Cataract Multifocal Explantataion / Replacement for Monofocal IOL

hi John

how is your near vision with symfony?

and did ur vision improve after the YAG?

Hello john56935,

The symfony was inserted to my-then dominant right eye. My right eye has better visual accuity but is more light disturbances while my left eye (panoptix) has less light disturbances with a bit of residual astigmatism affecting my visual acuity. Neither eye is good but seems to compensate where the other is lacking. I would check my vision almost every morning, and I found that sometimes I would switch to being left eye dominant. Occasionally, I would find myself being neither eye dominant. Don't think anyone here is experiencing this.

Good advice Viking for all. And having been on this roller coaster a bit longer you will continue to see changes. Some for the better and some others not.

Perhaps with 2 different IOLs your brain will choose the better view. Think it may be like that for me and I may need to see my optometrist sooner vs later. I usually go once a year. My RE and brain must be taking over as my RE is getting blurrier and blurrier - something with both eyes I don't notice but starting to with driving at night.

Need to co firm my self diagnosis of pco in LE. Got so much on the go right now and really wanted to wait the year for my new medical plan year in Jan.

But you are correct about time making the visual disturbances better. Unless something else accounts for these a d if really bothersome one needs to see their doctor. Which again is hard as we all gave different tolerance levels (much like pain thresholds). For one person it is minor & another it isn't minor.

Those concentric circles of Symfony I really have to look for now (2 years after surgeries). I know it is a brain thing because if I want to see them I can. Whereas they were vivid before now they are faint.

Now these pco thing has me on that frightening roller coaster and I have really been procrastinating about seeing my optometrist. Guess been through a lot this past year in other areas and just don't need a procedure - plus yag has me freaked out. Perhaps permanence of something? I don't know.

Perhaps you may relate Viking. Not having good eyesight before was something you just coped and adapted to and now this whole world new world is available. Possibility of losing something you have to me is worse. I thought I was going blind before I went to see my optometrist (at my age cataracts were last thing on my mind) and I knew something was wrong for 6 months. When I went for that appointment hoping I just needed glasses I was scared it was something worse. Cataracts wasn't even on my radar of possibilities. pCO treatment has me feeling that way again.

Yes I agree, and I can relate, I would not want to loose what I have now, for the same reason I would never risk changing anything at this point.

I understand why the thought of pco and yag are giving you a hard time, even that I am considering pco as part of the package, I am not looking forward to it.

Good thing in your situation is, that you have a great result with your lenses, I would have taken your result any day.

I know it is easy for me to say, but the way I see it, with the result you have, the thought of being able to make a lens exchange if some much better lenses comes in the future, is not really relevant to you, because I don´t think there will ever come a lens that would be worth the effort, with the good result you have now.

I think the only thing that comes some day, that would be pronounced better than what we have now is stem cells, but at that time yag or no yag probably has no relevance at all, we will probably all be poor candidates for stem cells with our iols, if we even live that long.

I have no doubt that you will have a great result with the yag as well, I am sure that when it is all done, you will think back and wonder, why you worried that much 😃

Easy for me to say, I know, but I know several people that have had the yag treatment, and they have perfect good results, and don´t think about it.

One of them had it done for more than 20 years ago, he almost could not remember it, when I asked him about it.

As you probably can sense, my own roller coaster is at a peak right now, I have just finished an 8 day course that I have wanted to take for years, but stayed away from it, because I knew there was way too much reading involved, that I was not able to do before.

Now I could read everything that was presented to us on paper, I could see everything at the blackboard, I could see everything in slideshows, I was not depended on listening and remembering everything that was said, as I have been all my life.

I had brought a pair of reading glasses just to feel safe, but I never had to use them, how great is that!

So right now life feels pretty fantastic 😃

Can't express how happy I am for you - it is a gift to treasure.

Not afraid of yag due to permanence of it (not thinking exchange) - just the possibility of yag causing damage. When I first had the surgeries bever heard about this pco or '2nd cataract' as it is sometimes called and when I first came across it seemed a remote possibility but now my thinking is it is not a matter of if it's when. Younger one is it is inevitable.

You are likely right and all will be well. Can't help the feeling of dread though.

When I first had the surgeries never heard about this pco or '2nd cataract'

You reminded me of that guy we met outside the clinic who had his cataract surgery done (3-4 days earlier). I mentioned PCO to him and he had no clue so he almost got a heart attack.

I must have really messed up his week by giving him that information!

Your YAG will be fine! Don't end up having an accident or worse because of PCO related bad vision.

