Unfortunately there isn't a good description of what these "extended depth of focus" lenses do, so some people are confusing the Symfony with standard multifocal lenses. The issue is perhaps best illustrated by considering photographs. Sometimes you'll see a photograph where only 1 object in the picture is in focus, and the rest of the objects in the background at different distances are a bit blurry. Other times you'll see a photo where even objects at varying distances are all in focus, the photo has a larger "depth of focus". Here are some links to pages which show photos of scenes taken at varied depths of focus to illustrate the point:
https://library.creativecow.net/terry_todd/depth_of_field_converters/1
http://www.better-digital-photo-tips.com/depth-of-field.html
http://grayposters.weebly.com/depth-of-field.html
http://help.solidworks.com/2010/English/SolidWorks/photoview/allcontent/solidworks/noncore/photoview/settings/settings_dialog_box_-_camera_settings_tab.html?format=P
http://julienauphotodesign.com/uncategorized/me-too-monday-aperture-depth-of-field/
http://www.thevideogenius.com/what-is-iso/
The natural eye has some "depth of focus", it doesn't merely see things at 1 exact distance. If you are say looking at someone 6 feet away, your eye is able to see the shape of their face even though say the tip of their nose is a little less than 6 feet away. Even those who have monofocal lens implants can see things that aren't merely at 1 exact distance, there are some things at almost the same distance that are in good enough focus. Someone with a bifocal lens doesn't merely see at say exactly 15 inches, they may see best at that distance but there is some "depth of focus" around that point that lets them see at least some at 12 inches, etc.
The Symfony lens extends the depth of focus so that more distances are in focus at the same time. Since eyes naturally have some depth of focus, the brain is able to adapt to varying degrees of depth of focus.
In contrast, a multifocal lens is doing something that is new to the eye but which people can somehow adapt to, as I did when I wore multifocal contact lenses. 2 or 3 different in focus images for different distances shine on your retina at the same time, and the brain decides which one to pay attention to (in addition to some "depth of focus" around the exact focal points).
This maybe premature.
I am 54 years old. My prescription for glasses was -6D in both eyes.
I had cataract surgery on my left eye on October 31, 2018 in Austin , TX. The surgeon was Dr Steven Dell. He implanted a plain Technis Symfony.
My vision is still fluctuating. My visual acuity at post op was at least 20/40. The inflammation was a little more than hoped and the optometrist increased the frequency of drops from 3 to 4 a day.
The DR said to not expect too much at first. Dr Dell put some drops into the eye to constrict the pupil size for about 72 hours.
I am now reading an old digital alarm clock from 17 feet away. My visual system is now using the left eye as my dominant eye.
I am having very few artifacts such as halos from the Symfony lens. I walked 1.5 miles to a nearby Starbucks, and grocery store without glasses and could read street signs with little issue.
I am watching a TV from 10 feet away with little difficulty. The near vision is a little more problematic but is improving. I will probably need readers for small stuff.
Surgery for the right eye is scheduled for November 7, 2018.
I've had these lenses for 3 months and I'm wondering if the glare and halos will ever go away.
My experience, two months out in left eye and two months out in right eye: Distance is crisp and colors are sharper. Daytime driving is noticeably easier. Nighttime driving is a problem; severe halos around headlights and streetlights, like starbursts coming at me down the highway. I also experience the same to some degree with bright images on a dark background on the television screen. Not as intense as with driving, but noticeable halos. My ophthalmologist says they will go away in time, but I am not yet convinced.
Computer work is fine, although I have increased font size a bit for less eye strain. Need 1.25 to 1.50 reading glasses for smaller print in books and on labels. I have residual astigmatism in the right eye, which had a toric lens implant. This may require treatment with Lasik.
Considering the expense of the lenses, I may have been better off with mono-focal lenses and continued glasses, which would have been covered by insurance. So the jury is out with me.
