Cataract Lens choices
Posted , 10 users are following.
Hi, I'm about to undergo cataract surgery in about a month and pondering what lens to use.Would appreciate any suggestion for my situation.
I'm 61 and has been nearsighted since youth. My eye prescription is as follows:
-6.0, -0.75, +2.5
-6.5, DS, +2.5
So I'm quite nearsighted on both eyes, slightly astigmatism on my right eye, and moderate presbyopia on both eyes. I've been wearing progress glassed for the last ~10 yrs. The cataract doctor was pretty sure that Sympony lens is most suitable for me. The main reason he mentioned is Symfony lens has the best chance of allowing me not needing glasses after surgery.
The thing is I don't really mind wearing glasses. My main goal after surgery is to be able to see well in all distances even if I have to wear glasses. The research I have on Symphony is it may give me good distance vision without glasses but monitor and reading may be borderline acceptable. Here are my questions:
1. Would it be a good idea that the Symphony lens is set to optimize intermediate and near visions? The distance visions then become borderline acceptable, meaning I can still function without glasses but if I want to sharpen up I wear glasses. So the end result is I will wear glasses to correct mild nearsightedness most of the time but remove glasses when reading monitor and books.
2. Can the above scenario be achieved with standard monofocal lens? Sympony lens is expensive.
Thanks in advance, Robert
0 likes, 43 replies
robert20416
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at201 robert20416
Posted
at201
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Sue.An robert20416
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See them at a certain distance (guessing about 30 yards) - as I near the light they disappear. They aren’t around all lights - some I don’t see at all like streetlights have no concentric circles and now big glare gone that I was seeing about 3 weeks ago. See the circles mostly around brake lights when brakes applied and the amber turn signal
Lights. Red streetlights too as well as certain LED porch lights.
soks Sue.An
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How big are the concentric circles? I have not had a surgery yet but now I am starting to see rainbow halo around lights at night that appear/disappear.
Sue.An soks
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If you spend your living driving at night wouldn’t recommend these lenses. Although I saw a thread on flier talk about pilots and lenses for cataracts and apparently Symfony lenses are 1st premium lenses being approved.
at201 soks
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Sue.An at201
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Guest robert20416
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I agree with some other contributors here -- if you have no objection to wearing glasses then I can't imagine why you would take the greater risk of distortion with the multifocal lenses. Glasses are only an inconvenience, not a permanent distortion. So far I am vey happy with near mini-monovision with a monofocal lens (Cataract eye -1.0D and other eye -1.5D) as I only need glasses for far distance (driving, movies, etc.). If you prefer, you can get corrected more for distance, then only wear glasses for near vision. Multifocals give you the best chance of seeing without correction, but the risks of artifacts are higher. If you are willing to wear glasses some of the time, I just don't see the purpose of taking that risk.
Night-Hawk Guest
Posted
I agree - the purpose of the multifocals and Symfony is to try to eliminate eyeglasses completely or at least more than is possible with monofocals. If one can live with eyeglasses for at least just one of the 3 focus ranges (their individual choice) than monofocals perhaps with mini-monovision should be able to cover 2 of the 3 focus ranges without glasses in most cases and with the least artifacts and best possible sharp vision and contrast sensitivity.
That will be my plan unless after my first eye's surgery result, I don't think I can effectively get enough focus range with monofocal IOLs in both eyes with mini-monovision.
robert20416
Posted
I went to see another eye surgeon this morning for 2nd opinion. This doctor has very different approaches to say the least:
1. She suggests monovision for distance and intermediate ranges. And I will likely need dollar store glasses for reading fine print. She does not recommend and is actually puzzled why anyone would want monovision for intermediate and near ranges. She assures me that I won't have depth perception problem.
2. If i prefer the multifocal lens, she recommend Restor. I mentioned Symfony and she responded by no no and shaked her head. She said the Restor 3.0(?) may have glare/circle problems, but not Restor 2.5(?, I could have gotten the number wrong).
3. She uses ultrasound to clear up cataract. When I mentioned femtosecond laser used by the first doctor, she said it is no better, waste of money.
4. She found no astigmatism, whereas my regular eye doctor and 1st eye surgeon found mild astigmatism.
Eventually, she recommends i have my left eye(non-dominant) done the intermediate mono-focal IOL first. Then, I can decide on my right eye to have distance or near mono-focal.