Don't over think it when the time comes 😃

are you sure it is pco? are you experiencing it in both eyes? if you can see the circles crisply it should still be mild. my symptoms in the order of progression were crisp tail light circles got smudgy. white light circles still remain crisp. and then near vision is more affected. and most recently my classic cataract symptom -- the green light is the most distorted. i saw Deb's doctor and he said he suggests large YAG for multifocals to retain all the benefits. i was reminded of W-H theory that plate haptic is more stable so i asked him what if the IOL falls in with the large hole. he said the fibrosis is so strong that the lens is not going anywhere. he also told me that the floaters exaggerate the PCO effect. good luck.

if the disturbances are physiological i don't think time makes them better. i am glad for everyone who got good results or have adjusted to their results and are able to move on. i would love for the day when i am not thinking about this and stop visiting this site. i understand that it is early days for the OP and hope he gets great vision but younger age, larger pupil and faster PCO are odds stacked against ability to neuroadapt and move on easily. and again i really hope he does. some of us are not complaining about the 10 circles or the halo around light or the starbursts and some of us are. so other are complaining about ability to see things because they are blocked by a light glare so large that it is impossible to see. the sensitivity and tolerance for every disturbance is very individual and hopefully everyone gets to their destination.

Lol - yep bet that guy headed straight to google to look up PCO !!!

Honestly it isn't something discussed at consult. I was at a street BBQ and someone casually mentioned having their eyes polished that day. Curious I asked what he meant. It was then I learned you are never really done - this is the gift that keeps on giving!

Likelihood all will go well is high. My RE compensates do much with both eyes open I don't notice. If not PCO my astigmatism increased. That is a decision I would have to decide corrective eye wear or more procedure.

H'mm I do have floaters and had them all my life so that could be one reason. It seems all distances are blurry to same degree. Far intermediate near -all is blurry to same degree.. RE is still so perfect! I wonder if increased astigmatism can cause this too. But contrast is less in LE as well as blurriness and it does feel like what cataract was like before surgery.

Hope so too. I can understand if that glare were present always how hard that would be ad some find that night time glare alone hard enough.

. i was reminded of W-H theory that plate haptic is more stable so i asked him what if the IOL falls in with the large hole. he said the fibrosis is so strong that the lens is not going..

I meant in the early weeks when there is greater chance of lens twisting and rotating. Did not think about post YAG. Good to know though.

From Zeiss-

• For rotational stability and better centration over time.
• Less sensitive to decentration and tilt

Btw did he mean your particular fibrosis is super strong or all fibrosis in general?

"Btw did he mean your particular fibrosis is super strong or all fibrosis in general?" -- he meant in general.

for anyone wanting to experience the dysphotopsia, i suggest getting dilation just before dark and then going outside and trying to function. even inside there would be dull glare around all light sources.

Actually I do recall that. after first surgery I went out at night and light streaked out all angles - even inside lights did that. I tried to sleep as much as possible as it was u comfortable - gives one a headache. Is it like that all the tome for you soks? Must be awful and frustrating that no one can do anything.

Are their any lens recommendations that would give you a better chance of reducing this - maybe pupil independent lenses?

pupil independent lens is an advertising gimmick. both synergy and symfony are pupil independent.

i have dysphotopsia only at night after the sky gets black.

Recently we were walking on an uphill footpath next to a main road. There were lot of cars waiting at traffic lights up front and then coming downhill towards us.

My wife could see some starbursts from her cataract eye but not much or any from her IOL eye.

I on the other hand was seeing HUGE ones from both my non cataract eyes. Really fine very thin long rays (like No.1) but without the centre brightness or any white opaqueness. They were see through but at least 2 to 3 times the length of the front part of the car in size.

Only on the cars with white LED lights though. Anyway was just an observation.

I am of the opinion that glare and starbursts can and do happen for those without cataracts. All my life had issue with glare - used to blame it on blue eyes. But sunglasses are a must for me since as long as I can recall

the clearly defined starburst in #1 is the startburst from the symfony lens. its much smaller compared to the car. in the picture the starburst is much bigger compared to the car. but i am not complaining about this. that would be something easily livable with. now what happens is suddenly an arc shoots out 5 times larger than the start burst and the area between the starburst and the arc is filled with light glare which is not see through.

Yikes, that sounds bad, does the arc go away quickly, like if the car passes by or you turn your head or squint your eyes? Does your doctor give you any explanation? I see something close to #3 but then overlay about 20 concentric rings that extend out again half as much. The rings are most noticeable with red traffic lights or when a car hits its brakes with those individual red LED lights (not the continuous strips). They should show those pictures on the symfony website!

I can't imagine it 😦

Does it blind you suddenly? or annoys you? or scares you? or all of them?

i am stuck. i have dysphotopsia, pco and poor near.

What will you do? Will you postpone any action for now or will you make a move and go with the NJ doc?

the arc and illumination will go away as i get closer to the light source or or some other light hits my eye and only the starburst will remain. so it will appear like flares of shooting arcs. also it will not happen in well illuminated streets. sometimes it will. i have not seen concentric circles around red light now for months but probably because of PCO.

it is an annoyance. it is blinding but i can look at light source immediately to make it go away. i am still deciding, but my other eye is tanking fast. i use the miotic drops on an irregular basis but i have once made a turn into the wrong lane after that because both eyes were constricted with medication in the dark.

I think i experience those too, i have just learned to live with them too. Hey, at least you don't see the concentric rings 😃 I didn't try the drops just for that very reason, it reduces the amount of light coming into the eye and can make driving even more dangerous