Dr. Change QA Session on Synergy IOL

Can you elaborate on this. I am also looking at mixing and matching. Do you just prefer the clear lens or is mixing and matching different lens filter an issue with vision quality. If so do you have any links to article I should read on the topic.

if you see the symfony and pan optix comparison from shannon wong you see that symfony distance is A+ as opposed to pan optix A.

there is also an article from april 2020 that says it remains to be seen whether symfony plus needs to be matched with symfony.

also i am saying that only because i already have a symfony.

The new Symfony Plus and Synergy are the 2 IOL I am looking at. Even though the new ZHR00 has been FDA approved since May, it is hard to get any information on it. For example does it still have the outstanding distance vision and how do the dysphotopsias compare to the original ZXR00. I want to read articles by American Doctors that have implanted 100s of these lens and compared the results.

I think if Synergy has the same dysphotopsias as Symfony then it would eventually replace Symfony and Synergy and PanOpitix would be the 2 dominate defractive IOLs.

But so far the few articles out there provides conflicting information. Be nice to at least have a clear picture of the tradeoffs before making a decision.

S+ is not available commercially so no one is implanting it.

Symfony Plus received FDA approval May 1, 2020, so it should be available in the US. I assume that current references to the "Symfony" lens include Symfony Plus, which is just a modification to existing Symfony technology. It apparently improves near vision by 0.5 D and adds a violet filter.

symfony plus is not available.

Approved and available are not quite the same thing. Surgeons need ready access to all the various powers of lenses so they can effectively use the lens in all the different eye requirements. Kerry Assil, MD, of the Assil Eye Institute in the Los Angeles area may be worth checking out. "Assil evaluated the Symfony Plus in a multicenter study and said he found the improvement in near vision over the Symfony was large and patient satisfaction with the Symfony Plus was high." From his website. He should know if it is actually available or if not, then when.

I can't seem to find the link to the article, but I recall a report on one study where a blue light filter lens was put in one eye, and a clear lens in the other eye. Essentially none of the recipients found it to be a problem. I think the reason I am having trouble finding it, is that the study was done for another purpose other than mismatched light filtering, and my memory fails me in what it was! I would suggest it is rather minor factor in the scheme of issues. Right now I have a blue light filter lens in one eye and nothing in my other eye except for a cataract which gives me a distinct yellow/orange tint in that eye, in comparison to the eye that has blue light filtering. the blue filtering eye whites are brilliantly white and to my brain with no yellow tint at all. With both eyes open and not thinking about it, the IOL blue light filtering eye seems to dominate most of the time, and when it doesn't the overall vision might be a slight yellow tint from the cataract. Overall not disturbing to my vision. I wish it was as it would improve my argument for getting surgery on my second eye!

there are a couple of videos comparing pan optix and symfony on youtube. those guys would be in similar situation and do not report any difference.

I have not paid that much attention on the time frame from FDA approval until the lens is available to Opthamalogist.Is this a normal time frame or does this seems like an unusually long time?

I am wondering if production is being affected by Covid or there might be something else going on. I just keep wondering if Synergy could be FDA approved soon. And if so, why would there be both a Symfony Plus and Synergy IOL, unless the Synergy has greater dysphotopsias. I keep reading the Synergy is not a multi-focal so how does it get down to 33cm near vision. If the Synergy IOl has similar dysphotopsias to the Symphony Plus, why would anyone choice the latter? Just wondering if this is factoring into a full out release of the Symfony Plus.

I am not sure how the system works. There seems to be an approval date and then a general availability release date. I suppose there is the technical side of the issue, the marketing demand for the lens, and also supply of the lens. Probably it all has to come together for the lens to be fully released and available.

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It seems to me that the Synergy must be a multi focal lens of some type to get the range they claim to have. The Symfony is said to be an EDOF lens. My expectation would be that the Synergy would have more dysphotopsias.

synergy is a combination of tecnis bifocal with the highest near add and new edof for intermediate distances.

"highest near add ". That would be the Tenic MF 4.0 which I passed on as it had the worse dysphotopsias (which is why they created the low adds), so I hope not as that would make me rethink getting that IOL.

i think it would that is why they should make non yellow synergy to match it with a monofocal or symfony to reduce the dysphotopsia effect.

I too am rethinking Synergy. Just read a press release from Alcon about the US launch of Vivity, which sheds some light on FDA approval versus commercial availability. Vivity was just launched nationwide a few weeks ago. It received FDA approval in February 2020. It was offered to select ophthalmologists in September 2020 for a pilot phase. The national release was January 7, 2021. It took 11 months to go from approval to commercial availability. My ophthalmologist has recently implanted two Vivity lenses. Synergy is still awaiting FDA approval. I don't want to be part of a pilot phase, and I agree Synergy may have significant dysphotopsias. Ophthalmologists promoting Synergy appear to be using the term "tolerable" to describe dysphotopsias with Synergy. It's likely Symfony Plus is currently in a pilot phase and will launch commercially in the near future. Not sure it adds enough near vision to the Symfony platform, but image quality sounds superior to the Panoptix, which I am seriously reconsidering. I still worry about glistenings with Panoptix. I only have good vision in one eye. This is a critical decision for me.

symfony got fda approval in july 2016 and it was available in august 2016. it had been available in europe since 2014. i think synergy will be immediately available after fda approval as it would have been available in europe for close to 2 years.

i think panoptix has less night time effect and i too am concerned about the glistening.

That's Interesting.

First I would add Symphony Plus and Synergy also should have crisper distance (closest to a monofocal) and superior vision in dim light (not factoring in dysphotopsias). Just additional factors to be considered.

So if the company has already setup the manufacturing and distribution network to deliver to Europe it can quickly extend that to the US. After seeing how long the Symfony Plus is taking, this is a Big Relief. So if the Synergy is FDA approved it could actually be readily available sooner than the Symfony Plus.

I hope this is the case, otherwise I was thinking lets say 6 months for Synergy FDA approval, then another year before US Opthmalogist are implanting the lens and then another 6 months to 1 year before starting to read about Real-World Results.

synergy seems to be following similar timeline to symfony. 2014 europe launch with CE Mark approval. 2015 canada launch with Health Canada approval. 2016 US launch.

the following is fda approval date for symfony.

Tecnis Symfony Extended Range Of Vision Intraocula...Johnson & Johnson Surgical VisP980040 S06507/15/2016

Maybe I am crazy, but thinking the Synergy should be a quicker FDA appoval. The FDA is a pain in the butt and the Symfony was a bit revolutionary even though built on the Tecnis MF platform. The Snergy in prospective should be a piece of cake.

I mean if they can approve a Revolutionary NEW RNA messaging vaccine days after clinical trial results, Synergy should be a walk in the park!!!!

the vaccine was needed by everybody hence the speed. but it would be great if synergy became available early.

I'm waiting for Synergy at this point. My ophthalmologist now anticipates availability in May or June. My vision is deteriorating too quickly to wait any longer than this summer. Looked for any recent videos yesterday and found a couple pediatric cataract surgeries utilizing Synergy. I hope we see more real world surgery videos and articles/videos sharing outcomes before those of us waiting have to make a final IOL decision.

i cannot wait any longer now! i am just pretending at this point.

i don't know if I will make it either. PanOptix may be the way to go. If I were not amblyoptic, I would probably have had cataract surgery already and I would have opted for PanOptix.

many surgeons in Toronto area are doing Synergy implants but with Covid related travel restrictions, who know when one could travel up north from the US.