Contrast reduction with the Tecnis Symfony lens in non cataract eyes

Hello, just a question about your night vision with the symfony lens.  im 52 and had my left eye done about 1 month ago.  it was due to a non-traumatic rapid onset cataract.  the day vision is great.  indoors i do notice some glare around artificial lights.  my main concern is the night vision.  i see the concentric circles and starburst glare with any automotive lights. i was considering getting the other eye done as my depth perception is noticeably off.  im curious if you've noticed any improvement or "adaptation" regarding the night vision since your procedure. 

I had Symfony lenses implanted July and August 2017 respectively.  Great daytime vision and although less glare and starbursts now the concentric circles still an issue.  These will not go away as they are part of the lens design.  It is the trade off to seeing well at all distances without glasses.

If you do not have a cataract in your other eye you may want to hold out for a better IOL.  Nothing is the same as one’s natural lens.

There is a new EDOF lens with a little better focus than Symfony that should become available soon called atLARA if you want to google to find out more.  But I would suspect it has some form of halos too - always worth waiting for ‘real’ patient reviews as the clinical trials tend to downplay these.

I too at 53 developed cataracts both eyes very quickly (my doctor indicated it may be related to my long use of steriod creams for eczema).   But from one year’s eye exam in 2016 where no mention of cataracts to following year could not get correction better than 20/50 and 20/60 with glasses necessitated my cataract surgery.

Hello Sue.An,

thanks for the info and taking the time to answer; the atLARA does look promising.  the symfony does seem to be a great lens in the day, but the night driving was quite the surprise. im not sure if you can comment, but my symfony eye vision the first 2 weeks post op was clear. at the 2 week mark, i noticed more glare with the indoor lights; the visual acuity is fine.  i had the 1 month follow up and they feel that the posterior capsule was clear. if the posterior capsule does start to opacify, is it usually a gradual process? i did ask at the follow up visit, and got the redirect to "give it more time". its hard not be be hyper-vigilant with your vision. my background is emergency medicine, so perhaps i need to be a more patient patient  

Have your opthamologist or optometrist do a full eye exam to know what your exact prescription is at about 6 weeks (time when healing should be complete). I found that helpful to know.   Both my eyes are plano although I see sharper through right eye than left.  But the astigmatism remaining is slightly higher at .50 in right eye vs left eye at .25.  That can cause some of the visual artifacts to be worse.

I haven’t noticed anything off with inside lighting except one time I was in a store with a black ceiling and found the overhead lighting to have too much glare.  I also see slight highlighting around white lettering on a black screen (TV, computer etc).

For first couple of months (6 to 8 weeks) I had very strong glare and starbursts- do much so I didn’t see any concentric circles and thought I was someone that wouldn’t see those.  But as the glare and starbursts subsided I started to see the concentric circles and to this day I still notice them around red stop lights, car brakes (when applied) and certain LED porch lights.  I even a couple of weeks ago noticed them in a public washroom up close on a red LED light that was on a motion sensors paper towel machine!   Glad though I don’t see them on floodlights and I can watch a soccer match and enjoy it like I used to!

For me I found the glare and starbursts worse to deal with and I think you’ll find in 6 month’s time those will diminish.  The concentric circles I tend to tune out but they haven’t diminished.  Some see those rings equally bright from the smaller Center ones all the way to the outer rings.  For me they are brighter on inside rings and get lighter on the bigger ones.  I do think it is lens design and what allows the elongated focus so not anticipating those to go away ever.

Unfortunately no lens is perfect.

Inside lighting - do you notice the glare more in dimmer settings or all the time?  I tend to find the glare more prevalent in low light settings.

It’s too bad most of us have to return to work within a week as it really takes time to adapt.

yes, the indoor fluorescent type of lights (department store) seem to make the surrounding glare more notable. i also agree that your natural lens is the best, until the cataract impedes the vision. i have a contact lens in the other eye and it also has a cataract, so its just a matter of time before it needs to be removed. trying different contacts in the non-symfony eye makes the depth perception just enough off that it makes the day a little harder. its only been six weeks from surgery, but the anomaly between the vision is difficult to adjust.  i followed a few of the other ongoing symfony discussions, and it seems that for better / symmetrical daytime vision, getting my other eye done would still seem like the best option. it seems that a lot of patients have the night time issues, but if glare subsides a little over time, then the spiderweb (concentric circles) are a reasonable trade off.  i'd be concerned with just one symfony and a monofocal in the other eye.  i do like the suggested improvements with the atLARA, but it may be a bit of wait. 

Not sure how far away we are from getting the atLARA lens.  For you - hopefully not long.

I did find overall vision improved after 2nd surgery.  I see well from 11 inches and beyond whereas that distance was 18 inches before - more fully extended arm to read iPhone.   I just actually finished fixing my sunglasses - lens fell out and had to screw it back in.  I am able to do tasks like that well with Symfony.

I appreciate the time you took to understand and respond to my questions. Most of the online Symfony discussions have been informative and offered some unique perspectives on expectations and outcomes.  I wasn’t sure what to expect from an online forum, so thanks for answering my message in the bottle.