Why was EDOF invented if Trifocal is better?

i think the edof may be a failed experiment. it did not live up to its expectations and drs are going back to trifocals.

there is serious loss of contrast with symfony compared to natural eye. cannot compare with monofocal.

do you mean pan optix focii at 40 cm and 60 cm? or do they have an additional near focal point.

how many focal points for near does the lisa have?

Well, edof does give you a wider vision range than a monofocal, so I would not say it has failed, but you are right it makes no sense that Zeiss have started to sell that edof, when they already had the Lisa.

But off course we should keep in mind, that others can have a different experience than I have.

The panoptix have 4 focal points, but the far focal point and the focal point closest to far is "melted" together, so in real life these works as one focal point.

The two remaining focal points are the 60cm intermediate and 40cm near focal points. Panoptix do have a drop off between far vision and intermediate, so in theory it has a soft spot somewhere around 80-100cm but I think it varies how much people feel the this drop off.

Lisa and Finevision have 3 focal points that are spread evenly, at far, 80cm and 40cm. In theory these have a drop off between the focal points, but I really don´t feel any soft spots at all.

I will politely disagree soks. Of course I would love to gave know if I would be a rare individual who would see all distances with a monofocal targeted for distance but that is a mystery that can't be solved. I am pleased with Symfony's results.

i am saying that because technis invented trifocal after already having edof.

i m happy for ur results though i believe u wud be the rare lottery with monofocal.

Quite possible and it would have saved me $1,800. By now I would think surgeons would know who would get better results have eye mapping is completed!

my near vision with SYMFONY is poor. it has become more bad probably because of PCO. what did they say about mix matching multifocals. one surgeon told me if i i am unhappy with near then match it with the bifocal available back then. edof and tri cud be better as edof would make up for the drops. synergy looks like a trifocal and promises no contrast lost. they also say continuous vision until 33cm or 12.9 inches which is pretty good.

also technis family helps with the colors consistency for symfony folks. while danish and some pan optix recipients don't notice soft spots. some lisa folks have experienced the soft spot and posted about it. also it seems that some people take time getting used to near with trifocal. i wonder if others have matched edof / tri or if danish is the pioneer of that combination.

i am scared of promises though. u r right dysphotopsia problem also remains a concern.

Sounds like typical marketing stuff from Abbott/J&J--the Eyhance is a game-changer, the Synergy is a game-changer, and i am sure they said the same about Symfony. It looks like they are trying to address the nighttime issues with synergy though with the destructive interference and violet light filter designs to try to mitigate the rings/halos. So perhaps it will mitigate those issues say from a 5 to a 4 but i don't think they will go away. Plus they don't call out the trade-offs, like will the blue filter affect the color differently than a Symfony. The only way to get some feedback is for patients/doctors to start posting about it on here or elsewhere, or ideally if they do clinical trials that include mixing symfony and synergy but i think that is a long way off and i don't think i have the luxury or patience to wait that long, but thanks for the heads up about it!

will u go with another Symfony? How is your near with the Symfony?

leaning towards another symfony but haven't ruled out monofocal for distance. Near with symfony isn't bad but seems to have degraded slightly post YAG but that could be my cataract in they other eye making it worse. I am trying to hold off until next year but still don't think those other tecnis lenses will be available in US then

John,

I think your comment about the defocus curves resulting in different experiences between patients is very accurate. In my case, with the a RESTOR 2.5D, I very much notice the defocus range between my far and intermediate focal points (and it's pretty close to where it should be based on the technical literature). I haven't found anyone else who notices it though and my surgeon said he can only remember one or two other patients that noticed it.

It's not a huge probably for me now, because the multifocal contact in my other eye fills in the difference but it's also why I am planning on Panoptix or some TBD EDOF design when that eye finally needs the surgery.

The trifocals don´t have the same drop between the focal points as bifocals such as the Restor have, it is to smooth out the curve and give usable intermediate the trifocal was made.

The Panoptix do still have a little soft spot between far and intermediate, but I don´t think people really notice it.

As an example with the Restor 2.75, you have two focal points, one far and one near at 2.75.

And as an example the Lisa trifocal have focal points for far, 1.66 and 3.33. So the focal points are much closer than on the bifocals, and therefore a smoother defocus curve.

The edof iols are really multifocal iols, where some light are "bend" to fill out the gap making the smooth defocus curve.

In bench testing the Symfony acts like a normal bifocal, with a focal point for far and a focal point at 1.75, so this is the actual range you get with it, but because some of the light are used to fill the gap, if has no dip at all between the two focal points, making it an edof iol.

And for the same reason, surgeons often make a little bit monovision with the two Symfonys, if you want good reading vision, because that range is not covered with the 1.75 range in itself.

The Zeiss Lara edof I have is a manipulated trifocal, where light fill out the gap the same way as on Symfony.

The Lara only makes +2.0, so marginally more than Symfony, but still not reading vision, in most cases you want 3.0 to have reading vision.

All that said, it makes a big difference to reading vision when both eyes are fixed, you can not judge your reading vision with only one eye done, no matter what iol you have.

With my Lara eye alone I don´t have good reading vision unless lighting is really good, but the Lara eye still makes reading a lot better on top of the trifocal, so even that the Lara is not in focus close up, it still adds a lot to the reading vision, it is pretty wild what our brain can do.

"The Panoptix do still have a little soft spot between far and intermediate, but I don´t think people really notice it." -- PanOptix claims that their intermediate is at 60cm vs 80cm with Lisa/FineVision since 60cm is more utilized than 80cm.

I think some people would still see a drop in lisa/fine from 40cm to 80cm. However 80cm would make it almost an EDoF as distance would most likely cover everything till 80cm + the have a near for 40cm.

For some people the drop would be in panoptix from 60cm to whatever distance their distance is covering. Their near range would be longer from 40cm to 60cm there should be minimal drop.

Thanks for explaining with the +Diopter measurements.

Well yes, the Panoptix intermediate is 2.2 and their near is 3.2, and therefore it have a drop off between intermediate and far, because the focal points are to far apart.

Whereas Lisa have the 1.66 (80cm) and 3.33 (40cm), and in theory it could have a soft spots between the focal points because they are to far apart, but in real life I don´t feel any soft spots at all, I feel good continuous vision, like I think users of Panoptix also feel good continuous vision.

I know Panoptix claims that 60cm is more used than 80cm, but I think that is a matter of personal opinion, in my daily job I work on two 32" pc screens that are placed 80-90cm from my head.

If I move my head so the screen is 60cm away, I see it fine with both eyes. The Lisa vision is slightly more sharp at 60cm, but difference is very small, so I really think that Panoptix company is just letting out hot air.

Panoptix works great in real life, so does Lisa, so does Finevision 😃

Here is some defocus curves from real life experience made by an experienced surgeon.

What is the deal with 33cm? That is the distance Synergy is advertising. Distance to 33cm of continuous vision.

The 33cm is just a distance where the surgeon have decided to make a measurement, you can measure at any distance you like, and these are results from actual implants from a number pf patients that have received the different kind of iols, this is not hot air from the manufacturers.

The manufacturers off course make their own measurements at the distances where their own lens performs the best compared to other lenses, to show the best side of their lens.

I think Synergi is just another trifocal, it will probably work great, like the other trifocals.

No matter what they do, they only have the same amount of light to spread in the range you want vision, so they can not make something that are very different, unless they come up with a totally different design, than multifocal lenses.

Again, even edof is just a manipulated narrow range multifocal.

All manufacturers tries to come up with strong selling points, but most of it is hot air....

That's probably true but i am glad i can stay in the technis family. and that the edof can cover the intermediate drops if any.