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Has Any One Else Had This Very Unusual Vision Issue with Symfony Lens?
I had a cataract surgery on my right eye a week back and decided to go with A Symfony Toric Lens because of all the positive things I have read about the lens. I have had a IOL in my left eye for almost 18 years, which I have been happy with for reading, so that I was looking basically for good distance and intermediate vision with the Symfony (I am used to monovision for the last 25 years).
My right eye still has some astigmatism (slowly improving), had issue with seeing streaks from lights for only the first 3 days, am seeing halo around the lights (will probably get adjusted to it), but also have another interesting vision issue which I had not seen mentioned by any of the doctors or the patients on the web. Using just my right eye, I don't just see a halo around a light, but see about 7 perfect concentric circles around the light, with the diameter of the outermost circle being about 3-4 times that of the halo diameter. Since the Symfony lens has the unique feature of having about the same number of circular “diffractive echelette design” in the lens, I am sure that the concentric circles which I am seeing is because of this proprietary design.
Looking through these circles to look at a light is like looking at a light through a spider web. It is not so bad that I wish that I had not selected Symfony lens (I like the Extended Vision),
But why has this Multiple Concentric Circle effect of Symfony Lens not been publicized more?
Have any of the other Symfony Lens users experienced seeing these concentric circles (and not just a halo) around a light?
My right eye still has some astigmatism (slowly improving), had issue with seeing streaks from lights for only the first 3 days, am seeing halo around the lights (will probably get adjusted to it), but also have another interesting vision issue which I had not seen mentioned by any of the doctors or the patients on the web. Using just my right eye, I don't just see a halo around a light, but see about 7 perfect concentric circles around the light, with the diameter of the outermost circle being about 3-4 times that of the halo diameter. Since the Symfony lens has the unique feature of having about the same number of circular “diffractive echelette design” in the lens, I am sure that the concentric circles which I am seeing is because of this proprietary design.
Looking through these circles to look at a light is like looking at a light through a spider web. It is not so bad that I wish that I had not selected Symfony lens (I like the Extended Vision),
But why has this Multiple Concentric Circle effect of Symfony Lens not been publicized more?
Have any of the other Symfony Lens users experienced seeing these concentric circles (and not just a halo) around a light?
Could to what degree individuals see the halos, circles, etc with IOLs vary with how much each person's pupils dilate in dark (low light) conditions? I've read some report their eye doctor have prescribed eye drops that can reduce the dilation of your eyes to help reduce the halo effect, so if someone naturally didn't dilate as much in the dark perhaps he would not be bothered as much by the halo, etc. effects? Could that be the key to the variation between how much this affects night vision between different individuals?
I'm considering perhaps having one eye with a Symfony Toric for good intermediate and acceptable reading distance and the other eye with a Tecnics Toric (monofocal) for good distance, that might provide good night vision better than both Symfony IOLs. Though if I started with the Symfony in one eye I could see if for me the night vision with it is a big issue or not before deciding months (or years) later for which IOL to use in the other eye?
I'm considering perhaps having one eye with a Symfony Toric for good intermediate and acceptable reading distance and the other eye with a Tecnics Toric (monofocal) for good distance, that might provide good night vision better than both Symfony IOLs. Though if I started with the Symfony in one eye I could see if for me the night vision with it is a big issue or not before deciding months (or years) later for which IOL to use in the other eye?
17 Comments
Could some with the Symfony IOL that experiences the halos/circles/spiderwebs from some lights in dark environment, try looking at an LED flashlight for awhile to constrict your pupils and then see how much the effect changes?
Our practice has had good experience with Tecnics aspherical monofocal and toric IOLs, minimal complaints of night vision problems, minimal dysphotopsia, minimal IOL rotation and not removal/exchange.
Have the newer Tecnics Toric monofocal IOLs realized the advantages they claim over Alcon's IQ Toric IOLs? Would the Tecnics torics now be recommended over the Alcon IQ torics? I know the Alcon has the blue filter which the Tecnics do not.
I think you shouldn't stress out over the choice of implants. Think about automobiles. Lots of ranting and raving over what is the "best" automobile but there clearly is no "best" automobile and most of them are extremely good and reliable delivering varingly levels of luxury, power, gas economy, etc. If there was a single IOL that was so superior to its peers then all surgeons would use it. In fact when surgeons have cataract surgery on themselves they pick different types of lens. 99.9% of people would not be able to tell the difference between a Alcon toric and a tecnis toric if the power and axis were the same.
