AT Lara or AT Lisa - what are they like?

Hi Sue,

Thanks for your reply - I have had a pretty good discussion with the surgeon, and I do have a list of questions for him. I guess the challenge is that the surgeons have to be cautious in their advice, and it is very different to hearing the experience of other patients or recipients. I'm not keen on mini-monovision. I'm also not keen on the idea of monofocals if I can get something that is a bit less reliant on glasses. I understand the limitations and also the night vision issues - although with cataracts I already have halos and stars! I'm really looking for something that gives me good distance, decent contrast, and that means I won't always be looking for glasses in general daily activities. It's really good getting an idea from you, and others about the 'real world' experience rather than just stats and clinical outcome averages.

Thanks again.

It's great you have a surgeon willing to discuss various options and it is good he isn't promising glasses free with premium lenses. Results patient to patient do vary and the healing process itself can bring about .25 diopters either way (near or far sighted) off target. If targeting plano most will target .25 less as it is far better to be under corrected than over corrected. Artificial lenses being much thinner 1mm vs 4mm of natural lens affects visual results once it settles.

I didn't want a mini monovision for myself either due to migraines and possibility of that setup increasing those. I do spend good deal if my day on a computer and wanted to avoid progressive lenses if possible. I am thankful I don't need glasses for most situations. My surgeon too didn't promise glasses free but did explain the trade off of night vision but I would be less dependent on glasses with Symfony. Went into surgery hoping for the best but knowing it may not work out that way.

Do you need both eyes done - are cataracts affecting them both? I suffered from night vision loss due to cataracts as well. Even if you need both eyes done I would suggest waiting till fist eye is completely healed before doing the other eye. That way small adjustments can be made to complement the first eye if need be.

The surgeon is very willing to talk which is good. Everyone has been very clear about how nothing is certain, but I just want to try and give myself the best possible opportunity. I spend time on a computer and switch to distance quite a lot - so I'm okay if I need glasses for very near work. I do need both eyes done, though neither is very bad, but in one eye it is very central. Plus my night vision and contrast vision has become very poor. You will understand how hard it is to describe - I can get pretty good results in an eye test, but it's not the same in day to day life.

At time of my diagnosis RE could see 20/60 and LE 20/40. In canada surgery is covered if cataracts make your eyesight 20/40 or worse. At the time even with glasses couldn't read big E. Roadsigns were nearly impossible to read and yes night vision was rubbish - halos and contrast issues. But if your eyesight can be corrected with glasses you do have time and even with my eyesight poor - near vision was still good and wanted time to research lens options.

If you don't mind wearing glasses for near (and you may not need them anyways) atLARA targeted for -.25 would give you good range. I found my near vision improved with Symfony after 2nd surgery.

Thanks Soks - that's an interesting suggestion. I will definitely ask the surgeon.

What terrific news - glad all is going so well for you!

For Symfony lenses I really think they are part of lens design versus any other issue. Over 18 months I have had them they've not diminished. They have gotten a little more defined - less fuzzy but inner 4 rings are vivid/bright and outer 4 rings very light.

Thanks for the update - it's interesting to hear from someone who has experienced the actual lens. I am also quite myopic but I've always had very good vision with RGP lenses. So, I was originally happy with the idea of the AT Lisa, but the opthalmologist worried me with three things: 1, he said that distance vision wasn't as good, 2, he said that contrast was significantly worse, and 3, he said that near vision wasn't guaranteed. Now, I know nothing is guaranteed but I've also read that the AT Lisa and Lara are both very good for distance so I guess that is relative. I do worry about a loss of contrast though - and I'd be very interested to hear your experience of that. Also, having read a lot about these recently, I'm wondering if the dips in focus between far, intermediate and near bother you at all? Thanks for your reply.

I cannot weigh in on the Zeiss lenses as they aren't available here in Canada. Britkennels will be better one to provide that input.

But my Symfony lenses are an EDoF lens like atLARA.

The EDoF lenses are different than the trifocal lenses like atLISA in that it is a continuous range of focus - no dips in one range to next. They also provide better contrast as the light isn't split between the 3 distinct zones like a trifocal. EDoF are supposed to be close to a monofocal when it comes to contrast. The advantage of the trifocal will be better close vision than EDoF but again that varies eye to eye. I wasn't expecting to see near as well as I do. Was told it would be 18 or 20 inches but I see sharply at 11 inches with Symfony . at LARA are supposed to provide a little more range than Symfony.

