Has Any One Else Noticed this Unusual Vision Issue with Symfony Lens
Posted , 63 users are following.
I had a cataract surgery on my right eye a week back and decided to go with A Symfony Toric Lens because of all the positive things I have read about the lens. I have had a IOL in my left eye for almost 18 years, which I have been happy with for reading, so that I was looking basically for good distance and intermediate vision with the Symfony (I am used to monovision for the last 25 years).
My right eye still has some astigmatism (slowly improving), had issue with seeing streaks from lights for only the first 3 days, am seeing halo around the lights (will probably get adjusted to it), but also have another interesting vision issue which I had not seen mentioned by any of the doctors or the patients on the web. Using just my right eye, I don't just see a halo around a light, but see about 7 perfect concentric circles around the light, with the diameter of the outermost circle being about 3-4 times that of the halo diameter. Since the Symfony lens has the unique feature of having about the same number of circular “diffractive echelette design” in the lens, I am sure that the concentric circles which I am seeing is because of this proprietary design.
Looking through these circles to look at a light is like looking at a light through a spider web. It is not so bad that I wish that I had not selected Symfony lens (I like the Extended Vision), but why has this effect not been publicized more? Have any of the other Symfony Lens users experienced seeing these concentric circles?
6 likes, 691 replies
Sue.An at201
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I am in the stage of considering what my options are for a lens. Wondering if anyone saw the article published in Medscape entitled Symfony intraocular lens haloes similar to multifocals. Would be interested in anyone's thoughts. This was published just 2 days ago May 9 2017.
at201 Sue.An
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softwaredev Sue.An
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at201 softwaredev
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Diverreb at201
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Maybe he's trying to get a job for Abbott Labs.... Or doing PR for Trump! :-)
softwaredev at201
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re: "Amazing!"
What is amazingly unfortunate is that they don't teach people in school about the basics of examining studies and experimental results, given how commonly they are reported in the media.
The study itself refers to "eyes", but its patients that neuroadapt. Having 10 eyes in one study group each added 1 patient having an issue is a change of 10% (if both eyes are operated on each), statistical fluctuations on such small groups render the result not statistically meaningful, with such large error bars, if they'd also had a monfocal control lens there is a good chance the difference with that wouldn't be statistically significant either. The fact that the patient demographics are so different on top of the size makes it not too useful a study in terms of visual artifacts. The visual acuity results may be somewhat useful even if its still small, unlike the visual artifact results, but when differences aren't statistically significant they don't mean anything useful. (and due to patient variations, may be more about that than the IOLs).
I'm hoping the surgical results (e.g. residual refractive error) are at least the same between the groups, but its possible the ages vary because they were done by different surgeons in different practices with different patient demographics, in which case the surgical results may also vary which impacts visual acuity and night vision artifact results.
That was a study presented at a conference. Such small studies are useful to generally confirm that the large studies are in the right ballpark, which is what I look to them for. If you saw a few small studies with visual acuity results rather different than the large studies, that would tend to make one wonder, but the studies tend to all be in the same ballpark (with small studies, a study or two out of a dozen would likely indicate statistical change rather than any suggestion of an issue). Unfortunately in terms of visual artifacts that aren't common, such studies aren't that useful in terms of determing statistical prevalence, they are fairly meaningless.
softwaredev Diverreb
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oops, I meant having 10 patients in one study group (20 eyes or less) means each added patient having an issue is a change of 10%, and statistical fluctuations in outcomes impact such a small study and make it rather useless in terms of night vision artifact assessment.
re: "Or doing PR for Trump! "
I voted against Trump, and you seem to have that backwards anyway, its Trump that would be basing his views on anecdotes and having trouble understanding scientific studies and what they mean, when they are outliers from large studies and not large enough to be meaningful.
at201 softwaredev
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softwaredev at201
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There is is nothing wrong with people not being interested enough in science and math to understand them. What is unfortunate is when people mindlessly disparage what they don't understand and pretend as though their views based on anedotes should be taken mores seriously by others than actual studies. Those who actually value science grasp its important to evaluate the strength of studies, not merely whether they say something you wish to believe or not. You disparage multiple large studies that say things you don't wish to believe, then when a flawed small study appears you latch onto it, which isn't the rational way to deal with the existence of competing studies. When at study only has 10 patients, and a phenomenon is indicated by large studies to occur only a few % of the time, the small study really can't say much useful about the issue regardless of the results. It is your attachment to anecdotes rather than science that is "untenable" from the perspctive of those who support science based medicine rather than pre-scientific superstitions and intuitions.
at201 softwaredev
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softwaredev at201
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The point is that there is no reason to change my mind when I've not been presented with logic and evidence to do so. If you have a background in science, your comments don't indicate an understanding of the basics. Unfortunately some folks are taught the results of the work scientists do, but not the process to evaluate science that is a work in progress, for instance competing stuides.
at201 softwaredev
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at201 softwaredev
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Firstly, you have a right to think that you have a “superior” brain, but you should not be insulting the intelligence of other people (such as Diverebb or me) on this post. I am sure that we are as intelligent and have as much as scientific background as you have. We can think as logically as you think you can. So, let us stop going there.