Hmmm, now I'm confused, haha.....
at201 robert20416
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You don't really need to be confused.
The bottom line is that she agrees with the suggestion that you should have monofocal lenses with mini-monovision. There are 2 associated choices when you do that.
You can have good near and intermediate visions without glasses and use glasses when you need good distance vision (for driving etc),
or
You can have good far and intermediate visions without glasses and use glasses when you need good near vision (for reading etc).
None of the two choices is necessarily better or worse than the other. The better selection is the one which fits your life style better and the one you may have been used to. You are the best judge of that and so, you should make the selection which feels right to you, and not the one which may seem better to someone else.
rose39842 at201
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Thanks for providing the valuable informations.
Eye-Kan-Sea robert20416
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Hi Robert,
Where are you living? USA, UK? I read about many borderline complaints about the Symfony IOL's. Some complain about glare, streaking and halos from bright light sources at night. Some have problems with close vision.
Pre-cataract surgeries, my vision was Lft: -8.5/+1.75 & Rt: -7.0/+1.5 -- similar to yours (I'm 65). I live in the Philippines where any IOL is available and doesn't have the restrictions of the FDA. I have implanted "Oculentis Mplus X" premium multifocal intraocular lens in both eyes. It's German and their IOL's are made in the Netherlands.
I have none of the issues of the Symfony IOL's. Near (5-12 inches) and intermediate (12-18 inches) vision is excellent and distant vision is 20/30. I'm very content with the overall vision. Better than wearing Alain Mikli high index progressive eyeglasses! Ansolutely no night vision problems. Far superior than when I wore eyeglasses. You have no need to buy a Sony Bravia because these IOL's are your "HDTV!" Eccellent light sensitivity. It was an unexpected surprise to get these IOL's. Then again it depends on where you live. They are available everywhere, but USA & Canada. Good luck.
By the way, no more eyeglasses!
robert20416 Eye-Kan-Sea
Posted
Eye-Kan-Sea, I'm in the USA. I have already had my right eye done with a Alcon monofocal lens two week ago corrected to -1.00D. I will have my left eye done about 3 weeks from now, still undecided to set this eye distance or near. Three months ago when I posted here, I was sitting on the fence as to what lens to implant until I met my current eye surgeon who is not a fan of multifocal lens. If I were to insist on a multifocal lens, then it will be Alcon's Restor 2.5. The hospital my surgeon belongs to seems to be all Alcon, everything from contact lens, monofocal, toric, multifocal...etc. If I stick with this surgeon, then Symfony is out as it is made by Tecnic, not Alcon.
at201 robert20416
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From what I know about the multifocal lenses, I feel that a multifocal lens will be the worst of the many options available to you. They provide a good vision at only couple of distances with a quick drop-off at in-between distances. They have more night vision than the other lenses.
In your situation, getting a monofocal lens aimed for about -0.25D seems to be easily the best option, since you already have the left eye at about -1.0D. Aiming for -0.25D will be better than aiming for plano. If your surgeon achieves this target, you should have good vision from about 26 inches and beyond, needing glasses only for reading fine print (this assumes that you have minimal astigmatism).
A Symfony lens in the right eye set for -0.25D or plano will in your case provide little benefit compared with a monofocal lens (since the left eye is already providing you good intermediate distance vision). All that the Symfony lens will do is to increase the chances for having night vision issues such as multiple concentric circles etc.
robert20416 at201
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at201, Thanks for the advice. I haven't thought of going for -0.25D if I chose distance for my left eye. It is a great suggestion as I will have less mono vision between two eyes. Thanks. Symfony is NOT under consideration.
My right eye does have astigmatism of 0.75 which was left untreated. This makes the distance/intermediate option less attractive. The surgery for my left eye is two weeks away. I need to make a decision on 1/11 whether to go for near or distance. I'm wearing contacts to get a feel of the two options. The problem is both options have their pros and cons, and I'm still sitting on the fence...lol
Sue.An robert20416
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Maybe work out what you do more of requiring near and far vision. Good luck - looks like decision time is soon.
at201 robert20416
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If you end up with -0.25D, you will not only have less monovision, but there will not be any discernible degradation of distance vision compared with ending up with plano. Aiming for -0.25D also reduces the chance for ending with farsightedness, which provides no additional benefit in distance vision, but reduces the usable good focus distance range.