Hi again, Giles,

Keeping in mind that these are my experiences, here is what I've experienced in the last year:

1. My distance vision is 20/20. I look out the window and can see things that I haven't seen clearly in over 40 years, despite wearing contacts. My close-up vision is also 100% (J1? or something like that). I don't need readers and probably never will. I was wearing +2 readers with my -8.0 and -8.5 contacts and my vision was crap. It was the same if I had to wear my Coke bottle glasses (it gave me great, great joy to destroy those monstrosities).

2. Forgive my ignorance, but what exactly do you mean by contrast? FWIW, colors are just as sharp and nothing is distorted.

3. As others have said, these are premium lenses and not available in the US. The German manufacturer, Zeiss, has a very high reputation and now I understand why. No, nothing can be guaranteed (do you have eye issues? retinas strong? etc), but if you can pay the extra that it may cost where you live, it is so worth it.

I have no dips between distances. It honestly is like seeing with my own natural lenses. I look up, I look down and it's "fluid." Of course, by that I mean there's not a slight adjustment or a little dip in the vision; it's exactly what you have with your own lenses. Again, I do see concentric circles in dim lighting, but the doc said it's due to my being a high myopic (evidently, we have a tendency for large eyeballs and so when you're pupils dilate, they're going to be larger than the norm). If you should also have this problem, it's a little annoyance at first, but it really does become second nature to just look at a light source for 2-4 seconds to solve the problem. Of course, I have to be honest and say that my vision with contacts was giving me tension headaches, etc, because I had so many issues...and contacts weren't going to resolve those (the new lenses and laser treatments did). So, ANYTHING would have been better than what I had, but this truly surpasses my expectations. Hubby had his eyes done first and he has had the same experience, no dips, 100% vision, etc. In the hands of a skilled surgeon, these are amazing lenses.

I hope that helps a bit.

Cheri

Thanks Cheri for your detailed description. Awesome that you don't have any dips in your vision at all. Sometimes actual experiences ate do different from what you read.

I think what Gilles meant by contrast sensitivity is no so much colors being vivid but at low or dim lighting situations. IE for myself in upscale restaurants where there is low lighting I cannot read the menu. I need to pull out my iphone flashlight. I was able to compare my 2 eyes during 6 weeks between surgeries. Even with a cataract in my eye I could read the menu with that eye but not so with Symfony eye. I recall last fall after going to parent-teacher interviews at her school when I was heading to parking lot (no outside lighting on) had trouble seeing where potential potholes and steps were in the pitch dark. Again the iphone flashlight came in very handy. Colors looked much brighter after surgery but my cataracts shed a brown tint on everything. Read a blog from a photographer recently that had clear lens exchange to correct near vision and opted for symfony lenses say in their blog the blues were slightly off but comparison between their eyes would be of someone younger with no cataracts. I can't say but blue looks blue to me.

Do you see well in low light conditions?

Have yourself a great evening - take care and keep enjoying your great new eyesight!

Hi Cheri and Sue,

Thanks for your long replies - it is really helpful. Sue is right that I was really trying to get an idea of low light conditions. Do you struggle to make things out at dusk or in the evening, or on grey days. That's what the opthalmologist was getting at - he suggested tri-focals let less light in, and so it can impact on low light situations. I've also read a lot about taking time to get used to the lenses - some people seem to take to them straight away, some take a while and it seems to get better as time passes. Was that your experience? Thanks to both of you for your comments.

Hi giles,

Mt 2 cents: I have an IOL (Symfony) in only one eye. I notice that low light vision is decreased in that eye only because I have a natural eye to compare against. If I had surgery on both eyes I would not have noticed the decrease in vision as I would have nothing to compare but the decreased would have been still there.

Giles - i think I recall reading or maybe it was my surgeon who said the contrast would be in range of 15% less than natural lens. Even with monofocals there is some reduction in contrast too.

I know the younger you are facing cataract surgery it is more about trade-offs and compromises. My surgeon said those who are older (70s+) gain something through cataract surgery they'd lost years ago.

I had cataracts both eyes and had 6 weeks between surgeries and can definitely say there was a contrast difference. But now 18 months out the contrast issue is not a big deal. The few times light is dim and i have to turn on a bright light or use iphone flashlight is minimal. Not bothersome to me.

The biggest compromise will be night vision or if you are younger/pupils dilate beyond IOL that is more troublesome.