye is very long and narrow so the surgeon is cautiously optimistic about the results. But it is looking good so far.
My contact lenses prescription was -10 and -11, so this is amazing for me. I can't wait for the second eye which is scheduled for April 13. The anatomy of my eye is very long and narrow so the surgeon is cautiously optimistic about the results. But it is looking good so far.
Who was your friend's alternate surgeon? Do they use the femtolaser, by any chance?
Surgeon has decided that the secondary cataract while more developed than anticipated is not impeding my vision so no more surgeries for a while.
It turns out that the irritation is a low grade infection so I have antibiotics again including a gel one to put at my lash line. Hopefully everything starts to clear up soon otherwise I may have to consider taking long term sick leave.
I was talking to someone yesterday who has considered cataract surgery at the Ottawa General. But they messed up several times in the preparation stages that he said he couldn't trust them for the surgery. He was very happy with his alternate surgeon.
It turns out that the irritation is a low grade infection so I have antibiotics again including a gel one to put at my lash line. Hopefully everything starts to clear up soon otherwise I may have to consider taking long term sick leave.
I was talking to someone yesterday who has considered cataract surgery at the Ottawa General. But they messed up several times in the preparation stages that he said he couldn't trust them for the surgery. He was very happy with his alternate surgeon.
re: "eyes were clearly irritated'
Irritated eyes, and the need to "drown" them suggests dry eyes, which can impact visual acuity. Unfortunately dry eyes can be a side effect of cataract surgery and take time to recover from , since some nerves may be cut by the incisions. Also, I don't know if you have allergies, but dry eyes can compound irritation during allergy season since the allergens may not be as diluted or rinsed off the eye.
The astigmatism of course is also part of the acuity issue obviously (you don't mention there being any in the left eye though), unfortunately operations can add "surgically induced astigmatism" due to the incisions. (I think you implied you got a regular lens in that eye and not a toric lens, otherwise lens rotation might be the issue).
Irritated eyes, and the need to "drown" them suggests dry eyes, which can impact visual acuity. Unfortunately dry eyes can be a side effect of cataract surgery and take time to recover from , since some nerves may be cut by the incisions. Also, I don't know if you have allergies, but dry eyes can compound irritation during allergy season since the allergens may not be as diluted or rinsed off the eye.
The astigmatism of course is also part of the acuity issue obviously (you don't mention there being any in the left eye though), unfortunately operations can add "surgically induced astigmatism" due to the incisions. (I think you implied you got a regular lens in that eye and not a toric lens, otherwise lens rotation might be the issue).
I forgot about turning down the brightness of the monitor. That certainly helps. The eye irritation and blurriness is still a problem.
I just saw the optometrist and there is no swelling that would contribute to the blurring or irritation. He noted that my eyes were clearly irritated despite having put lubricating drops in. He told me to just keep drowning my eyes.
With respect to the vision, I tested 20/25 minus 2 in the right eye and 20/20 minus 3 in the left.
But get this -- I now have astigmatism of 1.25 in my right eye! I have a check up with the surgeon next week and a report to give her from the optometrist.
I just saw the optometrist and there is no swelling that would contribute to the blurring or irritation. He noted that my eyes were clearly irritated despite having put lubricating drops in. He told me to just keep drowning my eyes.
With respect to the vision, I tested 20/25 minus 2 in the right eye and 20/20 minus 3 in the left.
But get this -- I now have astigmatism of 1.25 in my right eye! I have a check up with the surgeon next week and a report to give her from the optometrist.
The super sensitivity to light is common with any cataract surgery since people beforehand get used to the cataract reducing light, or even an aging lens does reduce light compared to a young adults. After my surgery I had to turn the brightness down on my computer monitors to the lowest setting, 0 or 1 or whatever it was, though I didn't need to use sunglasses inside. It has faded for me, after the first few days it wasn't a problem really, though it took a few months before I turned up my monitor brightness. (I didn't need the extra brightness, but figured I'd see if it was now comfortable to use that way and it was). I do still need sunglasses outside more at times when it might have been optional before (which is likely for the best anyway since its better for the eyes).