How about longer term stability on toric IOLs? Tecnics claims their toric IOLs have better rotational stability than others, for example. Thats very important!
Has not been a problem. Most of what you are reading is advertisement from the IOL companies and of course they all claim to be the best.
Is it true that most toric IOL rotation happens early on in the first weeks or first month and that it if no rotation happens by then it will stay stable after the healing is complete.
However since toric IOLs have only been available for a few years, I guess nobody can be sure of the very long timer stability, that I may need of 30+ years if I live as long as my parents that made it to their early 90s...
However since toric IOLs have only been available for a few years, I guess nobody can be sure of the very long timer stability, that I may need of 30+ years if I live as long as my parents that made it to their early 90s...
Indeed the IOL companies of course will claim they are superior in many of the factors to compare against competitors. Thats why I wish there was some 3rd party impartial review comparisons for us IOL shoppers. Since hopefully this is a once in a lifetime choice/decision I want to make it carefully with as much info as possible to weigh the pros and cons of each. Not just between IOL companies and types, but also between say toric IOL vs the various alternative cornea surgery techniques (LRI, AK, LASIK) to eliminate astigmatism.
Hmmmmm This weird program they use on MedHelp and don't seem to be able to fix just lost my answer. So toric IOLs rarely rotate because after 3-5 weeks the IOL forms adhesion's to the lens capsule. Most problems with toric IOL are off axis insertions at the time of surgery.
Yes, I read of toric IOL off axis issues more common on patients with smaller pupils. Is that something a surgeon more experienced with the Toric IOLs can prevent from happening? Is there any specific equipment with laser assisted cataract surgery that can help improve the chances of a good Toric IOL insertion from the start?
Yes its called ORA technology. Adds a great deal to the cost.
Yes, I read about Optiwave Refractive Analysis system (ORA) at the website of the eye surgeons I'm considering that have that advanced technology and IOLs. It appears to allow the surgeon to verify the IOL implanted in real time during the surgery?
That's what is claimed BY THE MANUFACTURER. No controlled study has shown a benefit of ORA or femtosecond laser over standard surgery.
Gggggg
Any update on if Halos went away. I'm 6 weeks put and just had a lens rotation. Lens was off by 16 degrees and I was told it was off by 3-10. Hoping some of the daytime halos to away soon. Vision is 20/25 after rotation and still healing again.
1 Comments
I had a Symfony IOL implanted in my non-dominant eye in early December 2016. I had previously had implanted a ReZoom lens in my dominant eye 11 years ago.
I too was a bit surprised by the spider web effect with the Symfony IOL. I am still glad I made the choice as my daytime office job vision is outstanding. While night time driving is not bothersome it is rather noticeable. I see different spider web intensity depending on the color of the light. At intersections for example I see these halos least with the green lights and most with the yellow followed by red. In addition, as I get closer to the source the spider web diminishes and disappears.
Before my Symfony implant I tuned out the single ring halo effect I have with my ReZoom implant. Now that the Symfony has been implanted for two months I have learned to tune out the spider web effect but unfortunately my brain has tuned in the single ring effect of my ReZoom lens.
The target was achieved to leave me slightly myopic in my Symfony implant for “balance” purposes ( I have poor intermediate focus with the ReZoom lens).
I am due to see my doctor later this month and may ask if we can test a tuning of my vision with contact lens” in an attempt to balance out my daytime vision with the night time halos.
I too was a bit surprised by the spider web effect with the Symfony IOL. I am still glad I made the choice as my daytime office job vision is outstanding. While night time driving is not bothersome it is rather noticeable. I see different spider web intensity depending on the color of the light. At intersections for example I see these halos least with the green lights and most with the yellow followed by red. In addition, as I get closer to the source the spider web diminishes and disappears.
Before my Symfony implant I tuned out the single ring halo effect I have with my ReZoom implant. Now that the Symfony has been implanted for two months I have learned to tune out the spider web effect but unfortunately my brain has tuned in the single ring effect of my ReZoom lens.
The target was achieved to leave me slightly myopic in my Symfony implant for “balance” purposes ( I have poor intermediate focus with the ReZoom lens).
