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my Symfony IOL results after cataract surgery
I'd posted before asking for information about lens options before surgery, but thought I'd start a new thread now that I've gotten the lens where perhaps others can add their results as well with the Symfony lens. It is a new type of "extended depth of focus" lens that uses a different design than multifocal and accommodating lenses.
I had Symfony lenses implanted in both eyes the first week of December. By 1 week postop my uncorrected vision at distance was between 20/15 and 20/20. At near my vision was already about 20/25 (but fluctuating a bit it had seemed better earlier that day). Given its improvement since then I'd guess its likely 20/20 or so, I can read the small print on my eye drop bottles for instance. Not everyone achieves this level of near vision with the lens so people shouldn't expect to necessarily get quite as good a result, and should be prepared for the possibility for needing reading glasses at near. I suspect the fact that I'm comparatively young for cataract surgery, 52, might have something to do with the results.
I had originally only planned on having 1 eye done (since the other was 20/20 correctible still), but when the patch came off the next day I discovered it might be hard to adapt to the difference in vision between the two eyes even with a contact lens in the other eye. I might have quickly adapted if I'd taken the time, but I decided I didn't want to risk it, so I had the 2nd eye operated on a few hours later.
My intermediate vision hasn't been tested explicitly but I suspect is at least 20/20. That is based on my subjective sense of it being better than near and because of the design of this lens where visual acuity drops off in a continuous curve from far to near, so intermediate should be around the same as far, definitely better then near. That is one of the differences between this lens and for instance a bifocal IOL where vision may be worse at intermediate than it is at near or far. I spend a large number of hours at a computer and was willing to risk needing reading glasses occasionally for near in order to get better intermediate vision. Most household tasks and social interactions occur at intermediate distance as well.
Unfortunately the lens isn't yet available in the US yet, they are starting a clinical trial here which is randomized with a monofocal lens (there is a 50% chance you would get a monofocal) so I went to Europe for my surgery. I figured that at my age I hopefully may be using these lenses for a few decades so it was worth a bit of effort to get a better lens. This industry publication suggests it might be generally available in the US in a couple of years, and that some US surgeons find it interesting:
http://ophthalmologytimes.modernmedicine.com/ophthalmologytimes/news/us-surgeons-anticipate-new-iols?page=0,1
"the Symfony IOL might be available in the US by late 2016 or early 2017...
Of the IOLs discussed at the ESCRS Congress, Dr. Olson and Dr. Packer concurred that the brand new Tecnis Symfony Extended Range of Vision IOL was the most interesting as it represents a new concept for addressing presbyopia that seems to overcome the limitations of multifocal IOLs....
from what I’ve heard so far from respected and trusted surgeons, patients implanted with this IOL are seeing 20/20 at distance and intermediate with very usable, J2 or J3 near vision and are not experiencing any loss of contrast or perceptible problems with glare, halos or other dysphotopsias. So, it looks like they are having their cake and eating it too.”
I had considered the option of getting a trifocal lens which targets far, intermediate, and near (also unfortunately not yet available in the US), or even a bifocal with a small add so its focused more at intermediate than near. However the studies so far seem to indicate that the Symfony provides better quality intermediate vision. In addition multifocal lenses reduce contrast sensitivity which is useful for night vision, while reports indicate the Symfony is at least as good as a monofocal lens. The other thing the Symfony does is to correct for "chromatic aberration", an issue which is discussed in this industry publication which quotes one prominent surgeon noting:
http://eyeworld.org/supplements/EW-December-supplement-2014.pdf
" Cataract surgery with an IOL with an Abbe number greater than that of the natural lens (47) can improve CA, so that our cataract patients could actually experience better vision quality than they did as young adults. "
Although the Symfony uses a high Abbe material (I'm assuming its the same Tecnis material that article lists as having a 55 Abbe), it also has other features to to correct for CA to improve image quality. It seemed like a good bet the image quality for distance would be comparable, and perhaps even better, than a monofocal lens, or an accommodating lens.