Hopefully the blurring will improve for you. Unfortunately toric lenses are trickier than regular lenses due to the potential rotation (and I'd just seen an article suggesting that although Tecnis lenses may be better in other ways, that they their toric lenses may be more prone to rotate than others). You mentioned gel being inserted to hold it in place which perhaps might be part of the issue and perhaps it will resolve.
Small amounts of astigmatism are usually corrected via some sort of incision rather than with a toric lens, but I'd read at least one article about a laser cataract surgeon who now prefers correcting a few diopters of astigmatism via the laser rather than with a toric lens (obviously most don't agree with that approach at the moment, but lasers are improving all the time. I don't know if data will eventually support his preference or not).
Hopefully the blurring will improve for you. Unfortunately toric lenses are trickier than regular lenses due to the potential rotation (and I'd just seen an article suggesting that although Tecnis lenses may be better in other ways, that they their toric lenses may be more prone to rotate than others). You mentioned gel being inserted to hold it in place which perhaps might be part of the issue and perhaps it will resolve.
Small amounts of astigmatism are usually corrected via some sort of incision rather than with a toric lens, but I'd read at least one article about a laser cataract surgeon who now prefers correcting a few diopters of astigmatism via the laser rather than with a toric lens (obviously most don't agree with that approach at the moment, but lasers are improving all the time. I don't know if data will eventually support his preference or not).
My surgeon is thrilled at the results. I just wonder if I would have been better off not tring to correct the astigmatism. I am happy with the results on my right eye.
After another week, the blurring is not giving me as much trouble even though it hasn't improved. But at least I don't have to wear an eye patch while reading. the super sensitivity to light is still periodic though. It is really strange to have to pull out my sunglasses indoors on occasion.
After another week, the blurring is not giving me as much trouble even though it hasn't improved. But at least I don't have to wear an eye patch while reading. the super sensitivity to light is still periodic though. It is really strange to have to pull out my sunglasses indoors on occasion.
Aside from the reports I've posted elsewhere on studies, this Australian publication gives an example of the sort of reactions I got from doctors while trying to figure out whether to use the Symfony:
https://www.mivision.com.au/iols-for-cataracts-provide-continuous-vision-range/
"“I read the results (from previous implants) and discussed the lens with colleagues overseas before taking this on. The lens was extremely interesting. I was excited to see if it performed as I thought it would, and it definitely does,” said Dr. Collie
Having implanted more than 50 lenses over four months, he said the Tecnis Symfony was almost at the point of being his default lens. “The Symfony benefits from a seamless transition between distance and near so you don’t have to be in a particular spot to get great vision,” said Dr. Collie." "
https://www.mivision.com.au/iols-for-cataracts-provide-continuous-vision-range/
"“I read the results (from previous implants) and discussed the lens with colleagues overseas before taking this on. The lens was extremely interesting. I was excited to see if it performed as I thought it would, and it definitely does,” said Dr. Collie
Having implanted more than 50 lenses over four months, he said the Tecnis Symfony was almost at the point of being his default lens. “The Symfony benefits from a seamless transition between distance and near so you don’t have to be in a particular spot to get great vision,” said Dr. Collie." "
re: "but from your posts, I'm wondering if it's better to stay with my monovision "
'
Mfhmark's results seem very puzzling, oddly it appears it is the monovision-like difference between her eyes that she seems to be attributing some of her difficulties to even though it appears small, and so she might have had even more trouble with a typical amount of monovision. Her issues seem partly based it seems on other issues perhaps like swelling, PCO, and lens rotation or some other factor. Until the other oddities are addressed, I'm suspecting the issues aren't due to the particular lens she chose rather than glitches with the surgery or her visual system that may have impacted any choice of lenses.