I am due to see my doctor later this month and may ask if we can test a tuning of my vision with contact lens” in an attempt to balance out my daytime vision with the night time halos.
1 Comments
Good luck. You had better luck with the ReZoom than most people.
I had the Symfony lens implanted on Jan 11, 2017.
It's only a week later but I immediately saw the circles, including a starburst and a stronger beam across these at about a 40 degree angle. This spider web image is a good description and occurs in headlights, brake lights, and any bright light.
My vision is 20/25 and is very close to my other eye with exception of slight loss of clarity or contrast watching TV or at long distances. Black and colors are less intense.
Viewing my phone at arms length is good.
These comparisons are against my other eye which has the AMO monofocal lens from 2 years ago. I also have light issues with this lens although not as annoying.
I see a semicircle with partial starburst which could best be described as an ( Asian Fan ).
Literature about this phenom was not available so I feel I was not given accurate info regarding side effects. Halos were downplayed.
It's still very early but I am not optimistic that these symptoms with night driving will subside given that my other eye still has issues.
It's only a week later but I immediately saw the circles, including a starburst and a stronger beam across these at about a 40 degree angle. This spider web image is a good description and occurs in headlights, brake lights, and any bright light.
My vision is 20/25 and is very close to my other eye with exception of slight loss of clarity or contrast watching TV or at long distances. Black and colors are less intense.
Viewing my phone at arms length is good.
These comparisons are against my other eye which has the AMO monofocal lens from 2 years ago. I also have light issues with this lens although not as annoying.
I see a semicircle with partial starburst which could best be described as an ( Asian Fan ).
Literature about this phenom was not available so I feel I was not given accurate info regarding side effects. Halos were downplayed.
It's still very early but I am not optimistic that these symptoms with night driving will subside given that my other eye still has issues.
7 Comments
In terms of comparison of vision between your eyes, it is interesting to hear from people with two different lenses. I will note however that can take some time to adapt to the Symfony's different optics, and your eye's physical healing may be impacting things at first as well. The differences between your eyes can also be impacted by things like any residual astigmatism or refractive error, or also merely other factors in terms of the eye's visual system. Even before my cataract appeared, I had slightly better corrected vision in one eye than the other even though both were considered healthy.
I'm not sure if the issue with the monofocal lens you are describing is meant to describe an odd shaped halo, or a phenomenon you see in general, a dysphotopsia perhaps from the lens edge which is a different issue.
In terms of "literature on this phenom" of Symfony halos, here is one article that covers the data on halos&glare with the Symfony vs. monofocals:
http://www.healio.com/ophthalmology/refractive-surgery/news/print/ocular-surgery-news/%7B02f433be-622c-4611-94b5-77900b429e20%7D/high-rates-of-spectacle-independence-patient-satisfaction-seen-with-symfony-iol
Unfortunately there is no IOL in existence that doesn't give someone problematic halos, even people still with their natural lens have issues that can cause halos. Data I'd seen suggests the Tecnis monofocal has a lower risk of problematic halos than other lenses, so if you do have a halo issue with a Tecnis monofocal even after a couple of years it may mean unfortunately your are more prone to the issue for some reason.
In terms of the Symfony halos, it is too early to say what your final result will be like since most people who do see halos even with monofocals during the initial few months do see them eventually go away. During the first week especially the eye is still healing physically, and then the brain need to adapt to its new optics. Even some people with multifocals who still see halos after the first few months have seen them subside over the the next several months or a year or two,
It may be that I haven't been out at night enough to adapt faster, but I've actually recently (at 2 years+ postop) started to notice I sometimes don't see halos around lights where I used to always see them (e.g. various LEDs around home).
In my case as I've posted before I haven't considered my halos with the Symfony to be problematic , they've been mild/translucent (and made up for by having less glare than I can remember before cataracts).
I'm not sure if the issue with the monofocal lens you are describing is meant to describe an odd shaped halo, or a phenomenon you see in general, a dysphotopsia perhaps from the lens edge which is a different issue.