Secondly, we know that you have complete faith in the original studies conducted for Abbott during the Symfony lens certification, which seemed to have showed that the night vision issues associated with Symfony to be not any worse than the monofocal lenses. Obviously, I also got fooled by the results of those studies before I decided to have the Symfony toric lens for my eye. Looking back, it is not surprising (at least to some of us) that the conclusions of that study were too good to be true, and were in contradiction of the fact the basic design features of Symfony introduce a new mechanism for creating multiple circles or halos around lights (without any feature to reduce the glare associated with Technis monofocal lenses). Thus, the results of the study were suspect, probably because of the inherent bias in the manufacturer (and the associated doctors) studies.
More and more people at this site have come forward to tell us of the night vision issues, such as the unique multiple circles or halos, associated with the Symfony lens. Now, a new study done by surgeons in Germany and published on the Medscape web site on May 9, 2017, concludes that the patients in Symfony lens may see halos as troubling as the the multifocal IOLs (which unarguably cause more halos than the monofocal lenses).
All these experiences and the Germany study results published in the Medscape should raise the red flags about the results of the original Abbott study during Symfony certification.
However, it seems that instead of recognizing that there may be an issue with the original studies, you have simply chosen to belittle the night vision issues of the people on this site again and again by calling those highly unusual and now to ignore the German study results by saying that it did not have enough people. What is most surprising is that all these night vision issues of the people and the German study results have not made the slightest change in your thinking! No, in my way of thinking, that is not the result of a good scientific thinking.
Any way, please take a step back and really think about your position on this issue. Also, any time someone shares his / her bad night vision experience with the Symfony lens, let us not jump in with the same pitch on how rare this issue is and how wonderful Symfony lens is. Symfony lens is good but not as good as originally advertised to be.
Sue.An softwaredev
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Hi SD - just a word of thanks for all your input on Symfony lenses. Although we have differing opinions I do thank you for being a balance to negative and positive outcomes. Just had 1st Symfony lens implanted yesterday and do far do good. Just saw my surgeon today post op. He is pleased with my outcome. Could read at 20/20. He said once 2nd eye done it would easier to read. Colours are different between 2 eyes so can't help compare them. Haven't yet gone outside at night so not sure if I have concentric circles glare and halos to look forward to. That may be the compromise but sure is terrific to see well during daylight hours.
lin59 at201
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lin59
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Sue.An lin59
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lin59 Sue.An
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at201 lin59
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I also got very frustrated with trying to convince him that the Symfony lenses have more issues than reported in the the original studies done for Abbott. Unfortunately, one can't always trust the studies funded by the medical suppliers, when there is a lot of money riding on the published results of the studies.
Diverreb at201
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lin59 Diverreb
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Oh for sure, in the US they're pushing the premium IOLs the same way they push refractive eye surgery like LASIK, PRK, LASEK, refractive lens exchange (RLE) regardless of whatever complications someone may have from any of those either right away or in the future. Can you say cha-ching ($$$$)?
john56935 at201
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Just my two cents as I have seen the arguments going back and forth with softwaredev and I think both sides are correct to a point but I agree with you that the Symfony marketing is deceptive and I think that is most likely intentional due to greed and unethical behavior. While we may be the unfortunate minority that have these night vision issues, a logical person will read the literature and conclude "better range of vision with a similar incidence of halos compared to other multifocal lens" makes it a no brainer to implant Symfony. The flaw that softwaredev seems to refuse to acknowledge is that what we are seeing is apparently much worse than with the other lenses--it is not an issue of frequency but of severity. Had I known that and been properly informed, I probably would have picked accommodating lenses with better nighttime vision and would have risked wearing glasses for reading rather than having my nighttime vision ruined. It has been 16 months since I had it implanted and the rings are no better than the day after surgery after being told repeatedly "they will get better over time" and "use more eyedrops". Nightime vision inside and outside for me is a very negative, disturbing experience and the only time I get emotional relief is during the daytime when I can tolerate this IOL. I still don't know what to do--have the lens swapped out at considerable cost and risk, double down and hope that Symfony in both eyes will somehow improve the outcome, try a distance monofocal in the other eye, or just live with it as-is and hope for some breakthrough lens to come on the market sometime in the near future. I know there is no perfect solution and I can live with the fact that I may have been in the unlucky minority with my negative outcome but saying what we see is no different from what others see with other IOLs is an egregious injustice. If I had the time and money I would go after Abbott, the people that did these flawed studies and approvals, and the unethical doctors out there that profit from these at the expense of trusting, unsuspecting misinformed patients.
at201 john56935
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Thanks for sharing your experience with the Symfony lens, which seems to be very similar to mine. I have not seen any change in seeing the multiple circles around lights at night since getting the Symfony lens in my right eye about 15 months back.
