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

Thanks for providing feedback in your experience. Glad to hear that you're comfortable with night driving as that has been my biggest concern when considering Symfony lenses for myself. Have to make up my mind in about 3 weeks time. I work at a computer the bulk of my work day and would like to be able to see clearly at that distance. Nice to know you have no trouble reading an iPhone too.

Someone I spoke to a week ago who had Symfony lenses implanted last Dec said her vision took about 5 weeks to settle.

Question re night driving - did the halos diminish over the 10 weeks or have they been consistent?

I had mine done four months ago....  There has been very little chage in the halo and concentric circle issues.  As far as computer work, the lenses are great, as they are for distance vision.  Close up stuff depends on the lighting.   Cell phones are backlit and are readable....  I still need reading glasses for menus in most resturants, a well as fine work, lke threading hooks with fishing line.  Since there are no direct comparisons that can be made, I can't tell you if other lenses are similar with the glare and halos.  The soft glare also occurs with white light against dark backgrounds on say TV.  Not a big deal, but it's there.  I still see more clearly at night and the glare, circle, halo issues, while annoying, aren't a deal breaker for me. If I knew ahead of time that another lens would give me the same results without the other isuues I'd do that, but to my knowledge such lenses don't exist at this point.  All docs will tell you that there are trade offs with every lens out there. As long as you are aware going in the perfection doesn't exist and you may experience the same issues listed here to one degree or another you can make an informed decision.

Yes I am rapidly coming to conclusion that perfection doesn't exist and have to decide what compromise I want to make.

For you is trade off of halos and concentric circles worth the better day vision of near and distance vision)?

If I were older likely thinking trade off not worth it but given I will be working another 10 years (80% in from of computer) that I might be better off with Symfony lenses despite the halos etc. I am surprised to hear many on this forum saying the circles are larger with Symfony than a multifocal lens. My doc said these were greatly reduced with Symfony. Sure hoping I can adapt and drive at night.

Yes. I agree with your statement that “...perfection doesn't exist and have to decide what compromise I want to make.”

However, in order to do that it is important to have all the information. When I had the Symfony lens installed in my right eye 6 months back, all I read was that the night vision with Symfony lens is as good as that the monofocal lens. Only after I started sharing my experience in this post, I found out that I was not the only one with the issue of seeing multiple circles around lights at night with Symfony lens. Thus, I am really glad that this issue is more recognized today.

Would I have made the same decision about using the Symfony lens for my right eye, if I had known about the night vision issue before the cataract surgery? Possibly yes. I had had a monofocal lens in my left eye set for reading distance for the last 18 years. I had been used to monovision with contact lenses for the last 30 years, with not-a-so-good experience for a week with multifocal contact lens. Thus, the choice for the right eye would have been reduced to having a good far and intermediate distance vision with Symfony lens (with some night vision issue) versus having a good vision with the monofocal lens set for distance (which would have given me a better night vision at the expense of good intermediate vision). Most probably, I would have opted for the Symfony lens in spite of the associated night vision issue.

Would I have made exactly the same decision if I did not already have a monofocal lens in my left eye (and knew about the Symfony lens night vision issue at distance before the surgeries)? Probably not.

This is what I would have done and thus, this is what I would suggest to other people at this time (have already shared this over the last 3-4 weeks in replying to various posts in this forum: so, I apologize for the repetition). Essentially, this consists of combining the use of the Symfony lens and the monofocal lens a little differently from what I have. Please consider this if good night vision is important to you and you still want to have good vision at far, intermediate as well as the near distances.

1. For your dominant eye, have a monofocal lens set for the best focus at far distance. That should provide you the best chance for avoiding the night vision issues.

2. For your non-dominant eye, have a Symfony lens set for the best focus at 32 to 40 inches. This should provide you good vision at the intermediate and near distances, without seeing the multiple circles around lights in the distance. (if you close your dominant eye, you may still see them; but you should not see them with both eyes open).

Most of the surgeons don't suggest a combination of different types of lenses, but would usually consider it favorably if you bring it up.

As a final note, please remember that if you have any astigmatism after cataract surgery or the best focus distance is not at the desired target, you may need vision enhancement (by LASIK or otherwise) to achieve the best final results. If your surgeon offers you that additional benefit free of charge or at a minimal cost, please keep that in mind during the surgeon selection. (I have had LASIK enhancement in both of my eyes. My Symfony surgeon included that as a no-cost benefit.)

 

"For you is trade off of halos and concentric circles worth the better day vision of near and distance vision)?"  

Yes!  For sure.  They do not prevent me from driving at night.  Just have to be a little more aware when they occur..... and not let them be too distracting.

They were pretty wacked the first week or two, and I remember being disappointed because I couldn't read the license plate in front of me. That's no longer an issue, and the the halos did calm down quite a bit. The change seemed to get less noticeable after that, but on the other hand, I grew more comfortable driving at night, which I had been extremely concerned about. It's apparently a bit of a crap shoot, as to what each person ends up with, with factors like how accurate and skillfull the doc is, your ability to heal, healing in a predicted manner, the ability of your mind to integrate and screen out extraneous information. That last one apparently can go on for months, or even, I've read, years. There seem to be a number of aspects to "seeing clearly" that come into play here, some of which can be quite subtle, and the combination of all of them put together add up to the quality of your vision. At least, that's the way I've come to understand it. I spent many dozens of hours pouring over the internet before I did this because I was so concerned I might make a mistake that would end up with me not only unable to drive at night, but being unable to see clearly enough to do my job. And the alternative was a monofocal lens with either a progressive lens, which I knew would drive me crazy, or mutiple pairs of glasses going on and off all day.