In terms of "literature on this phenom" of Symfony halos, here is one article that covers the data on halos&glare with the Symfony vs. monofocals:
http://www.healio.com/ophthalmology/refractive-surgery/news/print/ocular-surgery-news/%7B02f433be-622c-4611-94b5-77900b429e20%7D/high-rates-of-spectacle-independence-patient-satisfaction-seen-with-symfony-iol
Unfortunately there is no IOL in existence that doesn't give someone problematic halos, even people still with their natural lens have issues that can cause halos. Data I'd seen suggests the Tecnis monofocal has a lower risk of problematic halos than other lenses, so if you do have a halo issue with a Tecnis monofocal even after a couple of years it may mean unfortunately your are more prone to the issue for some reason.
In terms of the Symfony halos, it is too early to say what your final result will be like since most people who do see halos even with monofocals during the initial few months do see them eventually go away. During the first week especially the eye is still healing physically, and then the brain need to adapt to its new optics. Even some people with multifocals who still see halos after the first few months have seen them subside over the the next several months or a year or two,
It may be that I haven't been out at night enough to adapt faster, but I've actually recently (at 2 years+ postop) started to notice I sometimes don't see halos around lights where I used to always see them (e.g. various LEDs around home).
In my case as I've posted before I haven't considered my halos with the Symfony to be problematic , they've been mild/translucent (and made up for by having less glare than I can remember before cataracts).
Thanks SoftwareDeveloper. Both eyes have negligible astigmatism for these lens.
Rt. AMO Mono 19D 13mm 6mm
Lt. Symfony 18.5D SE 13mm 6mm
Hopefully the (light show) will calm down and I will post again after a few weeks.
Rt. AMO Mono 19D 13mm 6mm
Lt. Symfony 18.5D SE 13mm 6mm
Hopefully the (light show) will calm down and I will post again after a few weeks.
In rereading the Symfony brochue and it states, You may notice, Halos, starbursts, and glare and other visual symptoms.
When researching info about this lens, the common term used for comparisons to a monofocal lens was HALO. And compared to what specific IOL which is not spelled out. You would assume the best IOL's but maybe not, as that would make their comparisons less optimal?
STARBURSTS and CONCENTRIC CIRCLES were never mentioned and AT201's comments are spot on. It's a big stretch to lump all these together as simply HALOS.
In low light I see halos with both lenses and would describe this as ( A HAZE AROUND THE MOON ), as well as looking at LED's from electronic equipment in total darkness.
Brake lights bring out the concentric circles and starburst combined. (SPIDER WEB)
With headlights and other bright lights the STARBURST dominates.
My night vision is good in spite of this detraction.
My other experiences with medical procedures is that the negatives are always glossed over. I agree with at201, we were mislead!
Time will tell if these symptoms abate, so the JURY IS OUT if I would recommend this lens to friends.
When researching info about this lens, the common term used for comparisons to a monofocal lens was HALO. And compared to what specific IOL which is not spelled out. You would assume the best IOL's but maybe not, as that would make their comparisons less optimal?
STARBURSTS and CONCENTRIC CIRCLES were never mentioned and AT201's comments are spot on. It's a big stretch to lump all these together as simply HALOS.
In low light I see halos with both lenses and would describe this as ( A HAZE AROUND THE MOON ), as well as looking at LED's from electronic equipment in total darkness.
Brake lights bring out the concentric circles and starburst combined. (SPIDER WEB)
With headlights and other bright lights the STARBURST dominates.
My night vision is good in spite of this detraction.
My other experiences with medical procedures is that the negatives are always glossed over. I agree with at201, we were mislead!
Time will tell if these symptoms abate, so the JURY IS OUT if I would recommend this lens to friends.
Unfortunately even if a problem is rare, *someone* winds up being the statistic. Online forums can give a skewed view of the level of problems since usually only those with issues post, even if the vast majority of patients have no trouble.
It is unfortunate that they use the generic term "halo" to describe things with varied appearance, but thats been common all along and isn't unique to the Symfony. The halos with multifocal lenses can also involve multiple concentric circles. Here is one surgeon's blog post giving his patients experience with the Symfony after his first year of implanting it, where he comments on the halo issue:
http://eyesurgerysingapore.blogspot.com/2015/10/my-experience-implanting-symfony-lens.html
"What about halos?
Some patients, when asked, did describe mild halos around lights at night (such as car headlamps or traffic lights) but were not troubled by these halos. One patient even called it pretty!
The distinguishing feature of Symfony related halos (mentioned by 18% of my patients) seemed to be that they were quite mild/light, and patients were able to see through the halos.