Unfortunately an IOL isn't the same as a natural lens, even with a monofocal lens odd issues can arise, or people can struggle a bit to adapt and would have struggled with any lens. It is always possible there are some issues that hadn't shown up in the studies, e.g. one poster on Medhelp discovered when she tried to find a surgeon that the Synchrony lens had many negative comments from doctors (and is no longer available), though she risked it anyway. In my case I when I was hunting for a doctor outside the US to get my surgery, I contacted a few who had been using the Symfony and they all had good impressions of it as did a US doc who'd been involved in the study and others US docs who had heard from colleagues abroad who I'd asked about going overseas.
'
Mfhmark's results seem very puzzling, oddly it appears it is the monovision-like difference between her eyes that she seems to be attributing some of her difficulties to even though it appears small, and so she might have had even more trouble with a typical amount of monovision. Her issues seem partly based it seems on other issues perhaps like swelling, PCO, and lens rotation or some other factor. Until the other oddities are addressed, I'm suspecting the issues aren't due to the particular lens she chose rather than glitches with the surgery or her visual system that may have impacted any choice of lenses.
Unfortunately an IOL isn't the same as a natural lens, even with a monofocal lens odd issues can arise, or people can struggle a bit to adapt and would have struggled with any lens. It is always possible there are some issues that hadn't shown up in the studies, e.g. one poster on Medhelp discovered when she tried to find a surgeon that the Synchrony lens had many negative comments from doctors (and is no longer available), though she risked it anyway. In my case I when I was hunting for a doctor outside the US to get my surgery, I contacted a few who had been using the Symfony and they all had good impressions of it as did a US doc who'd been involved in the study and others US docs who had heard from colleagues abroad who I'd asked about going overseas.
re: "So now I find out that the Toric lens is good for near and far but not intermediate. "
Your results are rather puzzling. Did you get a different toric lens then and not the Symfony? That description seems more like a multifocal since the shape of the defocus curve should suggest that intermediate should be better than near. Though those results are close enough I'd assume the variation may be within testing error. The 20/25 at intermediate is a decent result. It doesn't seem like the blurring at all distances could be too much with those sorts of results. Did they do a binocular test of acuity to see if the results differ from the test with each eye separately which would then match your concerns about blurring due to the eyes being different? I don't know if you have some residual astigmatism, or if its something to do with the PCO you mentioned, or this issue of "packed in a denser gel", which isn't a standard part of cataract surgery.
You don't give the actual refractions which would help to assess how different the vision in the eyes are since 20/30 for distance in the right eye isn't bad, and but both eyes are still 20/20 for near, so it seems like only a small bit of monovision which most people adapt to (it could be the near is at different distances if you held a reading card differently). Your measurements suggest that at most distances there shouldn't be much difference between the eyes, and your need for patching one eye to read despite 20/20 near is rather puzzling. I haven't read anything that I can recall suggesting a cause for these odd issues, I don't know if your various other comments related to swelling, PCO and gel may have something to do with it, or if you have some other eye issue which somehow doesn't reduce acuity but impacts merging (e.g. I wonder if its even possible your eyes weren't really merging before surgery for some reason but you weren't aware of it)
Your results are rather puzzling. Did you get a different toric lens then and not the Symfony? That description seems more like a multifocal since the shape of the defocus curve should suggest that intermediate should be better than near. Though those results are close enough I'd assume the variation may be within testing error. The 20/25 at intermediate is a decent result. It doesn't seem like the blurring at all distances could be too much with those sorts of results. Did they do a binocular test of acuity to see if the results differ from the test with each eye separately which would then match your concerns about blurring due to the eyes being different? I don't know if you have some residual astigmatism, or if its something to do with the PCO you mentioned, or this issue of "packed in a denser gel", which isn't a standard part of cataract surgery.