I have a right eye cataract that has for the past year progressed so that it can't be corrected better than about 20/40 for distance. I also have early stage glaucoma that has been controlled for the past 3+ years and stable with eye drops. Doctor can detect an early stage cataract in the left eye, but it has no noticeable effects on vision in that eye yet, probably will take several years to do so, and it can correct to 20/15 or better easily. I have -2.75D cylinder astimagtism in the right eye and -2.00D cylinder in the left.
I was considering the Trulign toric IOL for the right eye, though it might require an additional small 0.50D cylinder LRI or equivalent in addition to the IOL to eliminate all of the -2.75D cylinder in that eye. But I found a highly rated medical clinic in my area (San Diego, CA) with eye surgeons that use the most state of the art laser equipment and the latest IOLs including Trulign and the new Symfony. So I'm wondering if the Symfony Toric IOL would be even better than Trulign for my right eye cataract surgery? The Symfony appears to have a higher cylinder model available that might be enough by itself (with no LRI) for the -2.75D cylinder in my right eye. And if that worked out, later in the future I could get it for my left eye as well which only has -2.00D cylinder.
Thank you for your detailed notes. Wish I had found this site before I had my surgery. Anyway, I'm 2 weeks post-op on left eye and 1 wk post-op for the right.
At my day-after checkups, distance in each eye was measured 20-20 with 1 incorrect letter bottom line. So, I'm very happy with that!
Reading was about 20-25 and 20-30ish on day 2, but I suspect it's a bit less now, especially with halo and glare on my phone. Should I expect continued improvement with my reading acuity?
Also, tonight I drove in the dark for the first time with my "new eyes." Quite a bit of halo, starburst and spider web things around lights. On day 2, my eyes were blurry but didn't have this much halo. Should I be concerned?
I have another checkup tomorrow and will ask. Hope I will continue to improve for another month or so, as I've heard it really can take that long.
Thanks for any feedback, it's appreciated.
Just had a symfony implanted. So far it's interesting. Vision is better. In day two have a shimmering or flickering effect. Do have halos and glare and a some floaters from the surgery. My hope is they go away. I'm still healing, but would like to know where my vision will end up. I'd say I need 1.5 readers for up close, which is just not that bad. Too early to tell on final outcome, bit I'm optimistic
Just had a symfony implanted. So far it's interesting. Vision is better. In day two have a shimmering or flickering effect. Do have halos and glare and a some floaters from the surgery. My hope is they go away. I'm still healing, but would like to know where my vision will end up. I'd say I need 1.5 readers for up close, which is just not that bad. Too early to tell on final outcome, bit I'm optimistic
I'm having surgery in a few weeks and haven't decided if I'm going with symphony or not. My concern is will I still need readers for up to 12 inch distance or not. I currently need them for example using my iPhone or reading small print within 12 inches. I have cataracts and astigmatism.
I wear glasses or contacts.
I had the symfony fitted a couple of months ago in one eye and am potentially having it removed. I'm going to try the Tetraflex instead.
The halos at night around headlights are quite severe for me with the symfony, I'm managing because my other eye still has the natural lens in, also I've had a separate eye test that showed a definite reduction in contrast sensitivity compared to the vision in my left eye; faint letters on the chart weren't visible at all with the synfony, it's a though it was a blank chart but could be seen with the natural lens. Looking at objects around the house, there just seems less detail compared to the eye with the natural lens. When looking at a person's face, lines seem to be smoothed out.
For some reason I ended up with a slight astigmatism after the surgery, which I believe is a risk for cataract surgery but even with wearing glasses to correct it the halos are there. With the astigmatism the accommodation doesn't really work, instead letters have ghosts that interfere and make the text unreadable but it does accommodate at least for text on a phone with the astigmatism corrected but not really enough for small print.
If there are ceiling lights above me switched on, there's kind of haze in my vision.
Even the TV has glare around it.
I suppose if I'd had both eyes done, I wouldn't notice the reduced quality in vision compared to the natural lens.
The reason I'm going for the accommodating lens instead; it's essentially a clear mono lens that can move, so hopefully won't have as bad halos or reduced contrast.