Although some results for the Crystalens look like it will similarly do well for intermediate while providing some chance at decent near vision, some showed a lower chance of good near, e.g. some of the studies listed for the March 2014 update in this government review:
http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/MedicalDevices/MedicalDevicesAdvisoryCommittee/OphthalmicDevicesPanel/UCM346413.pdf
Part of the concern I had with the Crystalens was that in some patients the lens does well, but in some it doesn't accommodate, which leaves it effectively being a monofocal lens ( but without things like the correction for chromatic abberation). There is also concern I'd read among some over whether over decades of aging anything would interfere with the physical movement of the lens, something non-accommodating lenses don't require. There is no perfect lens, so its partly a matter of placing a bet on which might work out well, and I figured that it was better to bet on something that didn't require the accommodation to work (in addition to other concerns regarding problems people have with the Crystalens, though those may be fewer in the newest versions). I hadn't searched to find the study behind the figure in this presentation, but it notes:
http://www.slideshare.net/alanglazier/accommodating-intra-ocular-lenses
that about half of Crystalens patients require reading correction. That may be in part because as it notes: ' "Pushing” does not equal “Sustaining” '. This issue is that someone with their natural lens still who is presbyopic for instance may be able to theoretically read a particular print size without glasses, but that the muscle effort to focus may be a strain to do for an extended period of time, and the Crystalens at least partly seems to require the same sort of accommodative effort. (though there is speculation it may be benefit from some extended depth of focus, which is what the Symfony is designed to use to begin with). I'll continue this in another post in a few minutes.
I had Symfony lenses implanted in both eyes the first week of December. By 1 week postop my uncorrected vision at distance was between 20/15 and 20/20. At near my vision was already about 20/25 (but fluctuating a bit it had seemed better earlier that day). Given its improvement since then I'd guess its likely 20/20 or so, I can read the small print on my eye drop bottles for instance. Not everyone achieves this level of near vision with the lens so people shouldn't expect to necessarily get quite as good a result, and should be prepared for the possibility for needing reading glasses at near. I suspect the fact that I'm comparatively young for cataract surgery, 52, might have something to do with the results.
I had originally only planned on having 1 eye done (since the other was 20/20 correctible still), but when the patch came off the next day I discovered it might be hard to adapt to the difference in vision between the two eyes even with a contact lens in the other eye. I might have quickly adapted if I'd taken the time, but I decided I didn't want to risk it, so I had the 2nd eye operated on a few hours later.
My intermediate vision hasn't been tested explicitly but I suspect is at least 20/20. That is based on my subjective sense of it being better than near and because of the design of this lens where visual acuity drops off in a continuous curve from far to near, so intermediate should be around the same as far, definitely better then near. That is one of the differences between this lens and for instance a bifocal IOL where vision may be worse at intermediate than it is at near or far. I spend a large number of hours at a computer and was willing to risk needing reading glasses occasionally for near in order to get better intermediate vision. Most household tasks and social interactions occur at intermediate distance as well.
Unfortunately the lens isn't yet available in the US yet, they are starting a clinical trial here which is randomized with a monofocal lens (there is a 50% chance you would get a monofocal) so I went to Europe for my surgery. I figured that at my age I hopefully may be using these lenses for a few decades so it was worth a bit of effort to get a better lens. This industry publication suggests it might be generally available in the US in a couple of years, and that some US surgeons find it interesting:
http://ophthalmologytimes.modernmedicine.com/ophthalmologytimes/news/us-surgeons-anticipate-new-iols?page=0,1
"the Symfony IOL might be available in the US by late 2016 or early 2017...
Of the IOLs discussed at the ESCRS Congress, Dr. Olson and Dr. Packer concurred that the brand new Tecnis Symfony Extended Range of Vision IOL was the most interesting as it represents a new concept for addressing presbyopia that seems to overcome the limitations of multifocal IOLs....
from what I’ve heard so far from respected and trusted surgeons, patients implanted with this IOL are seeing 20/20 at distance and intermediate with very usable, J2 or J3 near vision and are not experiencing any loss of contrast or perceptible problems with glare, halos or other dysphotopsias. So, it looks like they are having their cake and eating it too.”
I had considered the option of getting a trifocal lens which targets far, intermediate, and near (also unfortunately not yet available in the US), or even a bifocal with a small add so its focused more at intermediate than near. However the studies so far seem to indicate that the Symfony provides better quality intermediate vision. In addition multifocal lenses reduce contrast sensitivity which is useful for night vision, while reports indicate the Symfony is at least as good as a monofocal lens. The other thing the Symfony does is to correct for "chromatic aberration", an issue which is discussed in this industry publication which quotes one prominent surgeon noting:
http://eyeworld.org/supplements/EW-December-supplement-2014.pdf
" Cataract surgery with an IOL with an Abbe number greater than that of the natural lens (47) can improve CA, so that our cataract patients could actually experience better vision quality than they did as young adults. "
Although the Symfony uses a high Abbe material (I'm assuming its the same Tecnis material that article lists as having a 55 Abbe), it also has other features to to correct for CA to improve image quality. It seemed like a good bet the image quality for distance would be comparable, and perhaps even better, than a monofocal lens, or an accommodating lens.