Also, the fact that my doc tweaked this lens a little towards closer may have an effect on the quality of the glare I pick up? I'll know more about that when I get glasses to sharpen up distance in a few weeks.

Glad to know that you are overall happy with the vision, specially at close distance as desired by you, which you are getting with the Symfony lens.

Will be curious to know kind of prescription you will need in your glasses for the best vision at distance.

I am more than 6 months aout and night driving hasn't improved one bit. Lots of starbursts, lots of concentric circles tot he point I am having the lens taken out and a non-multifocal lens put in. just enough to fix the astigmatism. 

?The doctor will replace the lens free of charge, but the surgiucal center, anethesia, eye drops etc. I have to pay my share of. It's going to be close to $800 out of pocket. I called Tecnis, the makers of the Symfony lenses to complain about it all and find out what they will do and it's NOTHING.

My doctor won't use these Symfony lenses anymore because they are not good. 

?I just spoke with an attorney who is looking into seeing if there is a class action sort of lawsuit to recover damages for the financial, risk and annoyance/recovery burden I have to deal with.

?We may all want to look into this. 

?I'll update people here but 

Sad, really sad! No fault of the Symfony lens, as my doctor has been putting these in since they were approved here in the USA last July. I had mine put in this past February, and love them. I would say you may need adjustments, (as I did), possibly laser to correct any issue. It is crazy for any doctor to say the Symfony Lens is no good, many doctors would highly disagree, I am a very happy patient certainly do disagree! Find a doctor that knows how to test your vision properly, and is able to correct issues, and install the Symfony lens properly.

By the way... you mentioned that you have some astigmatism... that may be the problem with your post surgery progress turning out Poorly. The astigmatism 'Should have been corrected' before inserting your Symfony Lens, or shortly after... as mine was. This is a given, and should have been part of your Symfony package, as it was with mine. Please don't blame the lens if you are still dealing with the astigmatism that your surgeon should have, and did not correct.

It's not astigmatism. It's Starbursts and concentric circles and glare and I am not the first one to complain of it. He's already replaced 3 others and he has mine and another to do. I wish i never had this lens put in.

The astigmatism affects the goodness of the overall vision at all times, but does not have much of an impact on seeing multiple circles around lights at night. I say this from personal experience. Had a small amount of astigmatism and a slight need for additional spherical correction after the cataract surgery and the installation of the Symfony lens. Got a LASIK enhancement done (part of my Symfony package). The distance vision improved to 20/15, but there was not the slightest change in my seeing the multiple circles around lights at night

therave3154,

I am sorry to learn about your terrible experience with Symfony lens regarding your ability to drive at night. I also haven't seen any change in my seeing the multiple circles around lights at night in the distance. Fortunately for me, I don't drive much at night these days so that it is less frustrating.

At least, you have an understanding surgeon who is willing to replace the Symfony lens with a monofocal lens free of charge to help you meet your vision needs. Not all of them would do that.

This is just an update of my night time issue of seeing multiple concentic circles aound lights due to the Symfony lens in my right eye.

It has been about 7 months since my cataract surgery and my related post regarding this night vision issue.

There has been no change in my seeing these circles around lights (about 100 - 500 feet away) at night during this time. Those are as annoying as ever. I have learnt to live with them as we usually do with the things which we can't control (my not having to drive much at night helps with that), but surely wish that I did not have to put up with them.

Just as a minor side comment, I was a little surprised (although I should not have been) when I noticed a week back that even though the circles seem to be far away like the light in the center, an object even close to me does not block the circles so long as the i see the light. Thus, for example, if I block seeing an area left of the light with my finger or a black sheet of paper, the complete circles will still be there. Of course, thinking about it, since the concentric circles are formed by the Symfony lens design within the eye, if the light from a distance is seen by the eye, then blocking the area around the light does not change the seeing of those circles.

Just curious- do you see these circles with inside lights in your home?

I may be in same boat next week and only myself to blame although perhaps I would live with some other visual symptom equally as annoying.

I was reading earlier this week about age, pupil size and the younger a patient is their eyes typically dialate more causing more visual symptoms. If that's the case I am likely to experience those for a number of years.

Chatted with a colleague who retired 2 years ago who regularly plays golf. One of their friends opted for monofocal lenses not wanting to risk halos/glare but that's what he is experiencing anyways.

Thanks for update. Really do wonder if people do adapt or with passage of time pupils dialate less and less so symptoms go away gradually. But 7 months is a very long time.

I have not seen the circles around the inside lights (or the outside lights less than 50 feet). That is probably because the lighted circular areas and the in-between darker areas merge into each other at the shorter distances.

This observation is part of the reason that I feel that using a monofocal lens in the dominant eye for the far distance and a Symfony lens in the non-dominant eye for intermediate (and near) distance will probably provide good day time vision over the whole desired distance range without the night vision issue of the multiple circles.

havent had any opportunity to discuss this with surgeon. I had settled on Symfony - not sure he would want to mix and match. First eye being done Monday with a Symfony and guess I could ask

If opportunity arises Monday before my surgery (things work differently in Canada). It is kind of an assembly line at the hospital. My husband had same experience after his heart attack

with blue dye test and insert of a stent. all patients arrive at one time and operating team does one after the other.

