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Symfony vs Monofocal lens decision hard for me to make.
I have read many of the queries here and wanted to thank you for all the time and care you take. I'm not as keyed into the terminology as others here but I wanted to ask a question.
I am getting a cataract surgery in both eyes, and have seen two eye doctors thus far. Both have suggested that there are two basic options: a Symfony and a monofocal. But I am having trouble deciding. I am 60 years old. I am a professor and spend a lot of time reading and at the computer. I typically read a book or other printed matter at around 17 inches and the computer screen from about 24 and toggle between the two. I am on the computer for about 7-9 hours per day. I like to read without glasses but now often have to take my glasses off and put a book about 6 inches from my eyes to read effectively. I have worn glasses all my life and do not mind wearing them. In fact, I'd probably prefer to continue wearing them after the surgery anyway. My vision has gotten quite a bit worse in the last two years and my last eyeglass rx was unable to correct my vision to 20/20 and I was told this was due to cataracts. My current Rx as of 4/2015 was
D.V OD spherical -5.00 -125 Cylindrical, and Axis is listed as 120
OS speherical -7.00 -050 Cylindrical, and Axis is listed as 045. Under this chart is a note: Add -1275.
One eye doctor suggested: the monofocal set to distance or close.
OR: the Symfony with the following notation: Offset left eye. Mini Mono vision (-0.50 -0.75)
I have been told the following and just wanted to clarify: that the monofocal will perform better than the Symfony, at near (reading) and at computer distance than the Symfony, which typically will correct distance. There will be more haloing with the Symfony.
I do not do much driving or night driving as I live in nyc, so the haloing is not particularly relevant, at least in terms of driving. Is there any thought as to which of the two lenses would work better for me: I am leaning toward a monofocal , and then would wear glasses (progressives ) for distant vision as I do now. Is this the best solution?
I have a few queries:
is near and computer vision better with the Monofocal? Would it work better with my scenario as described above?
Can the symfony be set so that it provides better near and computer vision, so that if I do need to wear glasses, it would be for distant vision? and the near and computer vision would be basically glasses free?
If I get the monofocal, will I need glasses for either reading or computer use? If I get the Symfony will I need to get glasses for either reading or computer use?
There is one additional element, but is not primary, Insurance covers the monofocal lens but not the Symfony. The surgery itself is covered in both cases. Thanks very much!
I am getting a cataract surgery in both eyes, and have seen two eye doctors thus far. Both have suggested that there are two basic options: a Symfony and a monofocal. But I am having trouble deciding. I am 60 years old. I am a professor and spend a lot of time reading and at the computer. I typically read a book or other printed matter at around 17 inches and the computer screen from about 24 and toggle between the two. I am on the computer for about 7-9 hours per day. I like to read without glasses but now often have to take my glasses off and put a book about 6 inches from my eyes to read effectively. I have worn glasses all my life and do not mind wearing them. In fact, I'd probably prefer to continue wearing them after the surgery anyway. My vision has gotten quite a bit worse in the last two years and my last eyeglass rx was unable to correct my vision to 20/20 and I was told this was due to cataracts. My current Rx as of 4/2015 was
D.V OD spherical -5.00 -125 Cylindrical, and Axis is listed as 120
OS speherical -7.00 -050 Cylindrical, and Axis is listed as 045. Under this chart is a note: Add -1275.
One eye doctor suggested: the monofocal set to distance or close.
OR: the Symfony with the following notation: Offset left eye. Mini Mono vision (-0.50 -0.75)
I have been told the following and just wanted to clarify: that the monofocal will perform better than the Symfony, at near (reading) and at computer distance than the Symfony, which typically will correct distance. There will be more haloing with the Symfony.
I do not do much driving or night driving as I live in nyc, so the haloing is not particularly relevant, at least in terms of driving. Is there any thought as to which of the two lenses would work better for me: I am leaning toward a monofocal , and then would wear glasses (progressives ) for distant vision as I do now. Is this the best solution?
I have a few queries:
is near and computer vision better with the Monofocal? Would it work better with my scenario as described above?
Can the symfony be set so that it provides better near and computer vision, so that if I do need to wear glasses, it would be for distant vision? and the near and computer vision would be basically glasses free?
If I get the monofocal, will I need glasses for either reading or computer use? If I get the Symfony will I need to get glasses for either reading or computer use?
There is one additional element, but is not primary, Insurance covers the monofocal lens but not the Symfony. The surgery itself is covered in both cases. Thanks very much!