Although some results for the Crystalens look like it will similarly do well for intermediate while providing some chance at decent near vision, some showed a lower chance of good near, e.g. some of the studies listed for the March 2014 update in this government review:
http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/MedicalDevices/MedicalDevicesAdvisoryCommittee/OphthalmicDevicesPanel/UCM346413.pdf
Part of the concern I had with the Crystalens was that in some patients the lens does well, but in some it doesn't accommodate, which leaves it effectively being a monofocal lens ( but without things like the correction for chromatic abberation). There is also concern I'd read among some over whether over decades of aging anything would interfere with the physical movement of the lens, something non-accommodating lenses don't require. There is no perfect lens, so its partly a matter of placing a bet on which might work out well, and I figured that it was better to bet on something that didn't require the accommodation to work (in addition to other concerns regarding problems people have with the Crystalens, though those may be fewer in the newest versions). I hadn't searched to find the study behind the figure in this presentation, but it notes:
http://www.slideshare.net/alanglazier/accommodating-intra-ocular-lenses
that about half of Crystalens patients require reading correction. That may be in part because as it notes: ' "Pushing” does not equal “Sustaining” '. This issue is that someone with their natural lens still who is presbyopic for instance may be able to theoretically read a particular print size without glasses, but that the muscle effort to focus may be a strain to do for an extended period of time, and the Crystalens at least partly seems to require the same sort of accommodative effort. (though there is speculation it may be benefit from some extended depth of focus, which is what the Symfony is designed to use to begin with). I'll continue this in another post in a few minutes.
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).
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 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.
5 Comments
Your near vision is likely to improve after the surgery on your right eye. Thanks for bumping up SoftwareDeveloper's thread.
The inflammation is going down. My distance vision should settle down around 20/20. I had streaks from the 12:30 to 6:30 position when I looked lights. Those streaks may be related to an incision/s. They are gone. I see no concentric rings but it may be early. Lcd TV looks great. My iris is now starting to function. My near vision is better. I can read newspapers etc. The color white appears a little different. Headlights appear different, not worse, just different.
The surgeon does not use a laser for cataracts even though he was the second surgeon in the US to use a laser.
The cataract developed rapidly, but vision has not been great for a couple of years in that eye. I was not aware of the cataract until March 2017 when my vision in an eye exam deteriorated. The optometrist kind of ignored the issue.
The surgeon does not use a laser for cataracts even though he was the second surgeon in the US to use a laser.
The cataract developed rapidly, but vision has not been great for a couple of years in that eye. I was not aware of the cataract until March 2017 when my vision in an eye exam deteriorated. The optometrist kind of ignored the issue.
I've had these lenses for 3 months and I'm wondering if the glare and halos will ever go away.
1 Comments
Summary of postings here: sometimes yes, sometimes no, sometimes glasses over IOL helps, sometimes bad enough to do IOL exchange
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.
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.
1 Comments
That's for the information
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.
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.
2 Comments
My current eye doctor is a glaucoma specialist and eye surgeon. She does cataract eye surgeries but only with a limited set of IOLs, like the distance only Alcon Torics, but not the newer ones I'm interested in.
She has told me that due to glaucoma possibly reducing contrast sensitivity some, she would rule out the multifocal IOLs since they signficantly reduce contrast sensitivity further.
I'm hoping that the Symfony and the Trulign IOLs don't have that issue, and so I could still be a good candidate for those ones however. I'm age 62.
She has told me that due to glaucoma possibly reducing contrast sensitivity some, she would rule out the multifocal IOLs since they signficantly reduce contrast sensitivity further.
I'm hoping that the Symfony and the Trulign IOLs don't have that issue, and so I could still be a good candidate for those ones however. I'm age 62.
This conversation has a lot of posts and a quick review seems more unhappy or bothered by vision or glare than happy. Few cheerleaders like Software developer. Think hard before you run off to some clinic to get an "up-sell" lens. Also talk to your glaucoma specialist. Some physicians that do cataract surgery will not follow patients that leave their practice to go to a hyper-advertising, cataract/IOL 'factory" where they operate then dump the patient on local surgeons to follow them.
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.
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.
1 Comments
You are very early on so there is a very good chance of improvement. Most studies of IOLs don't even bother recording the incidence of night vision artifacts like halos until 3 or 6 months to let people get past the initial healing and neuroadaptation period where more people see them. Since you started a new page repeating the comment, I'd suggest making any followups there where I'll repost this.
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
1 Comments
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 wear glasses or contacts.
2 Comments
Unfortunately no one can tell you exactly how good your results will be since each person's natural depth of focus varies. The same lens in two different people will yield different results. All studies can show are average results (or sometimes the range found in the study), and patients online merely report their anecdotal results. Most patients report being free of glasses, and given the high % of people with smartphones that suggests most can deal with them. With a monofocal set for distance the odds are high you wouldn't be able to do much with a smartphone other than perhaps dial using a large font (though even that I hadn't checked on to be sure how likely it is). Monovision, setting one eye nearer, can help with a monofocal, but that helps even more with the Symfony and you can do a smaller degree of monovision and expect good results.
