PS, I should add for anyone who is outside the US and isn't aware of this, the reason I'm going outside the US is because the government here is remarkably slow about approving new lenses. There are options that have been available for a few years in Europe that we don't have. The FDA seems to be either extremely cautious and/or extremely incompetent.
I would have to go with FDA incompetence. At some point the safety factor just is not believable. They are so afraid to approve anything, because their might be a news story about something bad happening over one of their approvals. But the harm being done to the vast majority out ways the little and I mean little good they are doing. Just common sense says that after a lenses has been approved and used in Europe for years it should be available for use here in the US.. This should be a decision between the patient and the doctor not the FDA. Thank God the FDA does not have to approve operating systems or all of us in the USA would be still using DOS.
I think you may be putting the cart before the horse in trying to pre-select an IOL. I was also considering medical tourism (Tijuana Mexico looked like fun) but I finally decided that being close to home and support was my best option and made appointments for cataract evaluations based on recommendations from my primary MD and my Optometrist with ophthalmologists that have experience with all the IOLs, rather than a one-trick pony Dr who only implants one type. I cancelled the 3rd appointment when the first 2 told me pretty much the same thing.
Stay away from multifocals.
Best results (for MY eyes) would be with torics and laser assisted surgery.
Given that it will be about a month before your eyes fully heal, I wouldn't want to be more than a phone-call and a quick drive away from the surgeon for that time period....just in case.
From what I have read the Tecnis Symfony is pretty exciting giving you vision at all distance with reduced halos and glare in comparison to other multifocal lenses. But it is new so you would be a genie pig of sorts.
I will add I taked to another person that had cateract surgery and asked why he did not choose a multifocal IOL and he did not even know about the. Apparently his Dr. did not do them so tell even tell him about them. So in cae those Drs. do not do multifocal, you might want to talk to one more Dr. that does a lot of multifocal and get their assessment.
re: "wouldn't want to be more than a phone-call and a quick drive away"
I have a very good eye surgeon here in the US who diagnosed the cataract and has no problems with doing the followups if I get surgery elsewhere. Fortunately it is possible for educated non-doctors to read the online published literature about the various lenses and make an informed choice, which in my case is to decide that the lenses approved in Europe are a better bet.
re: "Stay away from multifocals"
The research on the multifocals in Europe shows they are much better than the older ones available in the US. Some surgeons in Europe I gather had stopped using multifocals due to problems with the older ones, but consider the newer ones good enough to use now. Initial results with the Symfony seem to show little incidence of visual side effects, and better odds of good intermediate vision while still having decent near.
re: "rather than a one-trick pony Dr who only implants one type"
Most doctors do a variety of IOLs since one size doesn't fit all,and there are good doctors outside the United States. Oddly it turns out in some cases its also cheaper to use an internationally prominent doctor (as judged by industry publications&invited panels, etc, not just their own website's claims), or an experienced one on faculty at a prestigious medical school, than it is to get this done in the US using a lower quality lens option.
Unfortunately it turns out many doctors don't yet offer the Symfony. Its manufacturer has poor marketing in that they don't list what clinics offer it, and many eye doctors don't list their IOLs on their websites. I have found clinics that offer it and I'll evaluate the doctors first. I don't need the very top doctors, merely a high quality one to do a straightforward surgery. I hadn't decided which country to go to yet, which is the main reason for checking on multiple clinics (since for instance there are good UK surgeons, but they are more expensive, and at least one was booked up until January).
maybe you want to schedule an appointment with the MyVisionCare team. they are situated in Canada. if you can't travel, you can still email them for your concerns
I had a Synchrony implanted overseas. I can tell you that I definitely ran into trouble with follow up care. Doctors would look at my eyes and react with kind of like "what IS that?"