So hoping this goes well. At this point just trusting his skill which may not be wise but there aren't options to go private like other countries.

I am considering getting a distance-only toric monofocal IOL in my right eye (dominant) and perhaps a Symfony toric IOL later in my left eye with perhaps a slight nearsighted shift (-0.5D) since my left eye can correct to better than 20/15, so might still get close to 20/20 distance with a -0.5D shift allowing better casual near vision.

My priorities are good steroscopic distance vision and good intermediate vision (24" or so to my PC monitor and large smartphone).

If I can get a little near vision (18" or so) that would be fine, but not as important to me since I'm OK with glasses for reading only.

I'm hoping that combo would allow me to not notice any night vision halos, etc from the Symfony since the other eye would take over mostly for distance viewing.  That seems to work right now since my right eye has the moderate cataract with halos around lights at night, but only corrects to ~20/40 while my left eye corrects to 20/15 so with both eyes at night I don't see the halos at all, only if I close my left eye!

The alternative for me would be Trulign Toric IOLs in both eyes since they don't have much of a night vision halo risk, not much different than monofocal IOLs.

7 Months out also....  Glare and circles have not improved at all.  The type of light seems to determine the intesity of the gare and/or circles.  The bright LED type headlights and tail lights are the worst.  I do see them occasionally inside if a brght LED light is in a darkend room, but it is not that frequent.  I also still see a glow around white or light colored text against dark backgrounds on the flat screen TV's or at the movies.   So as of now I give the lenses a 10 out of 10 during the day, an 8 out of 10 indoors, and a 6 out of 10 for night vision.  Still see really well at night, but the Glare/Circle issue is really annoying.  

Thanks for the update - really not sure anyone neuro adapts. More like learning to live with new normal I suppose. There are equally unhappy people with monofocals. I like that you consider daytime vision to be 10 out of 10 - hoping for same. At night would like to be able to watch my child play soccer without the circles around the field floodlights. Guess will know soon enough. Surgery Monday - Wednesday at the soccer field.

Your plan using the monofocal toric distance-only toric monofocal IOL in your right eye (dominant) and a Symfony toric IOL later in your left eye with a slightly nearsighted shift lens is exactly what I have been suggesting. You may even want to aim for -0.75 D for the left eye.

As you probably already know, the spherical correction for the IOLs is often about 0.5D from the target value. Also, the toric lens often rotates from the installed postion, resulting in astigmatism. Thus, please be mentally prepared for a LASIK enhancement. Fortunately, in my case, my Symfony lens package included free LASIK enhancement, if needed. And I needed that!

As I mentioned in another post to you, the Crystallens (which is the nontoric version of Trulign) did not work out well for my wife (at that time, Symfony had not been approved in USA). She is not happy with the amount of focus adjustment it provides, it does not cause halos but does cause light reflections at the lens edge, and results in a higher-than-average chance of Posterior Capsule Opacification (showed up in my wife's eye within a month or so after the surgery, requiring correction with YAG laser).

 

The surgeons never suggest mixing the types of lenses. However, if you ask them directly, they will usually go along with that because there is no basic reason for not mixing them.

I think that in most of the countries, including USA, the Medicare or even private insurance plans do not cover Premium lenses such as Symfony. So, in that sense, Canada is not that different. I any case, since you are paying more for Symfony lens, if using 2 Symfony lenses is resulting in a higher cost than 1 Symfony lens and 1 monofocal lense without much of an additional day time vision benefit and potentially a higher chance of a night vision issue, you should really discuss your options with your surgeon.

A little late now. What I meant with Canada is that regardless of durgeon if cataracts deemed bad enough (ie fail driving test 20/40) our Medicare will cover surgery and monofocal less. If I want premium lens I pay the hospital the upcharge of that from covered monofocal ($900 per Symfony lens). If I were in U.K. And wanted Symfony lenses I would need to go outside national health services to a private company and I would pay for surgery and lenses costing s verbal $1,000s per wye as surgery not covered at their private clinics. Is usa the same?

A little late to discuss options and at one point since all covered under our Canada health plan there is not time for in-depth discussions. Had I not even brought up options I would have been implanted with monofocals.

In USA, one goes through the same hospitals and doctors for the Premium lenses as for the monofocal lenses. The Medicare and most of the insurance plans pay the charges for the monofocal lenses (excluding the applicable deductibles). The excess amount for the premium lenses is paid by the patients to the doctors / hospitals (who set the additional costs for the different types of lenses).

Wish you best the best for a successful surgery next Monday.

I, too, am going to have the multifocal lenses removed and the regular distance lenses put in.  My NEW doctor, who has removed many of them, said that the concentric circles, starbursts, etc. will not go away.  That is the way the lens are made.  He does not push these lenses at all.  Fortunately, my insurance will pay for removal due to these problems.  I'm only out of pocket $250. Don't know where you live.  I live in the US.  Wish I had seen this blog before I had the first surgery done.

Thank you very much. Hoping it goes well too.

What type of multifocal lenses did you get? It's a real mystery why some are bothered by these halos starbursts etc and others aren't.

I'm having the symphony multifocals removed.

I sure hope I have a better result with the Symfony lenses. I have he's d successs stories and sad ones like yours. So sorry you've suffered like this. Ensure you gave an excellent surgeon for the 2nd surgery.