I don't know how large the screen is on your phone, what the font size is. In my case I've had no trouble using my smartphones without bothering to change fonts and just holding them at a natural distance without needing to even think about where I hold it (with one exception mentioned below). First it was with a 4.7" screen on an HTC One M7, now with a 5.1" screen on a Samsung Galaxy S7. Note: I upgraded phones for other reasons, I didn't factor in the screen size, I had no problem using the smaller screen on the old phone. With newspaper sites with multiple columns I do find it easier to read when I double-tap the screen to expand to one column (though I can read multicolumn headline size text and if I try I usually make out the multicolumn small font without going single column, I just need to concentrate to do so and sometimes find the right position to hold the phone to read the smaller font).
If you opt for micro-monovision that will increase the odds of having good enough near vision to read your phone. Holding the phone farther out might be of help if it turns out that 12 inches is a problem, or worst case trying larger fonts.
I don't know how large the screen is on your phone, what the font size is. In my case I've had no trouble using my smartphones without bothering to change fonts and just holding them at a natural distance without needing to even think about where I hold it (with one exception mentioned below). First it was with a 4.7" screen on an HTC One M7, now with a 5.1" screen on a Samsung Galaxy S7. Note: I upgraded phones for other reasons, I didn't factor in the screen size, I had no problem using the smaller screen on the old phone. With newspaper sites with multiple columns I do find it easier to read when I double-tap the screen to expand to one column (though I can read multicolumn headline size text and if I try I usually make out the multicolumn small font without going single column, I just need to concentrate to do so and sometimes find the right position to hold the phone to read the smaller font).
If you opt for micro-monovision that will increase the odds of having good enough near vision to read your phone. Holding the phone farther out might be of help if it turns out that 12 inches is a problem, or worst case trying larger fonts.
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.
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.
2 Comments
re: "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 would be careful before leaping to that conclusion. The FDA data for the Crystalens, which also matches that description, indicates a higher incidence of problematic halos with the Crystalens than with the Symfony. Some people get halos even with strictly monofocal lenses. The studies seem to show the incidence of problematic halos with the Symfony is in the general range of monofocals, higher than the best monofocal but lower than some other monofocals.
I haven't examined data for the Tetraflex since its not approved in the US and my initial reading didn't suggest it was an improvement over the Crystalens available here. Its possible it does have a lower incidence of problem halos, but I hadn't looked into it.
Most studies on halos are done after 3 or 6 months because more people even with monofocal see them initially before most fade after the first few months.
I know someone in town who had the Crystalens implanted, and he has complaints about his low light reading vision. We met in a well lighted auditorium after a lecture and he did an experiment with a near reading chart. He held a file folder over it to merely cast a shadow, and that was enough to cause his near vision to be reduced with the Crystalens noticeably.. but it didn't make a difference for me with the Symfony. We are about the same age (lighting needs do increase with age), but its possible it may be individual variation. In general however there may be some reduction in low light vision with an IOL.
It sounds like much your problem is due to the astigmatism, which can interfere with visual quality with any lens.. and I've seen some surgeons suggest the impact is less with the Symfony than with a monofocal.
I would suggest researching data on the Tetraflex before leaping to conclusions regarding how much it will improve things. It may be that if you do see halos with the Tetraflex that they would be less problematic for you than the sort you get with the Symfony.. but perhaps not. I don't recall how much near the Tetraflex has, its been at least 2 or more years since I looked into it.
I don't find any issue with the level of detail I see with the Symfony, but I got both eyes implanted a day apart so I didn't have time to compare, though in the hour I had to do while I decided whether to have the 2nd surgery and I walked around testing vision I didn't see anything that was a problem (merely a sense off imbalance between the two, if anything the Symfony eye seemed crisper). It seems better than I can recall having with contacts before I had a problem cataract.
I would be careful before leaping to that conclusion. The FDA data for the Crystalens, which also matches that description, indicates a higher incidence of problematic halos with the Crystalens than with the Symfony. Some people get halos even with strictly monofocal lenses. The studies seem to show the incidence of problematic halos with the Symfony is in the general range of monofocals, higher than the best monofocal but lower than some other monofocals.
I haven't examined data for the Tetraflex since its not approved in the US and my initial reading didn't suggest it was an improvement over the Crystalens available here. Its possible it does have a lower incidence of problem halos, but I hadn't looked into it.
Most studies on halos are done after 3 or 6 months because more people even with monofocal see them initially before most fade after the first few months.
