Has Any One Else Noticed this Unusual Vision Issue with Symfony Lens

Unfortunately, there has been not even the slightest change in my seeing the multiple circles or halos around lights at night over one and a half years since my cataract surgery. I see them as vividly as ever.

However I have learnt to live with them, as we do with all the annoying things in our lives. I don't have to drive much at night, but if I need to, I don't let these change my plans.

If you do have some floaters, those will probably go away soon on their own.That is what they usually do,

One usually sees more true colors after the cataract surgery. That is one change which is usually for the better. (unless one does not like any more the colors of the things which one may have bought before the cataract surgery)

For me there wasn't much difference after I had it done...  But it was quick and easy so I figured it was worth a shot to reduce the glare and circles....   Which it hasn't.   

I chose the EDOF Symfony Lens as well and am totally satisfied.  There are days I feel cheated having had cataracts young and worry about how long they last.  So many things can crop up even after a successful surgery..

I think for many here who opted for this specific lens early on they weren’t given any hint of the night vision issues.  All the literature and surgeons too were touting this lens to be as good as a monofocal with just a hint of a halo.   Certainly no mention of huge concentric circles (which you’d have to be blind) not to see.  For me the difference was I knew about these ahead of time and could make an informed choice - in most part due to this forum and a201’s experience.  At that time there was someone else (if I remember correctly went by name of software developer) who said brain adjusts and he doesn’t see them anymore.   Then a few more got these lenses and all saying they saw the circles.  I found an article published saying Symfony’s halos were as bad as other MF lenses - it was based on smaller study.  Software developer argued against that study stating those that got Symfony were older than other patients etc.  

I did inquire with my surgeon at that time (delayed my surgery) about the halos and he at least was honest to say I would find them likely worse than a monofocal but they were best on market for seamless vision.  He also said given my age no matter which lens I chose there was a compromise and it was really up to me which compromise I went with.

I guess what I am trying to say is it is best if a patient is given all the info - good and bad as they are the ones that have to live with the lens.  If one is blindsided or feels the lenses were oversold by the surgeon’s greed for profit it is a bitter pill to swallow.

I don’t think my seeing the concentric circles is any less than a201’s.  But I knew prior and perhaps that is what makes a difference.

I obviously don’t have the vision of a 20 year old - but been wearing glasses since 12 and always had vision issues due to a childhood illness (no one in my family ever wore glasses till presbyopia set in.)  I am happy with my vision - I can now work and enjoy sports again.  And since the glare and starbursts settled the concentric circles are easier to see through and night driving not the nightmare it was.

It sounds like you had a very honest forthcoming surgeon about the night vision issues and that made a difference in how you perceived the outcome.  For some this came as a total surprise and I am sympathetic.

Thanks for your previous advice.

Just had my first Symfony lens implanted 3 days ago and vision is sharp already from 11inches to 20 feet then slightly less clear but can still see into the distance fairly well.

we aimed for -0.89D and I don`t think we are far off that target.

Night halos and starbursts are quite bad at the moment,(first night drive test last night) but expected at this stage and will hopefully reduce a bit.

Colour definition is down about 10% from my other non cataract eye but whites are much whiter.

green is less green and grey is lighter grey.red and blue are similar.

Tom

I was hanging on to see if the Zeiss AT LARA would be available in a Toric version but Zeiss replied to me saying that it is not and not sure if will ever be so a Symfony lens it was to be.

Yes the night driving I too vividly recalling being somewhat of a challenge those early weeks.  Really had to plan my routes to stay on well lit roads.   I started to see those diminish around 6 weeks.  In fact glare was so bad I didn’t even see any concentric circles for weeks.  Now I basically the circles which due to lens design I am not expecting to go away.   But it is so enjoyable to have 2 eyes that see well - to play tennis, to run again, snorkel and actually see the beauty of coral and fish.  For me the trade-off was worth it.  I don’t drive excessively at night.  4 months of the year I do from work due to living in Canada but it’s a familiar route well lit.

Congratulationss Tom - so glad your surgery went well.  It is nice to see well from early days - so encouraging!

