Cataract Multifocal Explantataion / Replacement for Monofocal IOL
Posted , 14 users are following.
I am wondering if anyone here has replaced their EDOF or multifocal for a monofocal and came out satisified with their decision. I would love to hear your opinions. I currently have a panoptix LE and symfony RE. The light disturbances are really irritating to me, and I'm not sure if I'll ever "neuroadapt" to it or accept it as my life. I know IOL's aren't perfect, but I'm really struggling. If you have done the replacement / explantation, I would love to know your circumstances.
0 likes, 49 replies
W-H Meuwth
Posted
How long have you had Panoptix in the LE and Symfony in the RE? I am a fan of quality monofocals (mini-monovision) but unless someone has truly tried all types themselves it would be very hard to make a super objective recommendation.
If XYZ works for one person then it does not mean the same combination will work for someone else.
On top of that there are so many variables like eye shape and condition, psychology, level of possible neuro adaption, surgeon, type and sub-type of IOL etc etc.
So it seems that apart from Viking, you are the only one here with EDOF and Tri combination? For the sake of research both of you should get mini monovision with monofocals and report back 😃
Seriously though, maybe your multifocals need to be given bit more time. It seems you have had them installed very recently? Was your eye normal before (apart from the cataract I mean)?
Meuwth W-H
Posted
I'm 24 years old and got cataracts both eyes probably from steroid uses for allergies and eczema. I had 20/20 both eyes healthy and no glasses before I got cataracts. And now, I had Panoptix LE done last week, and Symfony RE two weeks ago. Both eyes seems pretty stable now and not much has changed after the 2-3 day. I assume because I am young it heals faster.
My symfony light disturbances has been the same since post-op day 1. I highly doubt it will go away. I am starting to hate the term "neuroadapataion" because it seems like a lazy way the industry dismisses a problem. Not to mention, I am 24. If the average patient is 60~70 yrs old, would they really care? I think imperfections would be much more forgivable when I'm at 60~70yrs, and I think this forgiveness has become what they call "neuroadaptation". I don't think people stop seeing what they see.
W-H Meuwth
Posted
Oh Meuwth! I am so sorry to hear that you got it at 24!!!! I thought my wife in her early 40s was bad enough!
I know what you mean about neuroadaptation but it is a real thing 😃 Not saying that it will do magic in your case but give it a chance. Two weeks out is very early days for a trifocal.
Anyway continue researching your IOL exchange options but monitor your current IOL and see how it goes, unless it is really driving you crazy give it couple of months!
What does your surgeon say?
soks Meuwth
Posted
"I am starting to hate the term "neuroadapataion" because it seems like a lazy way the industry dismisses a problem." -- i have to agree. if at all anything my vision has gotten worse with time.
sorry u r having to go through this at 24.
Meuwth W-H
Posted
W-H,
I think there was another young man on this forum who got it at 25. I believe his username starts with phil- . I don't think he posts on this forum anymore, but I strongly resonate with his depression. Kind of a funny thing if you think about it. Getting this procedure in your 20s is a nightmare, but a miracle/second chance at life when you're past 60. Five months ago, I was still seeing 20/20 with my natural eyes, and now I am deeply lost. Anyways, thank you for the kind thoughts. At least I'm not totally blind, and have this support group.
My surgeon has recommended me to give it some more time as well, but not much at all has changed since post-op day 1. I strongly think this is a result of the lens design. The probem is, the more time I wait to see if I will adapt to it, the more risk I have if I were to do a lens exchange. According to my surgeon, the more time that goes by, the more the IOL implant is scarred in place, making it more difficult to remove. Ontop of that, the integrity of the capsular bag that is used to secure the lens also becomes more prone to tears, which exposes the vitreous and a whole lot of other problems.
I believe you have monofocals IOL. What's your experience with it or if you have a link to a post where you have talked about it in whole? I'm curious to know with monofocals how much near vision you get. Can you talk to a person standing next to you and clearly see their face?