I know someone in town who had the Crystalens implanted, and he has complaints about his low light reading vision. We met in a well lighted auditorium after a lecture and he did an experiment with a near reading chart. He held a file folder over it to merely cast a shadow, and that was enough to cause his near vision to be reduced with the Crystalens noticeably.. but it didn't make a difference for me with the Symfony. We are about the same age (lighting needs do increase with age), but its possible it may be individual variation. In general however there may be some reduction in low light vision with an IOL.
It sounds like much your problem is due to the astigmatism, which can interfere with visual quality with any lens.. and I've seen some surgeons suggest the impact is less with the Symfony than with a monofocal.
I would suggest researching data on the Tetraflex before leaping to conclusions regarding how much it will improve things. It may be that if you do see halos with the Tetraflex that they would be less problematic for you than the sort you get with the Symfony.. but perhaps not. I don't recall how much near the Tetraflex has, its been at least 2 or more years since I looked into it.
I don't find any issue with the level of detail I see with the Symfony, but I got both eyes implanted a day apart so I didn't have time to compare, though in the hour I had to do while I decided whether to have the 2nd surgery and I walked around testing vision I didn't see anything that was a problem (merely a sense off imbalance between the two, if anything the Symfony eye seemed crisper). It seems better than I can recall having with contacts before I had a problem cataract.
Hi Triggered, I have the similar issue with my operated right eye. I am seeing less details and haze, but it's better before the operation. My doctor put on a -1.00 contact lens then i can see 20/30 vs. 20/60. he also thinks it could be secondary cataract. I am not sure now, but would be curious to hear your replacement operation.
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
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
5 Comments
I would be curious what the reasoning is. Some doctors are experts in medicine, but aren't as familiar with optics and seem to confuse the Symfony with a multifocal, and some doctors had bad experiences with the old multifocals (and aren't even aware the newer multifocals have also improved quite a lot compared to old versions). Doctors are also human, and some can find an approach that works well enough for them like a particular lens, and be hesitant to risk trying something new.
The studies I've seen show a higher percentage of Symfony patients are free of glasses than Crystalens patients so it has a larger range of vision. That also means if you get the lens targeted for intermediate distance, it would also give more near vision. A small minority of the Crystalens patients reportedly don't get more vision from it than they would a monofocal, and there may be some higher risk of other complications, which is one of the reasons I didn't go for it.
In terms of an LA doctor, I don't know of any offhand, but you might start a new thread asking about good LA surgeons (since some people may not care about the Symfony and not read this long thread). Also many cities have either newspapers or magazines that publish a "best doctors" list every year that is based on asking doctors who they would go to if they needed treatment (figuring they are have connections to hear who is good and are better able to evaluate another doctor then a typical patient).
You might try searching the net for Symfony and LA (or Los Angeles) for any doctors already promoting that they are using the lens or looking forward to it, or who were involved in the clinical trials . You may even see hits show up in the trade literature if a doctor is prominent. Unfortunately LA is such a big metro area that often they might use the name of the particular area nearby city they are in rather than LA.
The studies I've seen show a higher percentage of Symfony patients are free of glasses than Crystalens patients so it has a larger range of vision. That also means if you get the lens targeted for intermediate distance, it would also give more near vision. A small minority of the Crystalens patients reportedly don't get more vision from it than they would a monofocal, and there may be some higher risk of other complications, which is one of the reasons I didn't go for it.
In terms of an LA doctor, I don't know of any offhand, but you might start a new thread asking about good LA surgeons (since some people may not care about the Symfony and not read this long thread). Also many cities have either newspapers or magazines that publish a "best doctors" list every year that is based on asking doctors who they would go to if they needed treatment (figuring they are have connections to hear who is good and are better able to evaluate another doctor then a typical patient).
You might try searching the net for Symfony and LA (or Los Angeles) for any doctors already promoting that they are using the lens or looking forward to it, or who were involved in the clinical trials . You may even see hits show up in the trade literature if a doctor is prominent. Unfortunately LA is such a big metro area that often they might use the name of the particular area nearby city they are in rather than LA.
You may find someone on www.ratemds.com in LA. I think it is a world wide site. Good Luck!
Still looking for an LA doctor? My excellent SF doctor who originally rec. the Symfony is now @ Doheny Ctr in Fountain Valley: Benjamin Bert.
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.
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.
2 Comments
I have the ICLs and have been happy with them. I had much worse myopia (-10/-11) and astigmatism, and those lenses allowed me to live a normal life. However, the risk of cataract is increased with them, especially in older people, so that's something to think about (although many people develop cataracts anyway in their 60s and 70s).
That is why the Symfony is a good choice for me with the onset of a Cataract. SoftwareDev mentioned however a chance of Posterior capsule opacification (PCO) and that can be dealt with easily after surgery with Femtosecond Laser.