Hi at201 just wanted to give you an update on my cataract surgery yesterday. Symfony lens implanted and had my post op today with my surgeon. Have to say I am pleased with the results. Day and evening after surgery was very blurry. I was told wry nervous yo have surgery although only felt pressure - no pain. Kept eyeshield on except to put in drops. Did take the Ativan prior to surgery but it kicked in another hour after that and made me so nauseous that nothing stayed down. Hoped I didn't ruin position of iol but that couldn't be helped. Slept all afternoon evening and overnight and woke to a bright World. Couldn't believe the colours. I compare all the time to unoperated eye. Surgeon was pleased at my 20/20 vision. He said reading will be a little easier once 2nd eye is done.

Just want to thank you sincerely for all your input and support.

Haven't gone outside yet in the evening so might venture out later to see what that is like. Although having vision this good during the day sure is a good way to start.

That is great! It is always nice when the results of a surgery come out as well as could have been expected.

Hi just thought I would circle back with you. It's been 10 days since first eye done with Symfony . So far all is good. Having to wait till Aug 21 for 2nd eye surgery. I think somewhere you recommended maybe a monofocal for 2nd eye to minimize night vision affects. Would that still be something to consider given 1st turned out well? I know my surgeon recommended going with Symfony in both eyes. I think if I were to go with a monofocal he would need to redo some tests/mapping. When I finally decided on Symfony he had me come into his office for some specific test/calculations that wouldn't be needed if I went with standard lens. Make sense?

I was told I wouldn't have the best vision near and might want glasses for closer reading. Will need to assess that once 2nd eye done. Currently I can see my iPhone at about 18 inches out. computer and far distance are very good. Was tested 20/20 day after op and think it still is that.

Another comment. Before first eye done doing at home test thought my dominant eye was left. Now with one eye operated I do same test and i think right eye is dominant. Do you think eye that sees better takes over and becomes dominant eye? Just find that a little odd.

Thanks in advance for your feedback.

1. As far as I know, the eye measurements tests are the same for Symfony and monofocal lenses. Additional measurements may be required only for toric lenses.

2. You may want to wait for the decision on the second lens until you know exactly what your prescription is for the left eye and what your corrected distance vision is for the left eye.

3. Have you had a chance to check your night vision with the Symfony lens yet? Did you have any glasses  or a contact lens for the right eye at the time of the test?

4. The brain tends to pick the better ( or clearer) of the 2 images from the 2 eyes. Still, if the images are of similar quality, a dominant eye will take over.

5. If the right eye is dominant, then with the known information at this time, my suggestion will be go for the monofocal lens set for distance. This will improve the chances of good night vision, will not make much of a difference for your intermediate vision (Symfony lens is taking care of that), and will save you lots of money in the process.

However, as I said earlier, it is better to have more information for the left eye before making the final decision for the right eye.

Sorry I may have mixed up something. My right eye had a Symfony lens implanted 10 days so. Left eye is scheduled for surgery Aug21.

Currently wearing previous prescription glasses with lens poked out on right. Also have sunglasses (4 years ago) with original Serengeti lens in right eye (I kept original lenses and placed in right side for Symfony eye to see out of). Often it is too bright and I wear sunglasses a lot even inside.

I did have to go in for additional sitting in front of a machine specifically because I chose Symfony lenses. If I chose monofocal lenses that extra measurement not needed. I will have to ask about that as perhaps partial reason for my outcome.

Been out st night a few times. As recently as last night to watch my daughter's soccer match under big field floodlights. I kept looking at those and streetlights on drive home (passenger side of car) closing each eye. As far as I can tell glare etc worse with unoperated eye. With Symfony eye I get a glare around lights (they look fuzzy - hard to describe) but have yet to see concentric circles.

Last week a few days after surgery outside with sunglasses sunlight came in from an angle and I could see circles reflected on inside of sunglass lens. Pushed them higher on my nose and reflection disappeared.

So far I am pleased - closing unoperated eye I see iPhone from about 16 or 18 inches out . Tv distance is very good as is distance. I guess I was prepared for far worse night time issues deciding that I wanted my intermediate and distance daytime vision more. So far I am not bothered by night time vision but it is early days I know.

I guess I am not sure which of my eyes is dominant. Prior to operation I would have said my left. But since operation Symfony

Seems to take over. Reading is the more difficult task as imagine from eye with cataract is so different. Brain keeps trying to adjust but I get headaches by end of my work day. Would help if I didn't have to put in a lot of screen time between now and Aug 21. Don't think I will delay the surgery. By then Symfony should have healed a lot and if no significant issues will go ahead.

Symfony lenses in Canada not to bad only additional expense I would have is $900. If it saves me from years of glasses will be worth it. Prior to surgery I never wore glasses for near/reading g or around the house. Having to wear them all the time due to brightness or trying to balance eyes my nose hurts (course sunglasses weigh more than my regular ones). Perhaps contributing to headaches.

Do Symfony lenses cost more in USA?

Yes....  Mine were $5,600.00 US out of pocket for both.

That is signifantly more than we pay in Canada. I had thought your health care system paid for the surgery (or is that just for some states)? Here in Canada cataract surgery is covered (about $3400 perveye) and that would include a standard monofocal lens. Premium lenses would b charged for separately if you choose them and they are purchased through hospital. Our surgeons do not get any additional fees.