Actually, if I remember right, at the time I was looking seriously at the Symfony lens, the Symfony lens was being touted as providing
"better range of vision with a similar incidence of halos as the monofocal lenses"
and thus much better than implied by
"better range of vision with a similar incidence of halos compared to other multifocal lens"
I like to think that with forums such as these, people are more informed about the pros and cons of the Symfony lens so that they can make a better choice for themselves.
Diverreb john56935
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I've had them in both eyes for over a year now.... Both eyes are identical as far as the rings and glare. I wouldn't expect a second one to be any different than the first. If it is truly limited as to the number of people experiencing this problem you might think that Abbott would know why and be able to tell this group not to use their lenses.
Bravogoldenk9 Diverreb
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I was told the perfect lens has not been invented yet.I do not think Big Lens Maker is out to rip me off.I am grateful my blurry cataracts are gone and vision is fresh and bright.
I did warn my dr about the people complaining on these forums.I suggested he just offer monofocal lenses to anyone who seems difficult to p,ease.Make his life easier.
Sue.An Bravogoldenk9
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It’s a shame more doctors don’t have fuller conversations with their patients whether it is motivated by greed or time I don’t know. They need to match lenses with right patients. But there is also plenty of tools and info on the net. people that want to know find that info. Yes onus on doctors who took oaths to do no harm but there is a responsibility for individuals to do their own digging too for answers. As soon as I was diagnosed at 53 and shock wore off I started researching. Glad I did.
I guess if my daytime vision didn’t meet my expectations I would upset and say differently.
john56935 at201
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Even if less than 1% have these symptoms, if they implant 500K of these that is still up to 5000 people impacted. I still think most people would play those odds and still choose it, but if they described it like we have here (10 bright rings radiating out 5-10 feet or more from most light sources), I think people would think twice which is probably why they bury that info. Anyway, what is in your other eye? I just think that it would be easier for the brain to adapt to both eyes seeing the same way than mixing lenses or only having one eye done. When my IOL eye is sharp, the other is usually blurry and vice versa. At least I found a good doctor that says he never recommends these to people who pay attention to detail like doctors, engineers, and pilots as he finds they have a harder time adjusting. I appreciate he doesn't label them perfectionists or difficult to please like many others do. It has been a year since I saw him so I may add a comment/update when I go back soon.
john56935 Diverreb
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Did your vision improve at least when you had the second eye done? Even if the rings didn't improve, hopefully you feel like they work better together.
john56935 Bravogoldenk9
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where are these vision simulators--I only see ones that show diseases not different types of IOLs. If my doctor had told me there will always be halos with these that don't go away, I probably would have gone with monofocals. Only after did I learn that others have screening questionaires to identify certain personalities that may have a harder time with premium IOLs. Furthermore, my vision was not bad prior to this so it seems worse now to me than someone who had poor vision to start and feels that almost anything would be an improvement.
at201 john56935
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And seeing multiple circles or halos around lights at night has nothing to do with seeing more detail; it is about seeing things like large spider webs around lights, when no such thing exists in real life
Sue.An john56935
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I am sorry if you were deceived by this type of marketing.
You are right those of us (me included) had poor eyesight due to cataracts so we see an improvement whereas if you compared to good eyesight IOLs may sadly come up short. Possibly accounting for some of the differences in opinions here on the forums.
Bravogoldenk9 john56935
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The symfony was just approved in usa when i got it..I had researched it myself having had retinal surgery and subsequent cataract.Was told multi focal was not wise.My own research of clinical trials pointed out symfony worked quite well for those with mild retina issues,
My dr asked me if i would let prospective patients talk to me about my experiences.Many people getting cataracts are older and do not drive that much at night anymore..I told them about halos, reading in bright light etc..I said if very fussy really think over halos..I know people who cannot tolerate anything like that..
In any case just getting surgery without the blur from cataracts may be a disappointment.I daw halos and worse on headlights prior to surgery so everything is a big improvement.Ha ing 20/20 vision is a pleasure
I went to a big eye dept in a major hospital and between retina and cataracts had over 20 visits with measurements taken each time. y dr was very concerned i was comfortable with results.I know lenses can be exchanged if people are unhappy..However not sure how it works outside usa where there is a national health service.
I do know neither my dr nor his colleages are interested in getting rich by deceiving me.Rather tney tend to people who do not see well from macular degeneration, ornea issues and many horrible things.I am glad he is there.
The clinical trials initially were in europe.Most patients had significant cataracts and were older.I, too can report though i see galos they do not bother me compared to those from cataracts.
Bravogoldenk9
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Diverreb john56935
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