Personal thoughts
There is still no perfect solution for presbyopia as yet. However, I think for myself, the Tecnis Symfony is one of the best compromises out there at the moment.
1. Minimal halos
"
It is unfortunate that they use the generic term "halo" to describe things with varied appearance, but thats been common all along and isn't unique to the Symfony. The halos with multifocal lenses can also involve multiple concentric circles. Here is one surgeon's blog post giving his patients experience with the Symfony after his first year of implanting it, where he comments on the halo issue:
http://eyesurgerysingapore.blogspot.com/2015/10/my-experience-implanting-symfony-lens.html
"What about halos?
Some patients, when asked, did describe mild halos around lights at night (such as car headlamps or traffic lights) but were not troubled by these halos. One patient even called it pretty!
The distinguishing feature of Symfony related halos (mentioned by 18% of my patients) seemed to be that they were quite mild/light, and patients were able to see through the halos.
Personal thoughts
There is still no perfect solution for presbyopia as yet. However, I think for myself, the Tecnis Symfony is one of the best compromises out there at the moment.
1. Minimal halos
"
It has been about 3 weeks since my first post (and a month since my cataract surgery) on the visual issue of the undesirable concentric-circles, which I have been having with Symfony Lens. Thought that I may provide a quick update of my related experience for the benefit of the people who may be considering Symfony lens. so that they can make a more informed decision.
Even though my corrected distance vision (with glasses for correcting astigmatism) is 20/16 (6/4.75 in the metric scale), there has been no change in my seeing the undesirable concentric circles. If I look at a light in front of a house 50 yards away at night, I see a 1 to 2 feet diameter relatively-bright circular area around the light. I know that that can be an issue with even monofocal lenses. However, in addition to that area, I see 8-9 lighted circles (with dark bands separating them). These circles are less bright, but extend to about 10-12 feet diameter around the light, which is a huge area. I can see through the circles, but it is like seeing the world through a large spider web or even a dirty windshield in a car.
Of course, I see similar concentric circles around car headlights at night, with the concentric circles extending much wider than the width of the car. This would be a bigger issue for the people who have to drive a lot at night.
One can obviously learn to live with these effects and just enjoy the benefits which the Symfony lens offers. But it is important to be aware of these while making the lens choice after a cataract surgery.
To end this on a more positive note, I don't see the concentric-circles in the day time or at shorter distances inside a building.
Even though my corrected distance vision (with glasses for correcting astigmatism) is 20/16 (6/4.75 in the metric scale), there has been no change in my seeing the undesirable concentric circles. If I look at a light in front of a house 50 yards away at night, I see a 1 to 2 feet diameter relatively-bright circular area around the light. I know that that can be an issue with even monofocal lenses. However, in addition to that area, I see 8-9 lighted circles (with dark bands separating them). These circles are less bright, but extend to about 10-12 feet diameter around the light, which is a huge area. I can see through the circles, but it is like seeing the world through a large spider web or even a dirty windshield in a car.
Of course, I see similar concentric circles around car headlights at night, with the concentric circles extending much wider than the width of the car. This would be a bigger issue for the people who have to drive a lot at night.
One can obviously learn to live with these effects and just enjoy the benefits which the Symfony lens offers. But it is important to be aware of these while making the lens choice after a cataract surgery.
To end this on a more positive note, I don't see the concentric-circles in the day time or at shorter distances inside a building.
2 Comments
Its important to be aware of the risks of problems, but also to keep those risks in perspective. Studies report the risk of problematic halos with the Symfony as being comparable to those with a monofocal, not quite as good as the best monofocals but better than others (though its hard to know exactly how the risks between IOLs compare since often different studies ask questions slightly differently, so its only when 2 IOLs are used in the same study that you can be sure a comparison isn't misleading).
The nature of the halos that people see may be different with the Symfony, more likely to be concentric circles, but most people don't find them a problem. Unfortunately *someone* winds up being the statistic so its necessary to be prepared for the possibility, since unfortunately you can't predict who will have problems beforehand.
at201 hasn't had his IOLs that long, many people see halos reduce or go away during the first few months. That is why most studies on IOLs only report the issue after 3 or 6 months (though even after that point many see the halos become less of a problem).