I may be a one-off but I'm pretty disappointed and just hope it can be removed safetly enough to have an accommodating lens put in.
who is your L.A. doctor?
i am looking for a second opinion. i need an IOL and thought the symfony sounds my best option but my current dr says absolutely not, he wants to put in crystal lens. i hear crystall can have embedding issues so it stops accommodating in a percentage of people. when i asked why he simply stopped me cold and said no... i want a better explanation than "no".
i am in LA so am looking in this area...
thanks
RE: HenryEyesOnEarth
If you want an implantable lens and don't have cataracts there are lens made specifically for that purpose and they have the advantage of being removable (cataract lens are not considered "removable"). The Visian ICL is for myops, so you might consider researching that instead of cataract-specific lenses. ICL lenses go in behind the iris, not in the capsule bag like IOLs.
Astigmatism and myopia are easily, promptly corrected with lasik. You go in to surgery blind and walk out with vision equivalent to the best contact lenses you've ever worn. It's amazing,fast and almost painless. Not sure why you struggled with glasses if only myopia and astigmatism affected your eyes.
At 64 you are now also affected by presbyopia which lasik does not correct (in the US). I did lasik 15 years ago and I was a -8 with 1.5 astigmatism. Post-lasik my eyes remained stable at 20/20 until the cataracts appeared.
If you are developing "blurry" vision in one eye and are certain you do not have cataracts- ask your dr about presbyopia. That's "old eyes". Sometime after 40 our eyes develop it- it's just part of ageing. It's why you can buy "readers" in drugstores--everyone gets it eventually
Now that Symfany is approved in the US, I am scheduled for cataract surgery in ten days. Since the Symfany lenses are not yet stocked in the large hospitals/surgical centers in Los Angeles, the drug rep has to bring them to my surgeon. My dr has implanted many of Abbott labs other lenses, so I am comfortable being his first Symfony patient. I will update post-surgery.
RE: HenryEyesOnEarth
If you want an implantable lens and don't have cataracts there are lens made specifically for that purpose and they have the advantage of being removable (cataract lens are not considered "removable"). The Visian ICL is for myops, so you might consider researching that instead of cataract-specific lenses. ICL lenses go in behind the iris, not in the capsule bag like IOLs.
Astigmatism and myopia are easily, promptly corrected with lasik. You go in to surgery blind and walk out with vision equivalent to the best contact lenses you've ever worn. It's amazing,fast and almost painless. Not sure why you struggled with glasses if only myopia and astigmatism affected your eyes.
At 64 you are now also affected by presbyopia which lasik does not correct (in the US). I did lasik 15 years ago and I was a -8 with 1.5 astigmatism. Post-lasik my eyes remained stable at 20/20 until the cataracts appeared.
If you are developing "blurry" vision in one eye and are certain you do not have cataracts- ask your dr about presbyopia. That's "old eyes". Sometime after 40 our eyes develop it- it's just part of ageing. It's why you can buy "readers" in drugstores--everyone gets it eventually
Now that Symfany is approved in the US, I am scheduled for cataract surgery in ten days. Since the Symfany lenses are not yet stocked in the large hospitals/surgical centers in Los Angeles, the drug rep has to bring them to my surgeon. My dr has implanted many of Abbott labs other lenses, so I am comfortable being his first Symfony patient. I will update post-surgery.
Hi John C Hagan 111 MD and SoftwareDesigner, thank you for your excellent posts on the Tecnis Symfony IOLs. I have an astigmatism of about 1.25D on my left eye and both eyes are about -5.0 so I am quite myopic and have to wear glasses all the time. I am a musician and needed to find a way to read music charts sometimes 5 pages wide and about an arms length and 4 inches away. I found a solution about two years ago with Essilor 360 degree lenses. They worked great however I realized then that I would need 3 pairs of glasses at any given time. Now my left eye with the astigmitism is getting blurry and I was considering getting IOLs. I have no cataracts and have never had any issues with my eyes. I am 64 years of age and would like to correct my astigmatism and myopia for good if possible. I am looking for a practical solution however unsure if I should go this route. The Essilor 360 seems to provide that extended focal depth and 3D effect some have experienced with the Tecnis Symfony IOLs, with my left eye now getting blurry in that 3-8 foot range and my right dominant eye seems to see much farther than expected I just can't find anything out there that suggests it would be a good way to go if you have no cataracts. Thank you for your assistance!
