Choosing between a monofocal IOL vs Symfony IOL
Posted , 14 users are following.
Hello everybody I'm writing this because I am a 26 year old guy getting ready to get my cataract surgery in my left eye due to an accident that made me rapidly develop bad vision and require surgery in order to see clearly again out of that eye. (Although I have small cataracts in right eye as well) I have been waiting and waiting for a couple of years because at first, I wasn't comfortable getting a monofocal IOL which the opthamologist has been reccomending for me for quite some time; Because I had hopes of newer technology becoming available in the near term. I was eager about the Symfony when it was first announced it would be available here in the USA and after reading the specs I was determined to get this IOL implanted in my eye. on paper these lens seemed like the best lens possible that was available here in the USA but however it doesn't seem like many people are satisfied about some of the adverse effects that these Symfony lens are starting to becoming more and more frequent among people that get these implanted. My main worry about the IOL lens is that they have a risk of troublesome halo's, starbursts, and glares associated around bright lights. I am a young adult so I can fathom having to struggle with that issue for the rest of my life.
My main focus and passion that I want to do for my career will require me to be working on computers most of the time since I want to pursue a 3D animation and graphics engineering career in the entertainment industry. I love the idea of having the Symfony lens because it would be really convenient to work in that setting and atmosphere not requiring multiple types of glasses to see on the fly at screens and monitors and distance. Etc and I certainly would not mind using reading glasses for the near. but Im a bit Disappointed to see numerous reports of people complaining about the night time visuals in regards to bright lights. I feel like this would be something that would seriously make me question if it is truly worth having seamless distance/intermediate vision but not being able to handle going out at night from headlights/city lights/ bright. I'm only 26 years old and I know That I can not NOT avoid going out at night. Especially if I had to go to big cities like Los Angeles New York etc. what if I want to go to a night time festival with lots of LED lights or light projections? (Not that Thats all i do but if having Symfony lens makes those experiences unpleasant?) is it worth it? I honestly feel like if some of those issues were a problem for so many people would also apply to watching a cinema in the movies or viewing some types of hi resolution Video animations in dark environments would recreate that dramatic effect of bright light sensations like halos, glare that it makes that viewing unpleasant for their experience... most of the people say their fine for tv's and computers but what about dark scenes or when light is highly concentrated and dispersed might make somebody with Symfony dizzy? Would a monofocal IOL be safer just to avoid adverse reactions and sensations to extreme lights?
For people here that been implanted with the Symfony IOL vs a monofocal IOL do monofocal really have less glare and halos.
Also Monofocal IOL implants how are you doing with night vision? And also how is your computer time like quality of vision and light sensations etc. I see that a lot of people are satisfied with the Symfony for computer usuage because it offers more range towards intermediate but I honestly might consider trade off for monofocal and wearing those glasses to avoid those light artifacts associated with the Symfony.
Whenever I research articles on review/reports on the internet about the Symfony IOL their is a lot of contradicting information that makes choosing that lens extremely difficult for me...
I honestly don't know which studies to believe because I've read several and most of them say something different about the Symfony IOL. The one from medscape says that the nighttime problems are actually worst than multifocals and the case study from healio points out to it being comparable to a monofocal.... most people that post about the Symfony say their is a significant amount of glare/halos. And Not to mention that their is under the radar trait in Symfony that so many people are having several concentric circles around bright lights!! I can not deal with that if I were to pursue a computer graphics career. Although it may not be a make or break factor...
I know it's hard to compare subjectively. Anybody here with both a Symfony IOL and a monofocal IOL in the other eye?; that would probably be the best annodoctal experience to have. I have to make my decision soon in about a month. I really am having such a difficult decision to choose which IOL because this is likely going to be a permanent choice for the rest of my life and I'm still relatively young at 26. I know people talk about getting a new IOL lens swapped for their current IOL in the future but I would imagine this brings along repercussions because there are major risks involved with doing extra surgeries after your lens has healed into your eye. Vision may become worse afterwards despite switching lens for supposedly better tech. What I'm trying to say is the choice I make for my cataract surgery of IOL lens is most likely going to be a permanent decision for the rest of my entire life. I will have to think this over again but Thank you for taking the time if you read all of this.
0 likes, 33 replies
peter88910 miguel20862
Posted
I plan to install symfony in my right eye seeing all the benefits it has for a wider range.
Sue.An peter88910
Posted
Hi Peter
I have read the negative dysphotopsia you are experiencing can disappear in a few months after surgery. Have you had the monofocal lens long?
Other than that do you have good distance vision? If so you may want the Symfony lens targeted for a nearer range as this could likely lessen your chances of see the concentric circles and halos as those appear worse when in the distance.
The Symfony does give great panoramic vision - I haven't noticed any drop in vision from near (14 inches) to distance. Since my 2nd surgery last Monday haven't worn glasses - just regular sunglasses in sunlight.
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at201 peter88910
Posted
anne91418 miguel20862
Posted
Did you choose Symfony or Monofocal and why, or are you still deciding?
Thanks. Anne
miguel20862 anne91418
Posted
Hey Anne, as of right now I am leaning towards a monofocal lens set for distance. It seems like it's the safest choice for me to avoid any unwanted side effects so to speak with premium lens including the Symfony IOL.
