Considering Symfony IOL
Posted , 10 users are following.
I have been reading many of the Symfony discussions here - thx for all of the great discussions!
I have wore glasses since I was 10 and am now 61. Just went to (well known and respected) surgeon last week for consultaton re. Lasik. He recommended Symfony in my right eye. Here are my specifics:
Left eye dominant
Near sighted in rt eye and far sighted in my left eye
I believe (not 100% confident as the 1st intern type dr. gave it to me and it is not signed and dated - he gave to me as an fyi) my prescription is:
+2.25 - 0.75 x 162 +2.0
-0.50 - 0.50 x 041 +2.0
I thought I was near sighted in my right and far sighted in my left but the above seems to indicate different?
Anyway, I have always known my left eye was "better" and my right eye was weaker, in all aspects (near and far) it seems. Even with glasses the right eye never gets to where it can see better than my left eye, near or far. So my question/fear is this - "Is it possible for me to not wear glasses at all for reading, computer of distances by having Symfony installed in my right (weaker) eye only and then doing nothing to my left eye? The Dr. did say that eventually I may want Lasik in the left eye, but we should just see how it goes after having the 1st eye done. He also said that he thought I wouldn't be required to have readers, that I might want some mild readers for prolonged reading and/or computer work, which I am accustomed to doing several days per week.
What does everyone think? I appreciate everyone's thoughts.
0 likes, 14 replies
at201 sarends
Posted
Just to be sure, my comments below assume that your eye prescriptions are:
+2.25 - 0.75 x 162 +2.0 (for the right eye)
-0.50 - 0.50 x 041 +2.0: (for the left eye, which is the dominant eye).
1. You don't mention that you have a cataract in your right eye. I would advise againt having a cataract surgery just for improving vision or for removing the need for glasses for reading etc.
The Symfony lens is a good lens, but like every other lens, it has its associated issues. I have a Symfony Toric lens in my right eye in combination with a monofocal lens with distances set for monovision and allowing me to not having to use glasses at any distance. As I have indicated in these forums before, "I
am overall happy with my day vision with the combination and am satisfied with my choices. However, I do have an issue with the night vision because of multiple concentric circles seen with Symfony lens, as discussed under 'Has Any One Else Noticed This Unusual Vision Issue with Symfony Lens.'"
Are you using contact lenses right now or are you using glasses? I will probably stay with the same, except possibly for trying monovision with contact lenses to reduce the need for reading glasses. Since you will probably need cataract surgery in about 10 years, the LASIK improvement will not last for many years. However, if I had to choose between LASIK for right eye versus having a Symfony lens installed in my right eye just for improving vision, I would rather have LASIK surgery ( I have had LASIK in both eyes but this was after the cataract surgeries in those eyes).
sarends at201
Posted
I do not have cataracts now. My Dr. says that if I have Lasik surgery for my right (myopic) eye this will make it unable (with current technologies) to have an IOL at a later date. He emphasized, "with current technologies". The reason we (the Dr. and I) are considering the Symfony is because with Lasik we were contemplating monovision, correcting my right (nearsighted) eye for close up and correcting my left (dominant and far sighted) eye for clear distant vision. The Dr. did perform some tests to determine that it is likely that I would adapt fairly easily to monovision. However, he brought up the option for the Symfony in my right (non dominant and near sighted) eye and to (initially at least) leave my left eye alone. I like this idea (except for the reservations I am reading here) because, if it works well, it would leave me with both eyes being able to see (to some degree) able to focus near to far, and most of the time without glasses (the Dr. did tell me I might want low power readers to assist with reading or computer work. But, the Dr's hope, and mine, is that I would not (for the 1st time in 50 years) absolutely have to wear glasses 100% of the time. This is (very) appealing to me.
at201 sarends
Posted
I am glad that you are looking at the various options available to you at this time.
However, the statement that "if I have Lasik surgery for my right (myopic) eye this will make it unable (with current technologies) to have an IOL at a later date" is completely false. There is no problem in having a cataract surgery and an IOL after having LASIK done. You may want to google about that. The only disadvantage of having LASIK done before cataract surgery is that it is harder for a surgeon to figure out the exact IOL prescription. Thus, the prescription may be off by more than the typical error of -0.5 to +0.5 for an eye without LASIK.