I proved a real success with next morning great clarity which continued to even out over the months..I was so thrilled i never really cared about halos ..i did have a streak from a fold in back of capsule..

vision at night is so clear i see around starbursts..

i think you are the person who had fretted over the upcoming surgery?If so it really was not scary at all...

i am still amazed at no longer being nearsighted and with light see close to far...dim light causes small print to lose contrast...

as software told us only people with issues end up on forums..i liked his amazing thorough ess in researching...i doubt drs lie to make money at least none i use...a complaining  patiient not worth it..The trials were mostly on older people who do not drive all that much at night

10% less contrast sounds pretty much what I had read on Dr Por Yong Ming’s site on his experience implanting Symfony lenses.  There recently was someone asking him about that contrast reduction % (person was contemplating a clear lens exchange).  I was glad Dr Por discourages it - although he will on insistence of patient.  He said the contrast would be more noticeable to someone without cataracts and if he had to throw out a % it would be 15%.   

So out of curiosity are the colours more muted - less bright or different shade altogether?

Unfortunately my experience has taught me not all doctors are equal. Some are uncaring, some are in it for the money. Just like any other profession.

I am glad you found Software Developer helpful. I just couldn’t get past his uncaring thoughtless attitude. Perhaps if I could Have I could benefit from some of the good in his research of the trials.  

I just think everyone should be armed with the information needed to come to a decision they can live with. And there isn’t a one solution fits all. Although I am pleased with the Symfony Lens I am cognizant that others aren’t. In fact certain professions prohibit any other lens except monofocals IE pilots. I found that out on flyer talk forums.

Most of those ‘complaining ‘ weren’t told the whole story. Some the surgeries went sideways and that’s unfortunate and I plain feel badly for those situations.  

While I have a pilot's license, I don't fly professionally and I wonder if I could fly at night anymore, of course none of which was brought to my attention before getting the Symfony.  I believe that EDOF manufacturers would lose a lot of business if they accurately described the potential drawbacks but I finally found a decent vison simulator at mediawebtool dot com and look for halo and glare simulator.  Had some one shown me this I probably would have gone with monofocals and the tecnisvisionsimulator dot com is down-right fraudulent by comparison.  Would love to hear what people think about these.

I agree that if the tecnisvisionsimulator.com does not accurately simulate the associated night vision effects (such as halos or multiple circles, glare etc), as you and some others have noted, then  it is indeed a down-right fraudulent behavior.

Hi Sue, do they not let you mention websites on here because my last post isn't visible yet but I found a great simulator that is a pretty good representation of what I think we are all seeing.  Also, I was wondering if anyone has any info on the Zeiss AT LARA EDoF IO that is only in Europe so far.  It seems like they have reduced the halos with an improved design so I would be willing to wait until it comes to the US if my other cataract doesn't get worse.  I saw my doctor and am still in a holding pattern--he suggested YAG to fix PCO but then I am stuck with Symfony so I would rather do the other eye but he is suggesting monofocal but I think maybe this Zeiss lens would be a happy medium.

ATLARA looks promising.  A bit more extended focus than the Symfony and the promise of less halos.  Would be nice to get some reports from patients outside of the trials with these.  but generally technology gets better and better so maybe they are closer to a breakthrough lens.  

If you can hold out for surgery it would certainly give you another option.

My last reply is also for some reason waiting for a clearance from the moderator.

Any way, firstly, in answer to your original question about the believability of the tecnisvisionsimulator dot com, it does not surprise me that the Symfony manufacturer did not include a good representation of the night vision effects (such as multiple circles or halos around lights at night, glare etc). That is what the manufacturers usually do to make sure only the pros (and not cons) of their products are publicized. Their original web site also tried to present the data so that  it looked like the night visions issue for Symfony were similar to those for the monofocal lenses. The fact those are much worse for Symfony is presented in only some of the more recent publications.

Secondly, while the Zeiss AT LARA EDoF IO is expected to be somewhat  better than Symfony lens regarding the night vision issues, Zeiss  does state in a recent publication that:

"In pre-clinical tests using the "virtual implantation" setup, 48 subjects compared four different IOLs in a typical night traffic situation in a random blinded manner: one monofocal IOL, two EDoF IOLs (ZEISS AT LARA and J&J TECNIS Symfony), and one trifocal IOL."

The rankings for night driving conditions (1 being the best and 4 being the worst) were about 1.1 for monofocal, 2.5 for AT LARA, 3.0 for Symfony, and 3.4 for the trifocal lens."

Thus, while LARA may be slightly better than Symfony, individuals still rated the monofocal lenses much better for the night driving conditions than LARA.