Sue.An miguel20862
Posted
Wishing you all the best - sounds like your surgery is soon. Let us know how you make out. If you don't need both eyes done (wish that were my case) wait as there may be better options in years to come.
sunny68454 miguel20862
Posted
lin59 sunny68454
Posted
You might be better off to start a new topic, but I have monofocals set for distance and have different reading glasses strengths ranging from 1.5 to 2.5 I think (I had a few pairs around the house before my cataract surgery and don't remember the power of each of them). I don't necessarily need to wear them though, only for extended reading or extremely small print (and my mid-range and distance vision are both perfect without glasses). Why are you asking if the trade off is worth the halos if you already got a symfony lens? Just wondering...
lin59
Posted
Also, to me the risk that you won't be able to read without glasses with symfony IOLs is not worth it considering the advantage of intermediate (mid-range) vision without glasses with the symfony is only around 3% more than monofocals set for distance (around 98% for the symfony vs 95% for monofocals set for distance).
lin59 sunny68454
Posted
Instead of starting a new topic, you can post on the subject thread called "Near vision poor after getting Symfony...seeking others' experience" since there are other people posting on there right now who are having the same problem as you are.
miguel20862 sunny68454
Posted
at201 miguel20862
Posted
I see about 10 concentric circles (lighted bands separated by dark bands) around lights at low light (dawn or dusk) or night. I don't seem them at very close distance (for example, in a room). They are most visible at 30-200 yards distance. They cover a large area. For example, the ones around a car headlight expand to more than the width of the car. The red rings around the brake lights really stand out.
Since these circles are really the result of the reflections from the lens itself, one can see it on any object (on one side of the light) between the eye and the light.
If there is a lot of glare or starbursts from the light, those will make the circles less noticable.
In spite of the usual statement by many surgeons to their patients, these effects don't decrease with time. However, one can learn to live with them, as we usually do with the not-so-good things in life.
Speaking for myself again, I find them very annoying, but I don't let them stop myself from driving at night.
Sue.An miguel20862
Posted
Rather than discuss lens options thought I would suggest that you think about what your career entails and what visual needs / preferences you have. Most people with cataracts are retired or winding down their careers so their visual preferences might be more related to what they do in their leisure time. That is something I gave considerable thought to as I have at least another 10 years working full time before retiring. You’ve got many more to go so perhaps consider what you do or plan to do work wise. What distance do you need most at work? I was talking to a photographer not that long ago and for him he needed to see the camera and settings.
When do you have to make your deciyby?
Guest miguel20862
Posted
I don’t know if you have already decided on a lens, but would like to share my thoughts. It is very stressful to make a more or less permanent decision regarding your vision, especially at such a young age. If you were older and had already experienced some loss of accommodation, it might be a little easier to know what type of compromise you might want or need to make (In my case, my exerience with myopia + presbyopia led me to pick a mildly myopic monofocal IOL, which has worked out great at -1.00D so far; requiring glasses for driving, but not reading). No matter how many people you ask, you won’t be able to answer the most important question, which is how YOU will see after surgery.
If I were in your situation, at your age, for eye #1 I would select a monofocal lens set for distance vision for two reasons:
1) A monofocal distance lens seems to offer the best chance of what I’ll call an “ideal” IOL outcome; Clear distance vision, minimal artifact, good intermediate vision and fairly good near vision (glasses for fine print only). Even if this is not the most typical outcome, others on this forum and many people I know personally (including my Dad) can attest to this possibility. Selecting anything else (multifocal, myopia, etc.) prematurely introduces compromise, risk, and possibly expense you may find you didn’t need. Even if you end up requiring correction for near distance (a more likely outcome), you would still have clear distance vision in that eye, retaining the option to extend your near vision range when it comes to surgery on eye #2. Furthermore, you would be in about the same situation after presbyopia set in anyway (if you hadn’t developed a cataract).
2) Selecting a distance monofocal lens for eye #1 could help make a better decision about eye #2 (assuming there is some correlation between the vision depth of 2 eyes on the same person). Let’s say you achieved an “ideal” monofocal outcome with eye #1; you may decide to go for the same choice for eye #2. If, on the other hand, you ended up losing near vision in eye #1, you could do mini-mono, monovision, or a multifocal for the 2nd eye, depending on how the range ended up on the first eye. On the other hand, if you had selected a multifocal for eye #1, regardless of the outcome (good or bad), you still might not know whether you needed to take that risk, and would have to still sort of guess again for eye #2. Does that make sense? No one has a crystal ball here, but it just seems that the outcome with a tried-and-true monofocal is easier to predict from what I understand.
Although I personally wouldn’t choose the risk of permanent, uncorrectable artifact associated with a multifocal IOL, I wouldn’t try to talk you out of it — I just can’t see any compelling reason to select it for the first eye in your situation, since you don’t know what kind of result you will get with the monofocal.
Sounds like you and your doctor were already leaning in that direction, but good luck with whatever you decide!
Night-Hawk Guest
Posted
Excellent suggestions for the first eye's IOL choice!
Your listed reasons are why I went with a monofocal toric IOL for my first (right) eye operation earlier this week.
I will evaluate based on what I end up with my right eye with the monofocal IOL targeted for good distance vision, to help me plan for my left eye in the future.
If I don't get decent intermediate vision with using at least a fairly small correction (<1D) I would then consider a Symfony extended focus IOL for my other eye to get both good distance and good intermediate, though with the risk of night vision artifacts in that eye. Otherwise I could go with another monofocal toric in my left eye set for mini-monovision, a little nearsighted -1.0D or less.