In order to get the prescription for the IOL after LASIK closer to the desired value, the Mayo Clinic and other sites do say that:
"In addition to taking measurements of the eye, the surgeon also needs an accurate record of your prescription before and after LASIK surgery, as well as an accurate measurement of the curvature of your cornea before LASIK. The records from your LASIK surgery should contain this information."
So, please make sure that you have such records if you decide to have LASIK at this time.
ali58534 sarends
Posted
sarends ali58534
Posted
ali58534 sarends
Posted
sarends
Posted
OK, I was wrong about how I was interpreting my prescription - why was I thinking this? Here is my prescription again:
+2.25 - 0.75 x 162 +2.0
-0.50 - 0.50 x 041 +2.0
I am farsighted in right eye with a dyopter factor of +2.25 and I have astigmatism of .75.
In my left (stronger, mostly ok) dominant left eye I am slightly nearsighted having a dyopter of -.50 and I also have an astigmatism of .50. (I am not saying this so that anyone here understands this, I am only trying to state what my understanding is of my own prescription since I incorrectly stated it in my opening remarks).
What led to my misunderstanding was when I was conversing with my eye Dr. re. the possibility of Lasik surgery he was thinking this:
Correct my farsighted right eye for monovision to see clearly close up
Correct my near sighted (dominant) left eye for monovision for distance
I incorrectly was assuming that for monovision one would correct a near sighted eye to see clearly closeup (since it was already near sighted) and that one would also correct a farsighted eye, for monovision, to see clearly at distance (since it was already far sighted). But, I guess I was wrong as my Dr. was doing the opposite (he was planning to correct nearsighted eye to see clearly at distance and he was planning to correct farsighted eye to see clearly closeup). I can't say I totally understand this yet, but I wanted to simply reiterate here what I think is a better understanding of what my prescription is an what my Dr's thinking is.
And finally, to reiterate, he came up with the idea of the Symfony for my right (farsighted and all around weaker eye) so that it would be improved across the board (near, intermediate and far) since it is really not very good at seeing anything now without glasses. This is making more sense to me as I write this out, so excuse me while I record my thnking in order to better understand my situation, and my Dr's recommendation for the Symfony.
softwaredev sarends
Posted
You mention some tests suggesting you would adapt to monovision, but have you actually tried it with contact lenses? Unfortunately with most people considering IOLs, they've already got a problematic cataract interfering with their vision so they can't do a good test of it, but you can.
Even if you don't like the idea of regularly wearing contacts, if you can manage to do so for a while then you can test out options a little better before getting permanent correction via laser or refractive lens exchange. If you tried contacts in the past, but not recently, you might find the modern contacts are more comfortable and easier to deal with. You could also try a test with multifocal contacts, though it sometimes takes multiple tries to find which one works best for someone. The optics of a multifocal contact are different than something like the Symfony (and a bit different than even multifocal IOLs) but it might give you some idea of whether your visual system can adapt to different sorts of optics and to see if you prefer it to monofocals.
If you have one eye set for distance, a slight bit of monovision is useful with the Symfony to increase the odds that you'll get acceptible near, while not being enough to detract much from stereopsis or distance vision. Although most people don't need reading correction with the Symfony, some do so there is no guarantee, but its an even better bet with a bit of monovision. Its unlikely you'd need readers for computer work, but it depends on how far out your screen is, for instance many some people use laptops closer up than the typical desktop computer monitor.
The results of studies are averages, nothing is guaranteed. In my case the Symfony provides at distance 20/15 (at least, that line was easy to read but there wasn't one below it), 20/20 (plus a bit) at 80 cm and 20/30 at 40cm (at least, they didn't have a 20/25 line and I read some on the 20/20 line. In the past they used a chart I held at my best near distance and it was 20/25 consistently so it may be that at 40cm now).
If you google:
"visual acuity" "font size"
The first hit (and likely others) give examples of what visual acuity is required for what print size to know what to make of visual acuity results people talk about with IOLs for near.