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.
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.
2 Comments
re: "at 64"
At 64 years old, he has to be already familiar with presbyopia given the level of impact it would have had. I'll add that in the US there are now corneal inlays, the Raindrop and the Kamra, which are approved to deal with presbyopia. They are removable lenses inserted just below the surface of the eye. They don't correct for myopia or astigmatism though, which would need to be handled via laser correction. Surgeons differ regarding whether they think surgical correction via those or an IOL is a better option, both are things for someone that age to consider with different levels of risk and benefit.
re: "has implanted many of Abbot labs other lenses, so I am comfortable being his first Symfony patient"
Yup, it seems a safe bet to use a surgeon that has used other Tecnis lenses. The Symfony is implanted the same as the other Tecnis lenses, it is the same overall size&shape and merely has different optics.
At 64 years old, he has to be already familiar with presbyopia given the level of impact it would have had. I'll add that in the US there are now corneal inlays, the Raindrop and the Kamra, which are approved to deal with presbyopia. They are removable lenses inserted just below the surface of the eye. They don't correct for myopia or astigmatism though, which would need to be handled via laser correction. Surgeons differ regarding whether they think surgical correction via those or an IOL is a better option, both are things for someone that age to consider with different levels of risk and benefit.
re: "has implanted many of Abbot labs other lenses, so I am comfortable being his first Symfony patient"
Yup, it seems a safe bet to use a surgeon that has used other Tecnis lenses. The Symfony is implanted the same as the other Tecnis lenses, it is the same overall size&shape and merely has different optics.
Yes Presbyopia set in at around age 40, I was so frustrated chasing around to find the right focal point like a brick in the wall, tilting my head and getting neck pain, eye strain and feeling stuck trying to read music. I would need 3 pairs and thank god my wife is far sighted and drives.
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!
3 Comments
Sorry this post is a bit late. The procedure you are referring to, of replacing your natural lens even though you don't have cataracts is called refractive lens exchange (RLE) or clear lens exchange (CLE), if you wish to search for those. The procedure tends to be more common outside the US where they've had a wider selection of premium IOLs available to make it useful, due to the FDA being slow in its approvals.
Are you able to wear contact lenses, even for a short time? Contacts have improved over the years, so if you hadn't tried them in the last decade or so you might give them another shot. You could try a multifocal contact lens to see if that works out well for you before considering an IOL, or contact lenses in monovision. Both of those would be useful tests also, for instance to see if you can adapt to a tiny bit of monovision. (with the Symfony, a bit of micro-monovision, not enough to have much impact on distance vision or stereopsis, can be useful). A multifocal contact would also allow you to try to pin down where best to focus your eyes, since it sounds like you might wish them to be focused at intermediate distance rather than at far distance, to be able to give you enough range to see things up fairly close. (though 4 inches is going to be a bit of a struggle to get to with any contact or IOL lens).
It sounds like the astigmatism might be complicating issues (and does impact whether to use a toric contact lens or not, which can be harder to fit) You might consider getting the astigmatism corrected via an incision, even without lens replacement surgery, if that might help. Larger amounts of astigmatism tend to be corrected via a toric IOL if you have lens replacement surgery, but small amounts are usually corrected surgically using an incision (either via blade or laser), often a limbal relaxing incision (LRI). The amount you mention is on the borderline where some doctors might suggest a toric, and others an incision. Some surgeons will actually do an LRI at the slit lamp in their office since its a minor procedure since it doesn't involve actually putting anything in the eye, merely a surface incision, or they can do it using laser. So if the astigmatism is an issue you could ask about perhaps getting that corrected. If you are definitely going to have lens replacement, its best to wait on that since they can plan the incisions for the surgery itself to counteract part of the astigmatism, in addition to whatever incision they add to correct the rest.
Although the surgery is extremely safe, no surgery is 100% safe and someone winds up being the "statistic", so its something to consider but to be cautious about. Eventually everyone who lives long enough needs cataract surgery, but the longer you wait, the safer it gets and the better IOLs they will have.Its like the issue of buying a new computer or smartphone or TV, the longer you wait the better options you'll have.. but in the meantime you live with a less optimal solution.
Are you able to wear contact lenses, even for a short time? Contacts have improved over the years, so if you hadn't tried them in the last decade or so you might give them another shot. You could try a multifocal contact lens to see if that works out well for you before considering an IOL, or contact lenses in monovision. Both of those would be useful tests also, for instance to see if you can adapt to a tiny bit of monovision. (with the Symfony, a bit of micro-monovision, not enough to have much impact on distance vision or stereopsis, can be useful). A multifocal contact would also allow you to try to pin down where best to focus your eyes, since it sounds like you might wish them to be focused at intermediate distance rather than at far distance, to be able to give you enough range to see things up fairly close. (though 4 inches is going to be a bit of a struggle to get to with any contact or IOL lens).