The prices vary a lot between eye surgeons in different areas of the USA.

I got a high price quote from a top eye clinc that does a lot of LASIK and for their cataract surgeries with premium IOLs (Symfony, Torics, etc) they add a "premium package" that costs $2600-$3200 extra out of pocket in addition to the added cost for the premium IOL and femtolaser assisted surgery ($1000+).  These extra costs are in addition to the basic cataract surgery costs that medicare and health insurance covers most of - typically the patient has to pay about $500-$1000 for the basic part depending on the facility and anathesia used.

The "premium package" includes up to a year of no extra cost followup including any lasik or other laser "touchups" if needed to get the refractive results until you are satisfied.

And those price quotes were "per eye", so both eyes could easily cost me $10,000+ thru that place - but I suspect they are one of the highest price clinics in town since they have the best reviews and the latest high tech equipment and experienced eye surgeons.

Looks like you are doing great with the Symfony lens in the right eye. If your distance vision is good and your night vision is reasonable (without depending on the left eye), that makes choosing your next step a lot easier.

It seems that your main desire right now is to be able to read without any glasses. Since the extra price of the Symfony lens is not a big concern for you, my suggestion will be get a Symfony lens set for the best focus at 32 or 40 inches (corresponding to the prescription of -1.25 D or -1.0D). You will be using a little bit of monovision, which is much easier to adjust to than full monovision (although I adjusted to full monovision very easily, some people have an issue with that). More importantly, with that combination, you should be able to read without glasses at about 16 to 17 inches fine.

I am glad that my extra cost for a Symfony Toric lens and the included LASIK enahancement package was only about US $2200 in the Seattle area. It also included the the femolaser assisted surgery.

Thanks. Guess I am surprised how much extra fees there are in the states. On my 2nd visit with surgeon one of my questions to him was about additional fees for touch ups if needed. His response was it's rare and the machines today are much more accurate predicting power needed. He also said he doesn't get paid any more or less from health care whether I chose a premium lens or not.

In the waiting area day after surgery I was with same group of people who had surgery with my doctor st the hospital. One by one before surgeon saw us we were called into a room for eye test (open to area we were in so could hear interaction). After I came out one of the ladies asked me how was it I could see near and far with my one eye done. The others never knew about lens options (one didn't realize the surgery involved removing a lens). When I think back to my initial consult I think I brought up lens options not surgeon. When I was diagnosed with cataracts I had a 3 month wait to see opthamologist so did a lot of reading and found this forum.

Guess it begs the question for me is how often are adjustments required? Not sure I am a unique case where I see just fine now (admittedly these are early days - will know for sure after 6 months to a year goes by). Perhaps if surgeons in the states weren't paid all these extra fees perhaps they'd measure twice and cut once.

So pricey. And the higher the price perhaps expectations run high too. Our system quite different in Canada . Our government ensures our surgeons don't get extra. Even when I chose the premium lens I had to then deal with the hospital. Prior to 2012 the premium lenses were sold by opthamologists and the pricing varied between doctors and where you lived in Canada. After June 2012 the government required that these be purchased through hospitals. 1. They take advantage now of bulk buying reducing overall cost to patient and 2. Give patients discount if standard lens cost per eye of valued at $300.

Our system isn't perfect. Allows for everyone to have access to affordable healthcare but our wait times are long especially for certain types of surgeries. We do have some private (particularly for scans like MRIs ) so can cut down on wait times.

Usually, the surgeons can get the spherical correction within about 0.5 D of the desired value with the IOL.

The astigmatism correction can be a little trickier. The needed correction may be small enough that a toric lens is not used, but it may be enough to keep the vision from being clear. Also, new astigmatism (regular or irregular) may be introduced as a result of having to cut the cornea to put the lens in. If a toric lens is used, it may rotate by a few degrees from the installed position (lens designs do not prevent it from happening), which essentially introduces new source of astigmatism.

Speaking feom my own experience, after my cataract surgery in the left eye about 18 years back, I used a contact lens in that eye for many years before getting LASIK enhancement about 2 years back. For my right eye done about 8 months back, the Symfony toric lens had rotated about 15 degrees from the installed position. Had a choice of having it rotated back to the correct position, but decided to go with the LASIK enhancement for a more predictable result ( both choices being free for me at that stage did not affect the decision)

 

Update to my Symfony lens experience. Last night I saw the concentric circles. We were driving home from an away soccer game. Most of the trip on dark highway. When we were travelling behind transport trucks and vehicles I could see red translucent circles around the breaklights. Cars toward us on other side of divided highway I had usual glare from headlights but no concentric circles (perhaps as glare is so bright - don't know. As we got into our city limits with overhead streetlights the concentric circles disappeared.

I wondering if this has to do with low lighting on dark highway or the contrast? As I only have one eye operated on tried to close operated eye to see what other eye could determine. Unfortunately that eye sees blurry even with glasses due to cataract but overall road seemed brighter in front of us. Since menu in dimly lit restaurants was same experience last week perhaps it is a contrast sensitivity thing as well.

Anyways not sure if these circles will finish with time or not - just found it so odd that they would occur in this lighting situation versus night driving locally under streetlights.

I was cautioned about these night visuals by my opthamologist as well as these forums so at least not a surprise. I am still very pleased with daytime vision and accept I couldn't have best of both worlds.

As you've responded to many have you ever had comments on seeing these circles more and in areas without overhead lighting?