What IOL is best varies with the person. It used to be that many people wanted good closein reading distance for books, but people these days seem to attach more importance to intermediate distance for computers, social distance and household tasks. If close in near is more important to you there are other options. If you are outside the US, there are trifocal IOLs (not FDA approved) that provide better near than the Symfony and lower the risk of needing readers, at the expense of not quite as good intermediate (but still good) and a slightly higher risk of problems at night with halos&glare. In the US there are bifocals that give better near, with even lower quality intermediate and risk of halos&glare. (though the risk is fairly low).
sarends softwaredev
Posted
softwaredev, thanks for the thoughtful discussion, and your suggestions. The contacts are, I am sure, a smart suggestion, although I loathe thinking about it as I have tried contacts 3 times over the years (hard, soft with toric, etc), each time I felt I was going to die until they were removed.
I use a 13" MacBook Pro held at (I estimate) about 18" -21" for work and reading (kindle). Now that I think about it, although I love to read, I seldom read a paper book these days. I also use an iPhone 6s+ an awful lot for email and work apps etc.
Could you explain a bit more what you meant by, "a slight bit of monovision is useful with the Symfony to increase the odds that you'll get acceptible near". How is that accomplished? Can the Dr. bias the Symfony for a certain distance, say 20"?
Thx for all your help!
Emis Moderator comment: I have removed the link(s) directing to site(s) unsuitable for inclusion in the forums. If users want this information please use the Private Message service to request the details.
http://patient.uservoice.com/knowledgebase/articles/398331-private-messages
softwaredev sarends
Posted
The average results for a Symfony set for distance show about 20/30 for -2 diopters = 50cm= 19.7" on the site I just checked (studies vary a bit). A distance can be converted to a diopter focal point with diopters = - (100/distance_in_cm) and the other way: distance_in_cm = -(100/diopters).
In my case I have no trouble with smartphones using the usual fonts (android, one had a 4.7" screen, now one with a 5.1" screen, though the increased size wasn't a factor in choosing the upgrade). With a newspaper in double column mode I can make it out if I try,but double tap to expand it to one column mode, which isn't a big deal and I suspect is typical.
Monovision is setting one eye to be somewhat nearsighted to improve its near vision, which is commonly done for presbyopia with single focus contact lenses or laser correction, or done with monofocal IOLs for those getting cataract surgery. The problem is that with full monovision, you ar mostly using one eye for distance and one eye for near, which reduces stereopsis (3D perception, depth perception) a bit as well as reducing low light vision, etc., and perhaps reducing distance vision a bit. The larger the difference between the eyes, the closer in the near eye is set, the more chance of problems and of difficulty adapting.
An IOL set just slightly in a bit, e.g. -0.5D, still leaves fairly good distance vision in that eye and had little reduction in stereopsis since you are using both eys for most visual ranges. However that means you have near vision a little further in with that eye whic boosts near.
The surgeon chooses the best distance focal point for a lens as the only way they can "bias it". The amount of near vision people get inwards and outwards from that point can't be changed by the surgeon, it mereley varies with IOL model. (e.g. a monofocal vs. the Symfony vs. multifocals or the Crystalens).
zarinh sarends
Posted
Can some one help me. I will have cataract surgery pretty soon. I am badly near sighted and far sighted. I can't read a word without my reading glass. Same goes for far sighted , I can't drive without my driving glasses. Dr. Wanted to put old kind of lenses which correct my driving but reading will be +2.00 or so. But i
suffered with that kind of power. Then he suggested symphony lenses , according to him it'll correct both the problem . But it's a new technology and I'm kind of scared. First it'll cost me bundle. Insurance company will not pay a cent . So , I need to know , is it worth spending that kind of money. $2500.00 per eye. How risky it is. Will appreciate a answer.
thanks
at201 zarinh
Posted
As I have already mentioned above:
The Symfony lens is a good lens, but like every other lens, it has its associated issues. I have a Symfony Toric lens in my right eye in combination with a monofocal lens with distances set for monovision and allowing me to not having to use glasses at any distance. As I have indicated in these forums before, "I am overall happy with my day vision with the combination and am satisfied with my choices. However, I do have an issue with the night vision because of multiple concentric circles seen with Symfony lens, as discussed under 'Has Any One Else Noticed This Unusual Vision Issue with Symfony Lens.'"
So, the main thing is to be aware of the pros and cons of Symfony lens.
softwaredev zarinh
Posted
People can see the responses on the new page zarinh started on: "Symphony lenses for my cataract operation" instead of duplicating them here (click on "zarinh" to see the profile and you can find the post from there).
at201 softwaredev
Posted