Both eyes at once

Sorry , somehow I spontaneously posted . The left eye has been very steady and mediocre for several years. My doctor does recommend the surgery since there are cataract and it's not getting better . I hope for an easy three week wait.

Halos seem to be a constant theme. I think I'll take what happens with the new lens. I have pretty significant halo now.

Thanks

Very sorry you had this happen, bmag78.  Are you posting here to ask a question, or just to vent?  Since you posted as a reply to a thread about doing both eyes at once, do you have a question specifically related to that?

FYI, I'm not sure if you perhaps didn't notice that bmag78 is the original poster who started this thread/page, and is responding to the comments we've been making above with updates/more information.

Oops, sorry about that.  I tend to read the comments as I'm notified of them and hadn't noticed that.

Yes I have a question about that and asked my question way up top in the first post.

I kinda started this thread

Hi Diane and All

Were you satisfied with the results? My eyesight had a rapid deterioration.

I did my right eye yesterday with the Symfony Toric. Tho it's been less than 24 hours I couldn't be happier. There's some lingering swelling and pupils are still dilated so things haven't settled down yet but already I can read things I couldn't before, things are brighter and clearer . Winter in new York is drab but now it's clearly drab. Lol.

I just came from my one day follow up. Doctor said things went great and eye should get even better for a couple of days so I'm thrilled so far and I don't expect setback.

I have scheduled the left eye for Feb 21 and am very excited , especially if the left goes as well as the right.

My original post concerned doing both eyes at once. Tho the choice was made for me by the doctors schedule , I would still choose to have each eye done separately after a short interval , tho if time were an issue I would encourage that as well.

My main defense of a delay would be the ability to compensate for any irregularities in the original procedure during the second operation but my doctor nailed this eye spot on.

I have the luxury of time right now so I am comfortable with my choice .

If time were an issue and you had confidence in your doctor I wouldn't hesitate to do two at once. This would save a couple of bucks too , tho when it comes to eyes money is no object.

Since I brought up money , and apropos of nothing. I'll tell you my out of pocket costs , just as a reference.

$3000 USD per eye and $1000 USD for the fee at the facility where the procedure was done.

That's for the Symfony Toric.

All great and very happy. Thanks for all contributions.

"tho if time were an issue I would encourage that as well." To clarify i would encourage same day surgery if necessary

Hi bmag, you too are a star, I was just saying in one of my previous posts that I would love to hear from those who have had pain and successful surgery, cant remember if you had cataracts removed in both your eyes, please let us know from all that distance away in the Big Apple, what a wonderful place to live, have been there twice for a holiday, magic.  As you can probably tell I had both eyes done with 5 weeks between, my sight is OK but I have lots of awful symptoms, I am learning to live with them.  Again so pleased to hear that you have had successful surgery 

Regards Agnes

Sorry bmag, just noticed I should have said pain free and successful surgery

Regards Agnes

You are an inspiration Diane, this page mainly deals with problems after cataract surgery, it is so good to read letters like yours and will give comfort to those having to go through the op.  Lets hope all will be totally well with you and you sound good.  Would like to hear from others that have had successful surgery, like, what symptoms were like after surgery.

Regards Agnes

Hello to all here

After a week I'm still thrilled with the results. No complications and the only complaint I have are the halos which are conspicuous and a minor distraction but one that I would prefer to do without. They're only annoying while driving , (headlights , tail lights , light posts) .

I have an acquaintance who had this same procedure as mine a month ago and he's thrilled too and says the halos are very mild after 6 weeks.

I'm scheduled to do the second eye in two weeks but I'm actually now considering waiting for the "next best thing" to come along in a year or two.

Tho I think I'll still probably do the other eye on schedule.

Unfortunately it isn't clear there is a "next big thing" on the horizon within the next year or two. Europe and other places tend to approve things faster than the US does, for instance the Symfony was approved in Europe 2 years before it was available in the US. There isn't anything obviously the "next big thing" approved elsewhere at the moment as far as I'm aware. There are trifocals available outside the US which give better near than the Symfony, at the expense however of a slight reduction in intermediate (based on the average results), and a slight  increased risk of halos&glare issues and reduction in low light vision due to the light being split to 3 focal points. I also haven't heard of any of them even trying for approval in the  US, they were available some years before the Symfony  was elsewhere. There is a fairly recent trifocal, the Panoptix, which is from one of the largest lens companies, Alcon, which has many IOLs approved in the US so its possible they might try for approval here, but I hadn't heard anything about clinical trials for approval even being started. There are other extended depth of focus lenses in various stages of development outside the US, but they haven't yet received much testing to see how they compare for sure with the Symfony, but the difference is likely to be small.. and they may not be approved here soon since they aren't currently from big lens companies (though they might be bought up by one of course). The Mini Well is one I'm curious about based on some studies in Europe, though I'm not sure if it has a CE Mark yet or if the studies are just pre-approval trials and its not yet approved there. It *might* be a slight improvement over the Symfony, it isn't yet clear yet, the same with some others. 