There are some people that see halos but don't find them to be a problem, as in my case. Obviously I wish they weren't there, but they are so mild/translucent that I see through/past them. I think there is less glare in general at night than I recall back before cataracts so my night vision actually seems better overall than I can remember (though memory of a few years past may be flawed of course).
The nature of the halos that people see may be different with the Symfony, more likely to be concentric circles, but most people don't find them a problem. Unfortunately *someone* winds up being the statistic so its necessary to be prepared for the possibility, since unfortunately you can't predict who will have problems beforehand.
at201 hasn't had his IOLs that long, many people see halos reduce or go away during the first few months. That is why most studies on IOLs only report the issue after 3 or 6 months (though even after that point many see the halos become less of a problem).
There are some people that see halos but don't find them to be a problem, as in my case. Obviously I wish they weren't there, but they are so mild/translucent that I see through/past them. I think there is less glare in general at night than I recall back before cataracts so my night vision actually seems better overall than I can remember (though memory of a few years past may be flawed of course).
Interesting because this was one of the screening questions asked when I saw my soon-to-be cataract surgeon recently. The questions were along the lines of what is most important to me - seeing clearly at all distances with the possibility of some halos around lights, seeing clearly at distance but having to wear reading glasses up close, etc.
I have two Symfony lenses. One installed in October and the other in November. Left eye is near the right for distance. I have excellent vision. It is like going from standard definition to high definition. I get those rings. Perfect shape like Saturn rings. Car brake lights are mild but headlights are intense. Halogen lights are strong blinding out the rings the new LED headlights I can see the rings clearly.
1 Comments
Sorry for being late in responding to you. For some reason, I have not been getting any notifications that people have responded to my question.
Any way, thanks for your feedback. Even though we have to live with the visual issue of concentric circles or rings, it is nice to know about the similar experience of others.
Any way, thanks for your feedback. Even though we have to live with the visual issue of concentric circles or rings, it is nice to know about the similar experience of others.
'But why has this Multiple Concentric Circle effect of Symfony Lens not been publicized more? '
I have now-elderly ReStor D1s in both eyes for cataracts done some years ago. I am soooo pleased! My sight, night and day, near and far, is better than it was when I was a kid.
In my case, I believe I have at least 10 and maybe 13 concentric circles that my brain chooses from for focus. At first, I was aware of this arrangement, for it truly is a halo effect.
However, my brain adjusted to it almost instantly, for my new vision was so much better than it had been for years that the slight haloing was insignificant by comparison. In fact, I edited it out within hours.
I'd be willing to bet that the reason for the small amount of publicity concerning the effect is that most people's brains make the same quick adjustment and as a result, they adjust quickly and don't give negative feedback to their doctors.
I have now-elderly ReStor D1s in both eyes for cataracts done some years ago. I am soooo pleased! My sight, night and day, near and far, is better than it was when I was a kid.
In my case, I believe I have at least 10 and maybe 13 concentric circles that my brain chooses from for focus. At first, I was aware of this arrangement, for it truly is a halo effect.
However, my brain adjusted to it almost instantly, for my new vision was so much better than it had been for years that the slight haloing was insignificant by comparison. In fact, I edited it out within hours.
I'd be willing to bet that the reason for the small amount of publicity concerning the effect is that most people's brains make the same quick adjustment and as a result, they adjust quickly and don't give negative feedback to their doctors.
I did hear from a person on the "Patient" site, who has had exactly the same experience of seeing 7-10 concentric circles around a light (or its halo) due to the Symfony lens. He also gave me the idea of finding the drawings of this vision issue by searching for "My intraocular lens experience David Taylor, Stevenage, England" in a search engine.
It is a little bit of a relief to know that I am not the only one who has gone through this issue with Symfony lens, but I am still amazed that this issue has not mentioned at all by the proponents of Symfony lens.
It is a little bit of a relief to know that I am not the only one who has gone through this issue with Symfony lens, but I am still amazed that this issue has not mentioned at all by the proponents of Symfony lens.
7 Comments
As I responded on the patient site (where they moderate links which is why I suggest a google search):
The phenomenon you are describing is considered a halo, even though its more than one circle, so it has been publicized, though mostly because the incidence of halos is low comapred to multifocals. Its likely due to the diffractive rings and there can be similar halos with multifocal lenses (statistically more problematic than with the Symfony), .e.g. google:
"Optical bench performance of AcrySof® IQ ReSTOR®, AT LISA® tri, and FineVision® intraocular lenses"
and look at the simulated headlight images. The halos from monofocals do tend to be more concentrated in one center ring/blob than those of the Symfony and multifocals.