Thanks.

So you have only seen the circles around some lights in very dark conditions?

Might be associated with the eye getting more dilated in very low light, if you don't see the circles in a less dark enviroment?

Correct. I haven't left the city since surgery so night driving has been on streets with streetlights. I do see glare or flaring whatever it's called. But not too bothersome. Less than what I have with cataracts. But the circles came in our long drive back from an away soccer game for our daughter. 2 hours in a divided highway - no overhead streetlights. Cars and trucks in front of us I could see rings around headlights extending beyond vehicle. They were red so assuming this was taillights causing the rings of red colour.

Do you think it is the low light conditions? I did close operated eye and lighting in front of our car seemed brighter than when I closed unoperated eye . I did notice that in a restaurant last week too (upscale and dimly lit). I had trouble reading menu. I used flashlight mode with iPhone to read it. Caused amusement with table guests but solved the problem. Lol

Thats expected that reading vision is worse in dimly lit conditions, again probably due to the eye's pupil becoming more dilated which narrows the focal range a bit.

What might be a good experiment is to carry a small flashlight with you when in a very dark environment and when you see circles around light sources, try to undilate your eyes a bit by looking at the light from the flashlight for a minute or so and then turn it off and see if the circles around a light reduces?

just tried with a book in low light. Cataract eye can read print. Operated eye cannot - contrast low. When I shine flashlight in eyes doesn't seem to make a difference. Still was able to read in low light. Would this be same with monofocal lens? Wondering if I should reconsider a monofocal for left eye. Or would eyes be imbalanced then?

Talking with others it does take a number of weeks and/or months for eyes to settle and/or adjust to night vision.

Just not sure if there is any solution that would be satisfying both ways. Seems opthamologist was right that there is a compromise to make with what they currently have available. And I think the younger you are with cataracts the more true that is.

Driving could be challenging at night. Some areas in neighbourhood are darker and lights do glare. Just drove my daughter to Tim horton's - drove real slow. Much prefer daytime!

Are their drops to help constrict pupils that would last a while to help with night driving? Or would they not be healthy on pupil in long run?

Hi just thought I would let you know that my experience with Symfony is pretty much as you described yours. Just have one eye done - the other will be done Aug 21. My doctor didn't push any particular lens. In fact the waiting room of people who were also with me following day for post op check-up never knew there were lens options and one didn't realize the surgery involved removing g of your natural lens. When I think back it must have been a question I asked. Given at my age there would be a compromise (which surgeon did emphasize ) I decided on a premium lens given I will be working another 10 years and still have a cold at home and am quite active community/ sports etc. Symfony so far is a great daytime lens. Could not be more pleased with it. First 2 weeks I didn't notice any concentric circles. Lights had some glare - looked fuzzy (headlights and streetlights and porch lights). 2 nights ago we drove to an away soccer game on a divided highway without streetlights. I noticed the circles around red taillights (circles were red). Also last week went to a nice restaurant (dim lighting) and non operated eye could read it. Symfony lens could not. Used flashlight on iPhone. So low contrast lighting does have an impact. Would the same be said for a monofocal lens?

Due to my surgeon's caution and this forum I was not shocked. Even knowing the outcomes - there wasn't a better lens available now. I think I would have been equally compromised with monofocals and dealing with a different set of issues. As I age not sure I will do a lot of night driving. Also I don't notice the circles at night with overhead streetlights which is why I didn't think I got those disturbance started. Perhaps it is another low lighting issue.

Maybe in time I won't notice anymore.

It is a shame a lot of opthamologists don't caution people and likely why mine doesn't discuss unless asked. In Canada they are paid same amount no matter which lens people choose. For premium lens I pay the hospital difference in premium lens vs monofocal lens.

Thanks for your description- likely this is the normal outcome. I do like the way my vision is during the daytime. Still find it amazing to see detail. I really didn't reLize how much cataracts block. So compared to that this Symfony lens is a far less compromise.

As you also have found out that seeing the concentric circles around lights at nights depends on the ambient light, distance from the light, and other concurrent effects such as starbursts.

The concentric circles are essentially lighted bands separated by dark bands. So, my thinking is that when you are close to the light, the lighted bands merge with the dark bands so that while one sees a blurry glow around the light, one does not see the circles. As one gets a little farther away from the light (about 50 yards in my case), the bands become distinct so that the circles are easily seen (having a color in a light such as from brake lights makes them more vivid). Getting much farther away, the lighted areas become faded so that one stops seeing the multiple circles.

I am sure that different people have different contrast sensitivities so that can be a factor in why some people see these circles while others don't.

Finally, if one is seeing starbursts or a strong glare at the same time as when the conditions are right for seeing the multiple circles, the starburst or strong glare effects tend to be the overwhelming issues.

I think you are right on with that assessment. I knew from these forums and my doc didn't hide that possibility that this was the compromise. As there is no way to test out what other lens options would bring - I decided these would be my choice. I really like the way i see in daytime. And the expense is not excessive in Canada for premium lenses. Perhaps if something was off for my daytime vision as others have experienced I would be disappointed but that isn't the case with me. I am thinking my outcome is within the 85% satisfaction rate.I am sure better lenses are on the horizon but for now those of us who have premium lenses will have to adjust and find a way to live with night time issues.

Would you be able to tell me if your monofocal lens gives you good low light contrast ie can you read a menu in a dimly lit restaurant? Or is that lens set for distance - but then I would assume you could see the menu with glasses.