The "holy grail" of a true accommodating lens that gives a decent range of vision (unlike the Crystalens) seems a ways off. I'd seen mention that  one of them, the FluidVision is applying for European approval, a CE Mark, but I hadn't seen updates for a while so I don't know what the timescale is. Despite the hype about it, the early studies I've seen also suggest it might not be much of an improvement (if it is one)  when it does arrive, though I haven't seen enough to be sure, no head to head comparison trials (comparing different studies isn't always accurate since they may have different patient demographics, etc). It seems best also to be cautious about how early an adopter to be of an accommodating lens that needs to move in the eye since there is more that can potentially go wrong over time in terms of the friction and wear and interaction of the lens and the eye and positioning of the lens over time. Static lenses have been used for quite a while, e.g. the Symfony is physically the same material and overall size and shape as the widely used Tecnis monofocal and multifocals. Most of the features of a static lens are tested on optical benches easily, but accommodating lenses can only be fully tested in important ways in real eyes.

e.g. there was a lens the Synchrony which showed promise as providing more accommodation than something like the Crystalens, but I'd heard it was either pulled off the market, or just not being used by surgeons, due to a significant minority of patients having problems related to how it accommodates.  I'd checked into it before it got pulled, when I'd heard they were working on planning US trials,  before my surgery. I realized that although I'm an early adopter in general that I'd likely be more cautious about accommodating lenses than static lenses. I postponed my surgery for 2.5 years after the problem cataract appeared, since one eye still had good vision, in hopes of a better lens, and the Synchrony went away during that time so I never had to think through in detail   the risks of trying a new accommodating lens. 

 

The latest results I see for the FluidVision accommodating IOL, the one that I'd seen was in pursuit of a CE mark (European approval) can be found by googling:

"Thirty-six month monocular and 12 month binocular experience with a fluid-filled accommodative intraocular lens"

where the abstract of a study presentation notes:

"Best monocular corrected distance VA was very stable averaging logMAR -0.02 through 24 months. Distance corrected intermediate and near VAs were also stable averaging logMAR 0.10 for intermediate and logMAR 0.24 for near. Binocular corrected distance VA averaged logMAR -0.06 through 12 months. Amplitude of accommodation was stable at 3.3 D monocular and 3.9 D binocular."

If you'd only seen the last sentence, the claims of 3.3D-3.9D accommodation sound good, which is why many stories about next generation accommodating lenses pique interest (e.g. wondering if it'd be worth a lens exchange for me, if they'd work for someone who already had their natural lens removed),  but it depends on how they define it the range of accommodation (there are different metrics out there)

The actual near result they mention (which is also I notice is  given as "distance corrected" rather than the uncorrected vision,  to make it slightly better) is logmar 0.24, about halfway  between 20/32 and 20/40, which isn't  quite as good as most Symfony results (again, cross-study comparisons can be misleading)   or at best comparable rather than noticeably better. For intermediate its  logmar 0.1 which is 20/25, which also isn't quite as good as the Symfony.  Even the distance acuity is only just at 20/20, and the Symfony tends to do a bit better. Its an early study though and they may have refined the lens since then, and again cross-study comparisions can be a bit misleading, but to me it isn't clear its an improvement. Its possible that for very near vision it doesn't degrade as quickly as the Symfony, that the near may not be great but it doesn't go down much further, but it if so it isn't clear whether it matches trifocals. 

Of course the results will improve as the lens is refined, e.g. I think they use larger incisions still, but the point is it isn't clear the lens is there yet, which means doubtful there will be a version approved anywhere within a couple of years that is a noticeable improvement worth waiting for.

Of course the hope is that a single focus accommodating lens might have less issues with halo&glare than a diffractive lens. However the actual studies of the potentially accommodating  Crystalens tend to show higher levels of halo&glare than the Symfony (with again a caveat that comparing studies can be misleading, questions asked can be different) despite its being a single focus lens that suppposedly accommodates. The aspects of the lens that make it accommodate might potentially lead to visual disturbances (and to its best distance vision not being quite as good).  I don't recall seeing figures from the FluidVision on issues like halo&glare though if there are any they'd be based only on early small studies still. 

 

Thanks for the comprehensive info. I'm almost certainly doing my other eye on schedule in two weeks but just some random thought.

I wasn't even aware of the accommodating lens. Though the theory sounds good , new tech always has some quirks right out of the box.

One oddity in my profession (ships) is that nobody wants to sail on a brand new ship or yacht since there are always unexpected problems or "gremlins".

I think I'll stick with the most recent "latest and greatest" and do another symfony.

Sorry if I went overboard, your comment about waiting for the next big just happened to touch on what I went through. I'd actually expected to just do the first eye and wait on the 2nd which barely had a cataract, but decided since i was traveling it was best to get it done.  When I had a cataract at age 49, I didn't like the thought of losing my near vision, but the only multifocals approved here then were high add bifocals that skipped over the intermediate vision important to a software developer (and for general all around use).  So I did my research and tried to wait for the US to approve the next big thing, or have clinical trials for one at least (though most are useless unless you wish to risk being assigned a monofcal control), until I finally gave up to go abroad for the Symfony when I couldn't wait any longer.

Once I got in the habit of following the issue, I've kept paying attention out of curiosity, and to be of help to others I know, and in case some lens appears that is worth the risk of a lens exchange (though there likely won't something worth the risk for  for quite a while since my vision is good enough now, but eventually they'll have one that'll restore visual range to that of an 18 year old,  and at some point after that they'll even include   a computer display along with it  :-) ).

.