Update 48 hours after Symfony lens implant. Delighted beyond belief. No haloes, no starbursts so far. Especially impressed with evening and night vision, which is where I had had particular difficulty. I am 69 btw and I hated the elderly hesitancy I had noticed over the past two or three years when walking outside during the evening and also going up and down flights of stairs. All gone - I feel 20 or even 30 years younger - pre-presbyopic and pre-cataract impaired.
During the evening I was able to read the paper, use the iPad and iPhone with ease, all while watching television - everything in focus just like it used to be. In fact, better than it used to be because I'm not wearing contact lenses - just so happy.
PS Thank you SoftwareDeveloper - your postings and experience on here gave me the confidence to go with my surgeon's recommendation for the result I wanted.
I had Symfony lens implanted in my left eye 24 hours ago. As instructed, I kept protective padding over eye until this morning so did not see the result until approx six hours ago. At first vision was misty, like steamed up spectacles, but this has now almost completely cleared. As only one eye has been done so far I have to cover the other eye to assess the Symfony - it's amazing! It's a bright sunny day and I can see clearly to distant trees yet also easily read my iPhone screen. I'm reading a paperback novel set in 10 point with ease. Using both eyes is better still, the right eye needed only a -1 corrective lens so the combination is perfect. I do have a cataract in the right eye but it does not yet impede my vision. Re the brighter colours reported by other posters, pink is suddenly much brighter. My Built laptop bag appears almost day-glo with my new eye, though quite subtle deeper pink with the other eye. I can see I will have to reassess my wardrobe and weed out the scarily bright clothes (smile). I am posting this on here because I had never heard of Symfony lens until my consultant recommended it to me after I expressed an interest in multifocals. Then, of course, I googled and found your posts.
I finally took the decision to take the surgery 26/07/2016 and I am more than glad that I did!!! I am having the toric Symfony for both eyes but the left is set to -0,5D to enhance the near vision(which it did! 50cm and far my vision is pin sharp!)
1st day I saw 2 halos around every source of light but crystal clear vision!
2nd day the 2 halos disappear k everything is pin sharp!the colour is amazingly clear and bright even before catarract when I was child my vision wasn t that good!
3rd day my vision is getting better and better ( I am having dry eye at times but they said its common issue for the 1st week)
I am more than happy for the Sumfony lens though and I recommend those iols for every patient who has catarract at younger age(I am 27 years old) and the vision is more than great even though it is a bit strange to get used to it but its too soon!the doctor said to wait one month to see how near will I be able to see to prescribe glasses for near even though now I can read but with my hand almost stretched!(as I said my eyes focuses at 50cm and far).for example I can t see when I am eating its blurry or to cut my nails!( it s funny I know but its impractical for those tasks..so I am going to need I little help with glasses for very near tasks but I can read even the little letters at the bottle of the drops with my arm almost stretched!)
Also my distant and intermediate vision is greater than ever!!!!
I drove at noon today there were a little issue with the headlights of the opposite cars or the lights of the road(tiny halos around every light) but not an issue at driving as it was with catarract..I expect to get better it s only 3 days from surgery!Again very glad with the toric Symfony! I don t know how s the feeling with other iols but I would do again the same choice!I was very hesitant to go on with the surgery but I am glad I did at last!so whoever has second thoughts I am telling you go for it you won t regret it , if it s ok with your doctor of course(here in Greece every doctor told me to go with monovision and monofocals even though I was appropriate candidate for the Symfony and I am glad for my choice after all!!!)
Where did you have your surgery done? In the US, or in another country? I assume that you and your surgeon must be in the same, or a nearby, country (since you have been able to continue to interact with him to get explanations - and perhaps further examinations). But maybe you travelled to get this done; it would be informative to hear whether you think travelling some distance has turned out to be a problem.