You don't give the actual refractions which would help to assess how different the vision in the eyes are since 20/30 for distance in the right eye isn't bad, and but both eyes are still 20/20 for near, so it seems like only a small bit of monovision which most people adapt to (it could be the near is at different distances if you held a reading card differently). Your measurements suggest that at most distances there shouldn't be much difference between the eyes, and your need for patching one eye to read despite 20/20 near is rather puzzling. I haven't read anything that I can recall suggesting a cause for these odd issues, I don't know if your various other comments related to swelling, PCO and gel may have something to do with it, or if you have some other eye issue which somehow doesn't reduce acuity but impacts merging (e.g. I wonder if its even possible your eyes weren't really merging before surgery for some reason but you weren't aware of it)
I had a very mature right cataract removed on Monday the dr. said it was really solid. Today my sight is 20/50 but for me after seeing nothing but a white cloud for 5 yrs I' super thrilled to be seeing period.
Hi -- Thank you for sharing your experiences. I'm also high myope (-9, -12) and need cataract surgery. The symfony iol has been discussed as an option but from your posts, I'm wondering if it's better to stay with my monovision contact lens situation after cataract surgery, given your feedback and that you need further procedures to correct your vision with the symfony iols. Also, if you don't mid, can you tell how much each eye and iol cost? Thanks.
So now I find out that the Toric lens is good for near and far but not intermediate. So the difference between the two eyes is markedly different. So different that I have trouble focussing and there is a bluring at all distances. The doctor says to give it time for neuro adaptation so that my brain will eventually use my right eye for near and the left eye for distance.
Left eye is 20/20 for distance, 20/25 intermediate, 20/20 near
Right eye is 20/30 for distance, 20/15 intermediate, 20/20 near
The left lense is less likely to shift as when they rotated the lense, they withdrew some gel and packed in a denser gel to hold the lense in place.
I think I will be wearing an eye patch for reading until I can get to the optometrist to see what can be done while my eyes adjust.
Left eye is 20/20 for distance, 20/25 intermediate, 20/20 near
Right eye is 20/30 for distance, 20/15 intermediate, 20/20 near
The left lense is less likely to shift as when they rotated the lense, they withdrew some gel and packed in a denser gel to hold the lense in place.
I think I will be wearing an eye patch for reading until I can get to the optometrist to see what can be done while my eyes adjust.
Sorry to hear you had bad luck with the lens rotating, there are a few people who posted on this site recently with far worse vision due to lens rotation with different toric lenses. I didn't need toric lenses so it hadn't come to mind that might be likely your issue. The surgeon of course is presumably assuming things will clear up after the swelling goes down, hopefully it will and it'll remain at least 20/20 so you'll have a good distance eye, and an eye giving you a bit nearer, so on balance hopefully in the end the results will turn out well even if you went through some struggles to get there.
One day after the lens was rotated and a gel inserted to hold it in place, the cornea is swollen. The vision will be blurry for a few days. But distance is now 20/20 when it was 20/40 pre-op. Now to wait for the vision to clear and see if my eye shifts the lens to 20/30 like it did on the other side.
The surgeon is very happy with the results. Me, not so much given the blurring. It could take a week to clear up.
The surgeon is very happy with the results. Me, not so much given the blurring. It could take a week to clear up.
3 weeks post op on the second eye shows that the Toric lens rotated. So back into surgery to fix it on Wed.
Yes for distance. Near and intermediate are not a problem. I didn't get the numbers for each eye, although it seems like the intermediate is a bit off for the left eye. The doctor says there would be no problem getting me to 20/20 with laser enhancement which would be in about 6 months. They will take care of the PCO first in about 3 months.
My optometrist isn't available until mid-May, so I will be going around blurry until then.