Thanks. As 2nd eye not done trying to assess if maybe a different lens would be better. Although as years go by not sure if I will be doing a lot of night driving . For now as a soccer mom - lots of that for next few years.

I can read a menu in a dimly-lit restaurant fine, but that is probably because my monofocal lens power is set for reading at about 17-18 inches.

One would expect a good monofocal lens (not all are the same) to provide better contrast than a Symfony lens, but it is hard to know the difference.

 

In Canada since the monofocal lens covered by Medicare not sure you get a choice of which lens. I did find the flashlight on ihone helped with the menu reading - lol.

You're right. The first day or two post-op, the pupils are still wide and so going outside at night to look at traffic is quite shocking; I saw spiderwebs, halos and glowing effects everywhere. But this was due to the extant effects of the surgery and the pupil widening solution they used not having wore off yet.

So then it is understood that should your pupils widen that much then you will see some of those larger halo effects. This is because more of the lens surface is being used to project light onto the retina.

For all trifocals, it should stand that the halos around high contrast lights will vary in intensity both due to contrast intensity and also the color of the light.

I myself have put in the trifocal lens 'Zeiss AT LISA'. This is perfect during daytime. But when the contrast gets very high - at night -  the fresnel like lens gives off diffraction at each stepped layer of the lens. This lens has 12 of those, hence 12 rings around a high intensity, high contrast light.

I found yellow lights to be the most disturbing, like sodium lights, or some leds - they looked like chinese lanterns rather than points of light.

Now let me say; I do believe that the human brain is really excellent at concentrating on the details while simultaneously ignoring the artificial or confounding stimuli. So I do believe that the brain's visual cortex can filter these halos when required or trained to, 

For example; by having the halo of a high contrast light in the background overlap a physical object that is actually in the foreground, that is an aberration of such obviously incorrect visual information that the visual cortex should learn to filter it out over time. 

Therefore, you may need to concentrate on the foreground detail so that the visual cortex can match the signature of the confounding stimuli and learn to filter it out.

And at the same time it's impractical to think it was not tested for. Optical engineers know that e.g. for light, the angle of reflection is varied within different media and that therefore, at some frequencies and also higher intensities, the bounded medium of the IOL strata would affect the angles of refraction such that aberrations would/could occur - and so they should have be tested for.

This makes it hard to understand why these drawbacks are not very well elucidated prior to such an invasive procedure.

 

Think the Dr.s are explaining the night vision better.Dr mark packer devised a eye like camera thing fitted with different lenses to be able to see what the patient sees.After all until they have cataract surgery the surgeon does not really know exactly what a patient sees.

I nowhave to make an effort to notice halos and starburst.Tney are there in tne dark but i tend to notice the car, the make, the license plate....or the faint glow around tne light of assorted routers and household things in the dark..I suppose i could drive myself nuts if halos were the only thing i saw at night,It took six months for one eye to fully stabilize.Had yag surgery on both eyes with first eye having a capsular wrinkle which caused a streak at night..

Having been nearsighted i am totally thrilled with clarity of daily life.Small print needs light or there is a loss of contrast which causes it to fade not blur.The symfony does well by me.

I am hoping those bothered by halos will find tney notice them less .They do not go away 

 

That's right mate, the visual acuity of near sight is tougher to solve, but they have!

I guess then that It's only reasonable that the distance issues could arise. Just to comfort, the ideal 

I hope you use lasik to fix the capsular wrinkle.

I should suggest that I got IOL at 40 years old due to astigmatism. 

In the previous post I allude to the idea that we focus on details in the foreground rather than the distracting lights. From personal experience I know that I find it tempting to look right at the lights. But what I'm suggesting is to look at the dimmer things; the foreground details instead. Because, until the cortex realigns the new visual information style we might be at the mercy of the old methodology.

they used the yag to remove back of capsule and the wrinkles.Once done exchanging lens not good idea though i was a happy camper.

Dr asked me to tell prospective patients about symfony vision.older people who rarely drive or out at night were fine but i did warn that halos deeply upset a few.I never liked glasses and am done with them but others are different,

At forty you have not experienced the slow loss of cataracts.Tbey are bad for lights at night...Tail lights can be bigger than the car!

If you hunt down dr mark packer you can learn about his experiment..Nobody ever knows exactly what others see

i have never seen anyone pushing premium lenses in my reading and youtube during lens research..Really not worth the complaints if not a motivated patient.Tnese surgeons do hu dreds of surgeries and depend on teferrals of happy patients.It is now a refractive procedure where patients expect 20/20 it is a far cry from the horrible surgery of the past...

I am curious Joe why at 40 you would opt for clear lens exchange to fix astigmatism.  Why not fix it with glasses?

Pupils will dilate more in younger patients so those light artifacts you describe after surgery can likely be an ongoing issue for years (till 60 years old) at which time pupils won’t dilate as much.