Was he a guy (or woman) who already had done a lot of Symfony implantations, or was this an early experience for him too? I'm asking this in order to get some feeling for how important it is for a surgeon to have previous Symfony experience. I know that Abbott (Technis) claims that the Symfony is precisely the same form factor as its existing and long-used monofocal lenses, but I wonder whether there might be some other kinds of differences beween the two types nevertheless.
Do you have any reasons to suspect that your horrible experience is due to (a) the Symfony IOL itself, or (b) shortcomings of the surgeon, or (c) something about the structure and condition of your own eyes that couldn't have been detected by anyone in advance, and might have happened with any surgeon and any lens?
Any first-hand information that you can supply would be very interesting and useful.
Now that Symfony has been approved by the FDA for use in the USA, does anyone know when it will be available, and/or what US cataract surgeons have experience using it?
Hi Roberto, had the same issue and it was astigmatism. My right eye was not focusing colors correctly so I saw grey shadows, particularly on computer screens with black text on a white background. Lasic on my eye fixed the problem.
Hi.
Thx for your reply and information. I saw infomercial on the panoptix last tuesday and it seemed interesting but also more like another trifocal. I wonder if perfecting this approach will deliver vastly better optics but like you say most trifocals are giving people great options and in general are a huge advance over mono or bifocals.
I find this subject in itself quite interesting and will look into the Panoptix and Rev IOL.
This day my near sight got better during rhe day but my work is behind a screen all day so may be it ajusts to it. When I came home and started to wrok again my nearsight was probably equal to yesterday. So I think in the end nothing has changed significantly.
I noted my eye feels dry when I wake up and it stays that way during the day. Got me some eyedrops and they alleviate it. Also note flickering when moving my eye which seems to be pretty normal and will take months to abate.
Still delighted with the results and happy.
re: "pretty regular lens in design"
Yup, I figured that lowered the risk of going with the Symfony even though it was fairly new when I got it. Its the same overall shape&material as the widely used Tecnis monofocals (and multifocals) so it was only the optics that was new, and much of that can be tested on an optical bench outside of the eye, and with some initial clinical studies showing good results to match.
The trifocals are also good choices still depending on whether people prefer good very near vision at the expense of slightly less intermediate (and a risk of halos). The reports I'd seen suggest the AT Lisa Tri and the FIneVision are fairly comparable, with some surgeons giving a slight edge to one or the other (on balance more with the AT Lisa Tri I think). I don't know how the new Alcon Panoptic and the Rev-IOL tri-ed (forget exact spelling offhand) compare. It is true that there was at least one surgeon who is a co-inventor of the FineVision so there may be some bias.
As I posted earlier in the thread, I went to a top surgeon in the Czech Republic (a common medical tourism destination for the UK I discovered) rather than going to the UK and paying more.
As I posted at the start of this thread, my eyes were done in early Dec. 2014, so about a year and a half. By my 1 week postop I was already at almost 20/15 distance and 20/25 at best near. Subjectively it seems there may have been a very slight improvement over the next weeks, but since then for distance they just confirmed they were at least 20/20 and didn't get an exact acuity for distance. I should sometime to see if I got past 20/15. My near acuity hasn't budged from 20/25, though I hadn't checked it for a while (I should just get a near chart).
Well I have no trouble posting in two threads, One where I can be detailed and another (this one) to be shorter.
Not following up on an email for me is a strike against too btw. I think exactly the same. Which country did you go to btw?
I also considered trifocals. FineVision to be exact but changed my opinion.
I wasn't happy about the remarks on halo's. Also since Symfony is a pretty regular lens in design I figured surgery would be quite easy.
A may be strange reason of minor importance is the fact that I noted some surgeons affiliated with FineVision were being negative in various papers and on a congress on other lenses especially Symfony. I don't like that a whole lot....Minor importance but noted.....
How long has it been since you had your eyes done? When was the final result reached? Thx for your answers and the excellent information you already provided!