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Synchrony IOL for cataracts, anyone with experience out there?
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Synchrony IOL for cataracts, anyone with experience out there?

       I am 29 and have cataracts in both eyes. I need surgery immediately, at least in my left eye. I have done extensive research and am fairly certain that nothing available to me here is going to give me what I’m looking for. I hold dual citizenship for the US and Germany. I am considering traveling there to get the Synchrony IOL (or the new version which is called the Synchrony VU.) The synchrony does not work for myopes, but I have never needed glasses, so I should be a candidate.
          Now according to articles and dozens of studies available online, this lens really sounds like the cats meow. Data goes back to 2003, it technically has a longer track record than Crystalens does. It has appeared that FDA approval is imminent since 2008. (My health insurance won’t pay in Germany, and you have no protection in the event of malpractice there either, I was hoping I’d be able to just get it here.) Another bonus is they are using the femto laser for the surgery in most surgical centers there, and it’s supposed to have much lower complication rates as well as reduced healing time, and be much safer than standard small incision.  
       There are now two versions of the Synchrony available, one of them is the original one which has been in FDA trials in the US, and the other is the Synchrony VU, which is supposed to have a 15% improvement in near vision over the older version. (It also appears that this update to the lens is the reason why FDA approval has been delayed, they want to forget the studies on the first one, and move on to the newer lens before approving.) Studies indicate that something like 90% of study participants can see 20/40 or better at near, with many seeing 20/25 or better.  It shows objectively measured evidence of up to 4 diopters of accommodation, and it continues to function even at 5 year follow up studies (with vision IMPROVING during that time) and AFTER YAG capsulotomy. Another interesting fact is YAG capsulotomy is almost never necessary, its very rare because this lens completely fills the capsular bag and scar tissue does not form. (Interestingly, cataract surgery does not raise your risk of retinal detachment, the YAG capsulotomy does because it creates a larger space for the vitreous in your eye to fill which can eventually cause it to peel off the retina)
Given my age, a lower risk of retinal detachment than every IOL in this country is a major bonus.  Also, while interlenticular opacification was a concern based on the design of the lens, studies involving rabbit eyes have not shown any occurences. Human studies reported 8% of participants using glasses for some activities some of the time, with only 3% using them for some activities all of the time.  In one study they determined that reading speed was slightly FASTER than with a monofocal IOL, and contrast sensitivity and perception of glare or haloes was identical, meaning, issues are rare. There should be no drawbacks to having a synchrony over having a standard monofocal based on study evidence. The ONLY drawback that can be found online is that the new version, the Synchrony VU, leaves a small percentage of patients one or two diopters myopic even after healing. They should be able to read while wearing their distance glasses, but they could require distance glasses. It goes on to say that if lasik is done on these participants, they had the same visual outcomes as the ones who turned out perfectly after surgery. It certainly sounds like it should revolutionize the market as soon as the FDA catches us up with the rest of the world.
     However, when I called a clinic in Munich, the doctor told me that in 30% of his patients, there is NO ACCOMODATION whatsoever, and the lens is essentially a very expensive monofocal. He also stated that he had stopped offering the Synchrony VU and switched back to the older version because MOST people who got it were myopic and unhappy. He stated he has almost no requests for this lens. At another clinic near Dusseldorf, they used the Synchrony VU, but they told me that 20% of patients have NO ACCOMODATION. It made me wonder why these figures were not reported in ANY of the studies available, nor were they mentioned or even implied by any of the dozens of the doctors who have been singing its praises since it was first developed. One would think that if this lens doesn’t work in 20-30% of people, that information should be reflected in the studies, but its not.
     Curious, I emailed three people whose names had appeared in studies about how great the Synchrony is. All had at least at one time, had a paid relationship with Visiogen and Abbot (the company that produces the lens) that had been disclosed wherever they made a mention to the synchrony. One of them replied to my email and said that he’d be happy to answer all of my questions on the phone, for $500 an hour, although in no way would the conversation constitute a doctor patient relationship.  Just what I need.
       The next one stated that my research was correct, many eyes were not able to accommodate at all, and even those that could were only able to accommodate very little. He had no idea why some could accommodate while others could not. He also stated that the lens has no UV protection at all, and going outside without sunglasses for any length of time would be dangerous. He stated that overseas surgeons have been less than enthusiastic about the synchrony, and he then recommended I do minimonovision with monofocals.
      The response from surgeon number three was just as bad. He apologized, stating that he did not have the time to answer my questions and couldn’t advise me without seeing me. He stated that I was correct that many patients did not get much accommodation, and then said something extremely troubling when you consider its source. “I personally would not send my own family member to Europe to get the lens at this time.”
      Okay. Obviously, there’s a problem here. First off, the studies are flat out concealing information. I don’t know if they are kicking out participants who cannot accommodate, or are basing visual acuity on both eyes together, so that even if one doesn’t work, they can still see close up from the other eye. I wouldn’t consider either one to be ethical. Secondly, if everything else about the Synchrony is true, (even if it doesn’t work for 1 out of every 4 eyes) why would everyone who is pushing this lens publicly advise me against it? Even taking into consideration that it may not work, I should still have an 87.5% chance of having at least one eye that can accommodate normally, with absolutely no drawbacks over a monofocal and a lower risk of retinal detachment. Why would one surgeon insist monofocals are a better option, and another tell me that he wouldn’t let his own family members get this lens? If I would only consider a monofocal here, and the Synchrony is touted as having all the benfits of a monofocal plus some and nobody can list any drawbacks then why is everyone warning me to stay away from it? Of course, they're being very ominous about it too, everyone tells me to stay away but nobody is willing to tell me why.
       I can’t find anyone who has this lens, there are no user reviews positive or negative. The data looks wonderful, but the same people who published the data are telling me to stay away from it. That and communicating with Europe has been next to impossible. I’ve pretty much concluded I’d just have to show up there if I want it. I’m desperate enough to avoid the loss of all accommodation while still in my twenties to do it, but I really need to know the truth about this. Why am I being advised a monofocal is a better option when all research indicates that the worst case outcome with the synchrony is a monofocal?
14 Comments Post a Comment
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233488_tn?1310696703
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Avatar_m_tn
I had many of the same questions as you last year and explored many of the same options.