It sounds like the astigmatism might be complicating issues (and does impact whether to use a toric contact lens or not, which can be harder to fit) You might consider getting the astigmatism corrected via an incision, even without lens replacement surgery, if that might help. Larger amounts of astigmatism tend to be corrected via a toric IOL if you have lens replacement surgery, but small amounts are usually corrected surgically using an incision (either via blade or laser), often a limbal relaxing incision (LRI). The amount you mention is on the borderline where some doctors might suggest a toric, and others an incision. Some surgeons will actually do an LRI at the slit lamp in their office since its a minor procedure since it doesn't involve actually putting anything in the eye, merely a surface incision, or they can do it using laser. So if the astigmatism is an issue you could ask about perhaps getting that corrected. If you are definitely going to have lens replacement, its best to wait on that since they can plan the incisions for the surgery itself to counteract part of the astigmatism, in addition to whatever incision they add to correct the rest.
Although the surgery is extremely safe, no surgery is 100% safe and someone winds up being the "statistic", so its something to consider but to be cautious about. Eventually everyone who lives long enough needs cataract surgery, but the longer you wait, the safer it gets and the better IOLs they will have.Its like the issue of buying a new computer or smartphone or TV, the longer you wait the better options you'll have.. but in the meantime you live with a less optimal solution.
Also, as I note in a reply below, another option to look into is to get laser correction for the myopia and astigmatism, then use a corneal inlay to deal with presbyopia.
Hi SoftwareDev, KKinCa, and all posters. I have some updates as I have gone in for my preoperative meeting here in Toronto with a very experienced Cataract Surgeon with over 150,000 eyes in the last 20 years and with all the latest technologies including the Catalys, Femtolaser, Lasik, PRK, ICL and IOL.
I have to update my condition somewhat as I was diagnosed with an onset of Cataract in my Left eye that is causing my blurring. My dominant Left Eye has diminished over the last 2 years to -6.25 from -5.5, no astigmatism. My Right non-dominant eye is steady at -4.5 and +0.50 Cylinder and 145 Axis. They have determined I would be a good candidate for the Tecnis Symfony Extended Range of Vision (non-Toric).
They have been using Symfony IOLs since they came out and nthe new EROV since Health Canada approved in 2015. After my tests the technician and consultant said you are going to love not needing glasses. I hope they are right ;-) I will be going in to surgery next Monday 07-Nov-16 for the right non-dominant eye and returning the next day for the Left and again the following day for post-op.
The slight astigmatism as SoftwareDev explained can be done at original lens removal. The slit as I understand can be placed to offset the astigmatism, remove the lens and then insert the new lens.
I also understand that the opening is so small that they let it heal without sutures.
Just a correction on my statement re reading music and my distance for the Essilor 360 was set at my arms length plus 4 inches or 1 metre, or 40". I will be happy to wear readers if necessary and hope to achieve optimum sight for intermediate sight including computer and reading music, both at 40" or so.
Thank you all for sharing your posts and experiences and I will be back to share mine.
I have to update my condition somewhat as I was diagnosed with an onset of Cataract in my Left eye that is causing my blurring. My dominant Left Eye has diminished over the last 2 years to -6.25 from -5.5, no astigmatism. My Right non-dominant eye is steady at -4.5 and +0.50 Cylinder and 145 Axis. They have determined I would be a good candidate for the Tecnis Symfony Extended Range of Vision (non-Toric).
They have been using Symfony IOLs since they came out and nthe new EROV since Health Canada approved in 2015. After my tests the technician and consultant said you are going to love not needing glasses. I hope they are right ;-) I will be going in to surgery next Monday 07-Nov-16 for the right non-dominant eye and returning the next day for the Left and again the following day for post-op.
The slight astigmatism as SoftwareDev explained can be done at original lens removal. The slit as I understand can be placed to offset the astigmatism, remove the lens and then insert the new lens.
I also understand that the opening is so small that they let it heal without sutures.
Just a correction on my statement re reading music and my distance for the Essilor 360 was set at my arms length plus 4 inches or 1 metre, or 40". I will be happy to wear readers if necessary and hope to achieve optimum sight for intermediate sight including computer and reading music, both at 40" or so.
Thank you all for sharing your posts and experiences and I will be back to share mine.
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.
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.
1 Comments
Excellent outcome, we're all very happy for you! If you don't mind, could you share what your Rx was before, and what your manifest refraction is now?
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!!!)
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!!!)