Meuwth soks
Posted
Soks,
I hope you the solution you are looking for as well. What are your current plans, if any?
W-H Meuwth
Posted
My wife has it, not me. I don't have cataract.
Like you my wife had perfect vision and never wore glasses. Three plus months ago suddenly out of the blue she started seeing very blurry and got diagnosed in both eyes with very fast spreading cataract.
As a result I joined this forum and Googled/YouTubed the hell out of cataract. We saw 4 surgeons in total and the 4th one was the one we felt most comfortable with (I have named him Dr Zeiss as he uses Zeiss IOLs mainly).
Yes!!!!
I think 40s is young for this! You on the other hand are like a baby in comparison!
Believe me, it is a nightmare getting in your 40s too. In the first week after diagnosis I joined a local online forum to locate good eye surgeons. I was very worried for my wife but was given a telling off by some people in their 70s and 80s. They said it is no big deal and stop fussing....go with any surgeon, even a resident doc will do! People can be such....
Truth is most people just go with any doc and take any IOL. Yes it is a straight forward operation but your decision and potential complications can impact rest of your life. So one has to choose with eyes wide open.
We are in the middle of the process. First/Near eye was done 3+ weeks ago and the next/Far eye will be done in 5 days time. I have many posts/threads here all over the place and they will confuse you lol
In short we went with mini-mono vision using Zeiss Asphina 509m, Aspherical Monofocal IOL. Cost was not an issue, we felt it was the best future proof option with less chance of visual issues. Was not an easy decision!!!!!! We were very tempted to go for Zeiss At Lisa in both eyes but ultimately we took advice of our Dr Zeiss and our gut feeling.
Left eye was set for near and Right will be set for far.
Operated Left eye was targeted for -1.25 but it has ended up at -1.5. Turned out to be a positive accident.
Right will be targeted for -0.25, let us see where it ends up. NERVOUS!!!!!
It depends what distance you target but yes my wife can clearly see me with only her left eye open. She is able to work on PC, use mobile phone, apply makeup etc etc. So all without glasses.
Her sharpest vision in the eye set for near eye is between 40-50cm
VERY usable vision upto 72cm
Can clearly see eyes of people she is talking to, upto 1.7m away then quality starts dropping faster by 2-3m. She can read car number plate instantly at 3m (not sharp though).
So something similar to this is what we are aiming for...
soks Meuwth
Posted
i am stuck. i have dysphotopsia, pco and poor near.
soks Meuwth
Posted
hi meuwth
did the disturbance start after both eyes were done or with just one eye?
i had an explantation appointment yesterday and the doctor told me no iol is perfect so decide carefully. also normally when the explant for dysphotopsia they replace with bausch and lomb softport lens. he also told me that another symfony may make my symptoms less noticeable. finally he said if alphagan drops help you then use mild polocarpine for a year and permanently stiffen your iris and reduce your pupil. pilocarpine is not good for long eyes.
he showed me pictures of floaters inside my eye and indicated that they may also make symptoms exaggerated.
Meuwth soks
Posted
Soks,
I had one eye done after the other with a week separated. Disturbances are present with both eyes. Of course doctors would tell you no iol is perfect. That's what anyone would say. Life isn't perfect.
What I want to know is how good monofocals are. I may not get any intermediate or near vision, but the panoptix and symfony frankly don't provide good enough vision near/intermediate anyway. It's not to say I don't get any near/intermediate vision, but it simply isn't good enough. I still wear glasses all the time to see comfortably.
soks Meuwth
Posted
why didnt you get pan optix in both?