It got bad when I needed a YAG done. They were afraid to do it. They said that the design of the IOL made it look like it might be dangerous. One doctor wanted to explant instead of a yag when I developed PCO, another wanted to do a vitrectomy so they could access the back of the lens and manually cut the hole instead of using a yag laser. They told me it was extremely risky and I might end up blind.
So of course I did nothing, the PCO got worse, which caused my prescription to shift. In response a doctor told me the IOL was probably dislocating due to advance fibrosis and could end up just lying around inthe back of my eye.
So I finally had no choice other than to go back to Germany. Walked in with 20/200 vision from PCO being led by my sister while having a panic attack because I expected an explant/vitrectomy/iris sutured IOL/blindness.
Turns out I just needed a yag. Which was perfectly safe synchrony or not. Which they had completed 20 minutes later and my vision was fine the next day save for floaters. And I can still accomodate. The US doctors scared the living crap out of me for no reason other than I had the operation overseas. And you know what else? They never suggested that I should go back overseas. They were going to explant an extremely difficult and dangerous to explant IOL (dual-optics) or vitrectomize me unecessarily, which would have caused me to lose accomodation. Either way I would have lost my near vision. The one doctor brave enough to try a yag was going to give me a 2mm opening. (Germany did 5mm, my vision would have been awful with 2mm)
The doctors in Germany were awesome. The clinic was awesome. Aside from really scary the experience was fine. And my vision is much better off than what I would have gotten here. (Im 30, bilateral implants and near vision is STILL J1+ or 20/16 with distance correction.) But BE PREPARED TO GO OVERSEAS FOR FOLLOW UP!
I still need a lasik touch up, guess where I'm going? I was warned that due to my age the PCO could reoccur, if it does, guess where I'm going?
Evidently you've convinced yourself that the Tecnis Symfony is the best choice.
It seems to be a modified Tecnis Multifocal to provide better intermediate vision which is the Tecnis Multifocal's weakest vision area. The Acrysof ReSTOR 2.5, and the toric versions of the 2.5 and 3.0 ReSTOR multifocals are currently undergoing US trials. They also seem like excellent IOL options and received CE Mark in Feb 2012.
Hopefully you will provide updates when/if you get the surgery.
Wow, sorry to hear about your troubles with US doctors doing followups. The eye doctor I have here seems to be very reasonable, I appreciate your warning, I will be sure to be prepared to go back for followups if needed. I do live in a decent size metro area,Boulder/Denver, so I'd hope if my current doc weren't reasonable I could find other nearby docs who are. I had considered the Synchrony lens in the past but consider other options better, I had seen a comment on this site suggesting the lens may have been pulled form the market, but I hadn't followed up to confirm that since I had been reading good results.
Actually I hadn't decided for sure if the Symfony is the best choice, partly since there is little study/data on it yet and it has just come out so there has been less time for more doctors to confirm the initial promising results. I figured it made sense to book surgery with a doctor who offered that as an option as well as a trifocal so I needn't decide until the last minute in case new information comes out in the meantime. Unfortunately I am hearing conflicting reports now about whether the FineVision or the AT Lisa is the best trifocal to consider as a backup option, which I seem to be a better fit than the ReSTOR for me.
What did your "very good eye surgeon here in the US who diagnosed the cataract." recommend for your eyes.
I'm assuming he did a cataract evaluation and measured your eyes for the needed powers and astigmatism corrections, if needed.
My local eye surgeon is one who doesn't implant the US approved multifocals due to concerns with them. Since he is in the US there is no reason for him to have explored the European options in depth. He does implant the Crystalens and seemed realistic about its questionable benefit, though it seems at least a better bet than a pure monofocal for those who don't want a multifocal (and won't leave the US for other accommodating lenses).
I only have 0.25D of corneal astigmatism, so that doesn't impact lens choice,and he did a thorough exam and didn't see any other eye health problems (my optometrist hadn't been sure what accounted for a rapid reduction of visual acuity, and shift in prescription, over a few months, so the MD checked to be sure this was the only issue he saw).