Usually most studies of IOLs only gather statistics after 3 or 6 months since most people who see halos early on see them disappear by then. Even some people with monofocals get halos, there isn't a lens yet that doesn't give problematic halos to some people. The statistics show the incidence of problem halos with the Symfony is in the range of monofocals, i.e. higher than a good monofocal like the Tecnis monofocal, but lower or comparable to some others.
That said, of course some people are the "statistic" that do have a problem.. as some do with any IOL
In my case I've never considered the halos a problem, but I'm one of the rare people who does sitll see them 2 years after surgery (perhaps because I just haven't been driving at night enough to adapt). I do see the concentric circles, but they are so light/translucent that I see through/past them so I don't consider them a problem.
Overall my night vision seems to be better than I can remember it being in the past, even before I had cataracts, in part since I seem to have less of a problem with glare than I can remember. I always seemed to feel I had poor night vision in the past compared to others, so I may be atypical. Despite the halos, headlights don't bother me as much since there is less glare from them, they cause less distraction from seeing the surrounding scene than I can remember from the past before cataracts. (though my memory may also be flawed since I put off surgery for a couple of years after the problem cataract appeared).
The phenomenon you are describing is considered a halo, even though its more than one circle, so it has been publicized, though mostly because the incidence of halos is low comapred to multifocals. Its likely due to the diffractive rings and there can be similar halos with multifocal lenses (statistically more problematic than with the Symfony), .e.g. google:
"Optical bench performance of AcrySof® IQ ReSTOR®, AT LISA® tri, and FineVision® intraocular lenses"
and look at the simulated headlight images. The halos from monofocals do tend to be more concentrated in one center ring/blob than those of the Symfony and multifocals.
Usually most studies of IOLs only gather statistics after 3 or 6 months since most people who see halos early on see them disappear by then. Even some people with monofocals get halos, there isn't a lens yet that doesn't give problematic halos to some people. The statistics show the incidence of problem halos with the Symfony is in the range of monofocals, i.e. higher than a good monofocal like the Tecnis monofocal, but lower or comparable to some others.
That said, of course some people are the "statistic" that do have a problem.. as some do with any IOL
In my case I've never considered the halos a problem, but I'm one of the rare people who does sitll see them 2 years after surgery (perhaps because I just haven't been driving at night enough to adapt). I do see the concentric circles, but they are so light/translucent that I see through/past them so I don't consider them a problem.
Overall my night vision seems to be better than I can remember it being in the past, even before I had cataracts, in part since I seem to have less of a problem with glare than I can remember. I always seemed to feel I had poor night vision in the past compared to others, so I may be atypical. Despite the halos, headlights don't bother me as much since there is less glare from them, they cause less distraction from seeing the surrounding scene than I can remember from the past before cataracts. (though my memory may also be flawed since I put off surgery for a couple of years after the problem cataract appeared).
Sorry for not responding to you on this web site earlier because I was not aware of this message here.
Thanks for your feedback. It is nice to know that I am not the only one with the issue of seeing the concentric circles with the symfony lens and that the vision may get better as the time passes.
However, I do think that to call 10 concentric circles extending about 10 feet each side of a head light also just a halo, when it may cover just a small area near a monofocal lens, is highly misleading. At least it was misleading to me. Let us just call a spade a spade. If there are many circles extending many feet beyond what a single-circle halo for a monofocal lens may extend, let us make sure that the potential users understand that. May be, we can tell the people that while one may have a halo with a monofocal lens, one may see many concentric halos (if one wants to call a concentric circle as a halo) with the symfony lens.
Even if one does not notice the halos after a few months, that should not excuse the manufacturer and the doctors from telling the people about this issue and mislead them by saying the halo is just like that for a monofocal lens when they are trying to make a decision about the lens selection.
With my limited driving at night up to this point, I can deal with this problem by just avoiding looking at the car headlights or other bright lights, just like I deal with someone driving a car with high beams (instead of low beams) coming towards with me, but that is not an ideal solution.
Thanks for your feedback. It is nice to know that I am not the only one with the issue of seeing the concentric circles with the symfony lens and that the vision may get better as the time passes.
