A diary of a Finevion IOL implant

[Woodvillewomble]

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

[Dogminder]

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.

[SoftwareDeveloper]

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.  

[Dogminder]

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?

[Vizard]

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.

[Woodvillewomble]

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

[Woodvillewomble]

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