"Symfony with the following notation: Offset left eye. Mini Mono vision (-0.50 -0.75) "
In some other previous threads on the Symfony IOL that "mini-mono vision" has been suggested before: fixed monofocal IOL for distance vision in one eye and a Symfony in the other eye set for intermediate+near vision. That combination should give better total range (distance, intermediate, and near) than regular mono-vision with two fixed monofocal IOLs, and hopefully less issues than using the multifocal(bifocal) IOLs.
Another option besides the Symfony IOL is the Crystalens or Trulign (toric version).
In some other previous threads on the Symfony IOL that "mini-mono vision" has been suggested before: fixed monofocal IOL for distance vision in one eye and a Symfony in the other eye set for intermediate+near vision. That combination should give better total range (distance, intermediate, and near) than regular mono-vision with two fixed monofocal IOLs, and hopefully less issues than using the multifocal(bifocal) IOLs.
Another option besides the Symfony IOL is the Crystalens or Trulign (toric version).
4 Comments
Dear Dr Hagen, thank you very much for your comments. I spoke again with my doctor today and he supplied updated info on my eyes:
This chart was supplied:
Distance Axis CYL SPH
OD 20/30 126 -00.75 -06.25
OS 20/30 047 -00.50 -7.50
The report also indicates that "astigmatism is mild and can be dealt manually." So I am unclear now if I have astigmatism or not. I always thought I had it. Is it possible that it has gone away? The figures I posted earlier today are from an eye exam dated 4/2015. The above is from 12/2016. The other option suggested was
Left nondominant: multifocal close and distant.
Right: dominant: middle and distant.
I am unclear if this is perhaps a better option than the symphony or the monofocal. In fact, I'm very confused. As per the comment by NightHawkGuy (thank you very much!) I was told by one of the doctors I consulted that she does not like to combine a Symfony with a monofocal. So now I'm really unclear what might work best here. Thanks again for help and time. Really appreciative of this.
This chart was supplied:
Distance Axis CYL SPH
OD 20/30 126 -00.75 -06.25
OS 20/30 047 -00.50 -7.50
The report also indicates that "astigmatism is mild and can be dealt manually." So I am unclear now if I have astigmatism or not. I always thought I had it. Is it possible that it has gone away? The figures I posted earlier today are from an eye exam dated 4/2015. The above is from 12/2016. The other option suggested was
Left nondominant: multifocal close and distant.
Right: dominant: middle and distant.
I am unclear if this is perhaps a better option than the symphony or the monofocal. In fact, I'm very confused. As per the comment by NightHawkGuy (thank you very much!) I was told by one of the doctors I consulted that she does not like to combine a Symfony with a monofocal. So now I'm really unclear what might work best here. Thanks again for help and time. Really appreciative of this.
You do have astigmatism in both eyes that is what the cylinder and axis refer to. You just don't have very much (half diopter LE and 3/4 diopter RE) Most toric IOLs start at about 1 or 1.25 diopters of cylinder. I don't have the experience of taking care of many patients with Symfony in one eye and monofocal in other eye. Most patients would do fine with monofocal IOL in both eyes in RE aiming for -0.25 and non-dominant -1.25. You would still need glasses for most things but without your glasses would have good distance vision in RE (greater than 20 feet) and able to use computer, see yourself in mirror and read in good light without glasses. Please read this article I wrote carefully: http://www.medhelp.org/user_journals/show/1648102/Consider-ALL-the-Options-Before-Your-Cataract-Surgery-Working-Through-Whats-Best-For-You
Thank you Dr Hagan and NightHawkGuy,
thank you very much for your comments. I wanted to ask if there are inherent problems combining the Symfony with the monofocal. This is not an option that anyone has brought up with me and I'm wondering if there is a medical reason for this, as perhaps neural adaptation is more difficult, and I'm still somewhat unclear if the combo would be more satisfactory than two monofocals. Of course I"ve read many of the posts by Software Developer and they are very positive about the Symfony lens as is one of my doctors, so I'm still uncertain what the various drawbacks and benefits would be given the above prescription. many thanks
thank you very much for your comments. I wanted to ask if there are inherent problems combining the Symfony with the monofocal. This is not an option that anyone has brought up with me and I'm wondering if there is a medical reason for this, as perhaps neural adaptation is more difficult, and I'm still somewhat unclear if the combo would be more satisfactory than two monofocals. Of course I"ve read many of the posts by Software Developer and they are very positive about the Symfony lens as is one of my doctors, so I'm still uncertain what the various drawbacks and benefits would be given the above prescription. many thanks
As I said I don't have any experience with that combo.
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