My optometrist isn't available until mid-May, so I will be going around blurry until then.
re: "still pretty blurry in the left eye"
I'm guessing you might just mean for distance without correction? You don't give the visual acuity separately for the left eye for intermediate/near to see if there is an issue (since the binocular acuity might be relying on the right eye). The issue of most concern is the "best corrected" vision in each eye, the vision you'll get with correction, which indicates whether there is a problem or whether its merely due to being myopic in that eye.
re: "suggested correction of -.75 and -1.00"
It seems they missed the refractive target and left you myopic which is why distance will be blurry of course. The 20/16 for near is obviously very good, which suggests your distance vision is likely to be very good with correction (contacts, glasses, or eventual laser enhancement after things settle down). Based on the fact that your near is better than intermediate, I'm guessing those correction numbers aren't fully correcting distance as much as they could, but giving you good enough distance vision while leaving more near.
I'm guessing you might just mean for distance without correction? You don't give the visual acuity separately for the left eye for intermediate/near to see if there is an issue (since the binocular acuity might be relying on the right eye). The issue of most concern is the "best corrected" vision in each eye, the vision you'll get with correction, which indicates whether there is a problem or whether its merely due to being myopic in that eye.
re: "suggested correction of -.75 and -1.00"
It seems they missed the refractive target and left you myopic which is why distance will be blurry of course. The 20/16 for near is obviously very good, which suggests your distance vision is likely to be very good with correction (contacts, glasses, or eventual laser enhancement after things settle down). Based on the fact that your near is better than intermediate, I'm guessing those correction numbers aren't fully correcting distance as much as they could, but giving you good enough distance vision while leaving more near.
4 weeks post op for right eye is 20/30
1 week post op for left eye is 20/40
Combined eyes is 20/25 for intermediate and 20/16 for near
When asked, the doctor suggested correction of -.75 and -1.00 - that is heaps better than -10 and -11 that I started with. But vision is still pretty blurry in the left eye. The doctor (subbing for surgeon) suggested said neuro adaption would take at least 4 weeks. But the right eye didn't blur at all. Images were very crisp and clean until it started to deteriorate 4-5 days post surgery. The doctor said that they may have put constricting drops in my eyes post surgery. I think the only difference between the surgeries was that they didn't put the gel anaesthetic on my eye, they just increased the freezing during surgery.
1 week post op for left eye is 20/40
Combined eyes is 20/25 for intermediate and 20/16 for near
When asked, the doctor suggested correction of -.75 and -1.00 - that is heaps better than -10 and -11 that I started with. But vision is still pretty blurry in the left eye. The doctor (subbing for surgeon) suggested said neuro adaption would take at least 4 weeks. But the right eye didn't blur at all. Images were very crisp and clean until it started to deteriorate 4-5 days post surgery. The doctor said that they may have put constricting drops in my eyes post surgery. I think the only difference between the surgeries was that they didn't put the gel anaesthetic on my eye, they just increased the freezing during surgery.
Yes, PCO has already started in the first eye so laser surgery in 3 months is being recommended. The eye pressure has also increased so one of my meds is being switched and a new med to relieve the pressure.
The surgeon didn't seem surprised that the near vision in the second eye was poor and didn't bother to test it. I suspect the target was different for each eye with the hope that one would be 20/20, and at worst the other would be 20/30.
The surgeon has also warned me that as my eye is very long, that the lens may shift forwards or backwards and that refractive corrections could be made 3 months after the PCO is fixed.
The surgeon didn't seem surprised that the near vision in the second eye was poor and didn't bother to test it. I suspect the target was different for each eye with the hope that one would be 20/20, and at worst the other would be 20/30.
The surgeon has also warned me that as my eye is very long, that the lens may shift forwards or backwards and that refractive corrections could be made 3 months after the PCO is fixed.
re: "there is more pain. Putting the drops in is excruciating. "
Its unfortunate you have pain, I didn't have any pain from the surgery (or during), that isn't typical, hopefully it'll go away soon and they give you appropriate pain meds.
re: "The proliferations have started already, so a follow up laser surgery will be necessary in about 3 months. "
I assume you mean PCO (posterior capsular opacification) in the first eye (you don't say), which is a fairly common side effect (it used to be most people got it, now its only a minority since lenses like the Tecnis ones have been designed to minimize the risk). Its is an easy issue to treat. That could explain the reduced vision in that eye. Although I gather PCO can form in the first first few weeks, it more commonly takes months (on average 2 years I'd read from one source) to develop. I would have thought swelling or some other issue more likely but I hadn't checked statistics, and I gather some people are more prone to PCO.