Meuwth soks
Posted
Ignorance. There was an overwhelming amount of positive sources about the Symfony, so I went with it. Then I found out how bad it was. After getting the first eye done, I decided to give the PanOptix a try in the other eye.
ann39244 Meuwth
Posted
I had my right eye catarct surgery March 15, 2019, and the left eye cataract surgery April 1, 2019. I selected the Symfony EDOF for both eyes. Immediately post surgery, the starbursts and spider webs were so blinding I did not want to drive.From the beginning, the starbursts never really changed in size or intensity. On July 15, 2019, I had the right eye Symfony lens replaced with a AcrySof® IQ Monofocal. With the AcrySof® IQ Monofocal IOL I was left with light streaks that fanned out and were longer than the starbursts. I also have some "yellow" in my vision compared to what I have with the remaiing Symfony lens that gives me very bright, white vision. After a second opinion to determine what was causing the streaks and color , it was found that my eye capsule has folds in it and it's the blue light filtering of the AcrySof lens that is causing the yellow vision (I was not told nor did I think to ask if the Acrysof would give me anything other than bright, white vision) . I was told that a YAG procedure would take care of the folds and there is nothing I can do about the yellow vision .I still need to get the Symfony in my left eye explanted and the YAG done on the right but have been paralyzed by my situation and just need a break and a different communicative surgeon.......). I am curious to hear what you decide to do. Please let me know if I can help further.
Deb03 ann39244
Posted
Ann - I also had folds after a lens exchange and just had a YAG laser procedure yesterday. It completely resolved the light streaks - also known as Maddox rod effect.
Meuwth ann39244
Posted
Ann39244,
Honestly, I do not know what I should do. The problems I have with my current vision is below:
Nighttime with both eyes:
-Blurry vision distance vision, difficult to drive, walk around
-Light disturbances with Halo and starburst
Symfony:
-Worse light disturbances than Panoptix LE. White parts of a computer, tv screen will create a "spillover" effect where the light will glow over darker areas of the screen
-Large concentric rings compared to the left eye panoptix
I do gain some intermediate and near range vision. I can read my phone and computer most of the time without glasses, but I want to emphasize that DESPITE my ability to read, it is with a lot of extra effort as it is still blurry and I need to make guesses. 99% of the time I put on glasses instead to comfortably do my work, so it feels like there was no point at all for this. I compromised my distance visual accuity, night vision, and I need to endure the light disturbances just to get a somewhat half-assed intermediate/near vision that, if I were to grade, I would give a 70% (C-) passing grade. The intermediate/near vision is "usable", but would I work, read, do fine work with it? Absolutely not.
It's hard for me to make a choice because I don't know if my difficulties are caused by the iol choice. Is this universal to all lens? Is this a problem with my eye (cornea, etc)? I would like to reduce the light disturbances. But I also worry about the risks with lens explantataion.
Meuwth
Posted
I am not sure why the above text cut off but here's what I said:
I do gain some intermediate and near range vision. I can read my phone and computer without glasses but I want to emphasize that despite my ability to read, it is with a lot of extra effort and guessing. Things are not sharp, but I can make out what they are. 99% of the time I found myself using glasses so I can see things more comfortably. If I were to grade my near/intermediate vision, I would give it a C- 70% passing grade. I could get by with it, but would I ever read, work, or do fine arts with this vision? Absolutely not. And it feels like this really defeats the purpose the premium lens. I compromised my distance vision and have to endure the light disturbances just get an half-assed intermediate/near vision.
Deb03 Meuwth
Posted
I don't have personal experience with your lenses, but seems to me that something must be off if your intermediate/near isn't very good. Perhaps the target was not hit or you have astigmatism. I am just guessing. Have you had your eyes refracted since the surgery to see what your numbers are?
Meuwth Deb03
Posted
My surgeon will be giving me my prescription next week. She wanted to wait a month first for my eyes to settle since prescription could vary in the early stages of recovery.
I also think it's because of residual astigmatism that caused me to get poor vision. However, I think poor night vision / poor vision in dim light setting is undeniably a part of the lens design as it splits up the light into various focus. This way light is not optimally used when there isn't enough light, hence everything will look blurrier and darker.