2 Comments
Very glad you are having such wonderful results. Did you go to another country or use a doctor in Greece who advised monofocals?
Very glad you are so happy with your results. Did you go to a surgeon in another country or use one in Greece who recommended monofocus?
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.
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.
3 Comments
I'm not sure if this is directed at me, but I'm in the US but had my surgery done in Europe since the Symfony wasn't available here, and only had the day 1 postop done over there. Traveling wasn't a problem. I was the first patient to get the Symfony with the surgeon I used, but I wasn't concerned because he had done 40,000+ surgeries and the Symfony is the same physical shape&size and implantation method as other Tecnis lenses (their monofocal&multifocal).
I'm not sure who had the "horrible experience" you are referring to. If you are referring to me and the flickering side effect (which isn't "horrible" anymore), as I mentioned as far as I can tell it has nothing to do with the lens choice but is due to my iris jiggling (iridodonesis) when the eye moves, a very rare side effect (not something they have statistics on, I get the impression that it may be only one out of tens of thousands of cases, or at least several thousands) that isn't something they couldn't guess at in advance, especially since only a subset of those who do have iridodonesis have a visual artifact. The artificial lens is smaller than the natural lens and so in some people the loss of support for the iris after cataract surgery can lead to movement of the iris.
I'm not sure who had the "horrible experience" you are referring to. If you are referring to me and the flickering side effect (which isn't "horrible" anymore), as I mentioned as far as I can tell it has nothing to do with the lens choice but is due to my iris jiggling (iridodonesis) when the eye moves, a very rare side effect (not something they have statistics on, I get the impression that it may be only one out of tens of thousands of cases, or at least several thousands) that isn't something they couldn't guess at in advance, especially since only a subset of those who do have iridodonesis have a visual artifact. The artificial lens is smaller than the natural lens and so in some people the loss of support for the iris after cataract surgery can lead to movement of the iris.
No, no, SoftwareDeveloper, it wasn't you - I was responding to "789Chris", whose post appeared at the very bottom of the list when I responded to it. Now it appears much farther up. In any event, he had said:
"789Chris
I had both eyes done with Symphony IOL 1 month ago and still have significantly blurry vision (20/50 in one eye and 20/70 in the other). I also see extremely intense starbursts and halos so much so that i think i will never be able to drive at night. Extremely disappointing and surgeon does want to give me any explanation.
Jul 29
Report "
I haven't found any further posts from him, so either there is some interesting story that we will never know, or else he is some kind of troll. It is certainly the most negative story involving the Symfony that I have seen yet.
"789Chris
I had both eyes done with Symphony IOL 1 month ago and still have significantly blurry vision (20/50 in one eye and 20/70 in the other). I also see extremely intense starbursts and halos so much so that i think i will never be able to drive at night. Extremely disappointing and surgeon does want to give me any explanation.
Jul 29
Report "
I haven't found any further posts from him, so either there is some interesting story that we will never know, or else he is some kind of troll. It is certainly the most negative story involving the Symfony that I have seen yet.
Sorry for the confusion, I didn't see the 789Chris post. I didn't think your post was directed at me, but since I started this thread/page I responded just in case as the default person replies are addressed to.
Unfortunately even with a monofocal some people can get problematic halos, there is no lens yet that doesn't give them to some people. Even those with a natural lens still can have halo issues. Also, most studies of halos are done at 3 months or 6 months or so postop because many more people have halos temporarily in the first few weeks/months postop, and the poster was only at 1 month postop. Even at one month, someone's eyes could still be healing. In this case its also possible he might have residual astigmatism or PCO or some other eye condition unrelated to the surgery. Unfortunately most people who have good results won't post afterwards, so its only those with issues that tend to post.
That post is recent so I doubt there would be any updates, if none are posted you could always try sending the poster a private message. In case you hadn't used them before, I'll note that Medhelp alerts the user that they have a private message via the email they registered so they are more likely to respond than to a public reply they may not notice.
Unfortunately even with a monofocal some people can get problematic halos, there is no lens yet that doesn't give them to some people. Even those with a natural lens still can have halo issues. Also, most studies of halos are done at 3 months or 6 months or so postop because many more people have halos temporarily in the first few weeks/months postop, and the poster was only at 1 month postop. Even at one month, someone's eyes could still be healing. In this case its also possible he might have residual astigmatism or PCO or some other eye condition unrelated to the surgery. Unfortunately most people who have good results won't post afterwards, so its only those with issues that tend to post.
That post is recent so I doubt there would be any updates, if none are posted you could always try sending the poster a private message. In case you hadn't used them before, I'll note that Medhelp alerts the user that they have a private message via the email they registered so they are more likely to respond than to a public reply they may not notice.
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.
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).
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!
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!
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