I'm guessing the 2nd eye is still just recovering from surgery, which seems the most likely the explanation for its 20/30, perhaps swelling is an issue, or perhaps they missed the mark on that one and left it myopic? I would have guessed 1 day postop would be too soon to have PCO concerns in that 2nd eye based on my reading, but I'm not positive since I hadn't researched the issue in detail before , since I don't have a PCO issue (and an eye surgeon guessed at 2 months postop that from looking at way my eyes are healing that I won't get PCO).
Its unfortunate you have pain, I didn't have any pain from the surgery (or during), that isn't typical, hopefully it'll go away soon and they give you appropriate pain meds.
re: "The proliferations have started already, so a follow up laser surgery will be necessary in about 3 months. "
I assume you mean PCO (posterior capsular opacification) in the first eye (you don't say), which is a fairly common side effect (it used to be most people got it, now its only a minority since lenses like the Tecnis ones have been designed to minimize the risk). Its is an easy issue to treat. That could explain the reduced vision in that eye. Although I gather PCO can form in the first first few weeks, it more commonly takes months (on average 2 years I'd read from one source) to develop. I would have thought swelling or some other issue more likely but I hadn't checked statistics, and I gather some people are more prone to PCO.
I'm guessing the 2nd eye is still just recovering from surgery, which seems the most likely the explanation for its 20/30, perhaps swelling is an issue, or perhaps they missed the mark on that one and left it myopic? I would have guessed 1 day postop would be too soon to have PCO concerns in that 2nd eye based on my reading, but I'm not positive since I hadn't researched the issue in detail before , since I don't have a PCO issue (and an eye surgeon guessed at 2 months postop that from looking at way my eyes are healing that I won't get PCO).
It seems my eye got nicked during surgery as putting in the eyebrows has been excruciating. It is supposed to heal quickly.
The proliferations have started already, so a follow up laser surgery will be necessary in about 3 months. Both eyes are now 20/30. But given the shape of my eye, the surgeon says that the lense may shift forwards or back as it heals. If I want corrective laser surgery that would be 3 months after the next surgery.
My near and intermediate vision wasn't tested today. It is definitely not 20/20. All the tests will be done next week.
The proliferations have started already, so a follow up laser surgery will be necessary in about 3 months. Both eyes are now 20/30. But given the shape of my eye, the surgeon says that the lense may shift forwards or back as it heals. If I want corrective laser surgery that would be 3 months after the next surgery.
My near and intermediate vision wasn't tested today. It is definitely not 20/20. All the tests will be done next week.
Left eye was done today and already, there are differences. My recovery on this eye is going to be much longer. The vision hasn't cleared up to the same extent at the end of the day and there is more pain. Putting the drops in is excruciating.
Post op check up in the morning for both eyes.
Post op check up in the morning for both eyes.
I should add that although I brought up the possibility of other eye issues, it seems like the fact that you had 20/15 vision at intermediate initially suggests that you should be able to get to at least 20/20 at distance, or worst case at least get that with correction.
Have an Answer?
You are reading content posted in the Eye Care Community
Top General Health Answerers
Kansas City, MO
Grand Prairie, TX
San Diego, CA
Discharge often isn't normal, and could mean an infection or an STD.
In this unique and fascinating report from Missouri Medicine, world-renowned expert Dr. Raymond Moody examines what really happens when we almost die.
Think a loved one may be experiencing hearing loss? Here are five warning signs to watch for.
When it comes to your health, timing is everything
We’ve got a crash course on metabolism basics.
Learn what you can do to avoid ski injury and other common winter sports injury.