However, I do think that to call 10 concentric circles extending about 10 feet each side of a head light also just a halo, when it may cover just a small area near a monofocal lens, is highly misleading. At least it was misleading to me. Let us just call a spade a spade. If there are many circles extending many feet beyond what a single-circle halo for a monofocal lens may extend, let us make sure that the potential users understand that. May be, we can tell the people that while one may have a halo with a monofocal lens, one may see many concentric halos (if one wants to call a concentric circle as a halo) with the symfony lens.
Even if one does not notice the halos after a few months, that should not excuse the manufacturer and the doctors from telling the people about this issue and mislead them by saying the halo is just like that for a monofocal lens when they are trying to make a decision about the lens selection.
With my limited driving at night up to this point, I can deal with this problem by just avoiding looking at the car headlights or other bright lights, just like I deal with someone driving a car with high beams (instead of low beams) coming towards with me, but that is not an ideal solution.
I couldn't agree with you more and was so glad you posted this. I just posted my story and am figuring out how to use this site. After 5 months I am seeing these disturbing bright, concentric rings as well and am considering swapping out the lens. I am equally frustrated that this was not explained to me nor clearly publicized and to add insult to injury I believe my surgery was premature and my vision is now worse than before. I have gotten different opinions on what to do and wish I would just wake up from this nightmare!
It isn't clear what you mean in terms of vision being "worse than before" since it should be better, unless you weren't old enough to have much presbyopia, age related loss of vision, in which case the range of vision will be less, but I'm guessing that isn't usually what someone would mean by "worse than before".
If your vision is "worse than before" that suggests there may be other eye health issues at play, or the lens power being off, and both of those can increase the odds of problematic night vision artifacts and could impact the results with any IOL. Some % of people have problematic night vision artifacts with monofocal IOLs, although the shape of them may be different.
Many people are frustrated with night vision artifacts, but usually that issue by itself isn't enough to have people wishing to "wake up from this nightmare", which is why I'm suspecting there is some other issue going on here if your vision the rest of the time isn't great.
If your vision is "worse than before" that suggests there may be other eye health issues at play, or the lens power being off, and both of those can increase the odds of problematic night vision artifacts and could impact the results with any IOL. Some % of people have problematic night vision artifacts with monofocal IOLs, although the shape of them may be different.
Many people are frustrated with night vision artifacts, but usually that issue by itself isn't enough to have people wishing to "wake up from this nightmare", which is why I'm suspecting there is some other issue going on here if your vision the rest of the time isn't great.
I am 52 years old and just went originally to get an opinion as I have PSC that are just starting but was scheduled for surgery with minimal consultation or explanation of the pros/cons of the different IOLs. I am learning so much after the fact but my surgeon apparently has a reputation of doing things prematurely. I was better than 20/40 pre-surgery and mildly presbyopic so I could function without ANY glasses if needed but I like sharp vision. I believe if I was just asked if they are bothering me I would have said not really and would have been told to wait until they become problematic. Yes, I saw halos/glare around headlights but who over 50 doesn't? Post-surgery I am told my numbers are good and the lens is centered but I am getting flickering and pulsing vision pretty frequently and always the 10 rings at night around lights. The only time my vision seems good is outside during the day with my Rx sunglasses and I believe that is primarily because of the sharpness from my non-surgery eye. Bright office lights and extended computer time are difficult and is causing issues at work as I think most people believe cataract surgery isn't a big deal and people are back at work within days as I was also expecting. I have gotten different opinions, from exchanging it for a distance monofocal and leave the other eye alone since the PSC is just starting, to trying a distance monofocal in the other dominant eye to see if that helps reduce the issues instead of another Symfony, to of course put another Symfony in as they supposedly work better in tandem. I don't think there are other problems going on as they tell me everything appears OK. I think the problem was that my vision was pretty good before and that any IOL is probably going to seem worse. Yes, maybe I can read a little better up close now, but not at the expense of diminished night vision and the indoor issues plus I would have been more than happy to just wear glasses. That is apparently why many doctors make their patients wait until the vision bad enough so that any IOL seems like an improvement but that is not what happened with me unfortunately.
I can't answer your question as I see few symphony patients in my practice. However use the search feature there are numerous discussions by articulate people who have had these lens put in their eyes. Hopefully some will respond to your questions
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