The synchrony was not an option for me due  my high myopia. I too encountered variable success rates with the Synchrony when talking to doctors.

I chose the light adjustable lens (LAL) from Calhoun Vision. I describe my experience in the following post:
http://www.medhelp.org/posts/Eye-Care/Cataract-lens-choice-Nanoflex-or-Light-Adjustable-Lens/show/1680667#post_7672779

As of today, my distance vision is 20/20 and i have not had any complications (no YAG so far -- being someone with a previous retinal detachment, this worries me).

If you want to have a good range of vision you may want to look at Binovision with the LAL.  Seach for Dr Sylvia Paulig from Germany. I considered it but best outcomes for it occur when both eyes are done withing a week of each other and the LAL adjustments are done on both. Given that I have a history of retinal detachment, I did not want to risk things with both eyes so I only did the LAL in my worst eye. I did talk to a patient of hers that had both eyes done and had a great outcome.

Feel free to msg me with any further questions,
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Avatar_f_tn
I wrote the above post a few months ago. I finally decided to bet the farm, and I went to Germany and had the Synchrony VU implanted bilaterally at Knappshafts Krankenhaus in Bochum. I should be able to answer all of the above questions if anyone is curious, as well as provide information about my own outcome. I just figured I should put this out there for anyone else who is in the same situation I was in. Feel free to message me.
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Avatar_n_tn
I appreciate both your posts so far and would love to hear any details you can provide. You also seem like a pretty good researcher, digging up some bad info on Synchrony. I had only read good things on the internet (and oddly, not a single post from a recipient, until now.).

I am also in the U.S. and tempted to get a higher-tech lens than is available here. Synchrony seemed the best thing out there, and I was thinking about London Eye Hospital who offered it, but I at least made an appointment with a surgeon here in the U.S.  for a consultation about it, figuring he might have some inside scoop, medical journal access, etc. I think he thought the consult was to get questions answered about his services before I used them, and he seemed to be insulted to some extent when he realized I wasn’t considering using him as a surgeon, but only for information or possibly to assist or ‘tune up’ or maintain my eyes afterwards. He said “do yourself a favor and don’t have that lens implanted”, but he didn’t offer his reasoning. However I asked what he thought about the Finevision multifocal lens they also could implant in London and he said “Now, I actually DO like that lens”, so perhaps he was giving his honest thoughts about both. I abandoned the rush to get an implant, waiting for … I don’t know. Something.

So here you are giving me some fresh hope again about the Synchrony. Did you forge ahead even with the bad data you previously dug up, or did you get some better data elsewhere? I hope you get good results in any case… And how is it so far? Are you able to accommodate? Does it take practice/concentration or does it happen naturally?
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233488_tn?1310696703
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Avatar_m_tn
Updates would be greatly appreciated.  Hopefully you are doing well.
What made you decide on the Synchrony over the Crystalens?  There must have been advantages to offset the lack of US availability/
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Avatar_m_tn
Hope you are doing well.  I'd really like to hear your outcome.  
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Avatar_m_tn
Yes, would love to hear about your outcome.
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Avatar_m_tn
It would be great to hear about your outcome.
Hope you are doing well.
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Avatar_m_tn
Hello, I live in New Zealand and cannot get Synchrony. I will be in Spain for 3
months and consider getting Synchrony whilst there. Would appreciate to hear more about your experiences.
Kind regards, john
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Avatar_f_tn
Hi, I hope you are well and happy with your decision to have your surgery done in Germany. I live in California and it was recommended to me to have cataract surgery with the AcrySof IQ ReSTOR multifocal lens.  After reading about it I worry it may not be the best for me.  Could you please report back and tell us how your surgery went, and what the outcome was.  I grew up in Germany and it would be easy to have the work done there.  Thank you for taking the time to post!
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Avatar_m_tn
I have held off a year now with hopes the Sychroney would get FDA approval.  But not yet.  My surgeon currently uses Restor but indicated if Synhcroney  was available he would recommend it as his #1 choice.

Please send me any pros or cons of the Restor asI can't wait another year on the FDA

Jim G
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