Refractive cataract surgery is gaining popularity. In some countries the use of premium lenses are restricted to private hospitals and surgical centers. However in Canada, a cataract patient if found suitable, can opt for the premium lenses and pay the difference in fees. My husband was informed by the ophthalmic technician that he was a suitable candidate for Symfony lenses; he came home, did some researching online and decided. The out-of-pocket expenses were a fraction of what it would cost if the implantation was done in say Singapore or the USA. His eye-surgeon was very thorough on all the pre- and post-Op instructions and possible side-effects.

initially i had no idea of the possibilies of  cataract surgery.My intense research discovered how some patients want  as close to childhood vision and consider the premium lenses.Here in us surgeons offer touch ups and whatever toget as close as possible.Still not perfected but the lenses are getting better and better..The more knowledgable patient like i was made it easy for the surgeon as i knew more about the lens than he didIt had just been approved in usa and i was the first to get it from him..All the european clinical and usa trials were available if one is a fanatic as i am..on another list a guy called softwaredeveloper did super intense research and travelled to get the yet to be approved lens several years ago.

Insurance here covers the basic surgery but one pays extra for symfony ..no trifocals here yet...

it never hurts to research as no one is as interested as the person himself..I even watched youtube eye surgeries so as to relax by seeing al the steps..

I also had done quite a bit of research on the Symfony lens before I had them installed. However, at least up to the time I had one installed in December 2016, over more than 1 year of looking the web sites for the new crop of contact lenses, I had not come across any mention about the multiple concentric circles seen around lights at night when using Symfony lens. There were just sales pitches by the Symfony manufacturer and the surgeons paid to do the trial studies about how wonderful it is, mentioning just the advantages and no disadvantage compared with a monofocal lens

As I have mentioned many a times in the past, the issue is not that the Symfony lens is not the best choice for many (as it may have been for me), but it is the lack of both the pros and cons discussed clearly by the  lens manufacturers and the surgeons. That was the main reason for my starting this post to at least make people aware of the issue of seeing the multiple circles around lights at night with the Symfony lens.

remember only the patients actually know exactly how they see at night.Multifocals have always been known due to how tney work with the retina..Symfony was less intrusive in the dark ....my experience is the drs want the beat results..happy patients..the clinical trials tend to have older people who probably are not night drivers anymore.The kleinmann study was i teresting to me as it used the lens in eyes with pathology with good results..night driving was not a focus so to speak..

you may start not noticing the halos as much.. unless you are quite young and drive alot at night under tough conditions.....your experience may help others who might be sensitive to the starbursts etc...monofocals and glasses might be best..

Hi Bravogoldenk9. Appreciate your point of view and know everyone’s perceptions can differ.  I am happy with the Symfony Lens - no glare or starbursts during the day.  Minimal glare and starbursts at night but the concentric circles I see haven’t diminished over year I have had them. I have learned to adapt my driving but they don’t go away - I would wager for anyone.

I know you appreciated software developer and the research he did and the fact he went to Europe to have Symfony lenses implanted before they were approved in the USA.  He posted a lot here when I was doing research for my cataract surgery.  He seemed to say that neuro adaption takes place and after 6 months the circles are no longer there.  I am not sure whether he was completely honest about that or not.  To this day I still wonder if he didn’t work for the manufacturer- convincing people to get these lenses.  I guess I will never know.  I know I pointed out a small study done May 2017 indicating preliminary patient reviews of symfony’s halos not much better than a multifocal and he completely discounted it touting the study was biased and those receiving Symfony lenses were older than those receiving other lenses (to me that was added weight to the truthfulness of the study as older people don’t drive as much at night).

To at201s point ( and many others ) time has gone by and yes patients are the ones who see what they see and I am 100% sure they’ve given feedback to their doctors about the concentric circles by now.  But still nothing from the experts on that his - only here on forums such as this.  doctors continue to hide the cons from patients and stress the pros.  The only plausible explanation for that is money.  They get far more money upselling premium lenses than standard ones. The honest thing to do would be to present the pros and cons of each lens (they can no longer hide behind they don’t know the cons). 

More open and honest conversations should be taking place.  Some patients such as myself would opt for premium lenses but others won’t - both are valid choices.  My needs aren’t the same as someone else’s and vice versa.

My astigmatism was causing bad vision at both short and long distances. The doctor explained that it would worsen over time and that contact lenses or lasik are not a good solution to it. I got two opinions though and this was the 2nd one. The first opinion advocated against IOL but that doctor didn't even offer it at all, so I discounted it. 

I am very pleased with the result. I had forgotten how good trees look with all the details!

Hi Joe - curious why you’d discount the first doc’s opinion vs second doc?

I am pleased you are happy with the results.  I assume you went through clear lens exchange vs cataract?  I would think most surgeons would not advocate for clear lens exchanges.  Astigmatism can be corrected with glasses.   Even though you ended up happy with your vision there are many variables (outside of surgeon skill) that your end results may not have been good.  The fact is IOLs aren’t perfect and come with trade-offs. They only come in increments of .50 unlike glasses or contacts which come in .25. Also the surgery itself can cause astigmatism and as that IOL heals it can leave you another .25 short sighted or farsighted.  Those should all be explained to a patient.  Those with cataracts that can no longer be corrected with glasses or contacts have no choice so it is a matter of IOL selection and those too should be fully explained pros and cons.

Which IOLs did you select?  Glad this turned out well for you.

FDA approved Tecnis Symfony in 2016 July 15. Then about 6 months later, FAA allowed the Symfony replacement lens option for pilots. It is on the website of AOPA on multifocal contact and IOL Implants. Pilot praised the Symfony replacement lenses (AOPA's article dd 20170608); I doubt that they were paid by Abbotts to implant their eyes with Symfony lenses.

There are interesting tables in an article (UK BMJ, 2018 May 09) not sponsored by any manufacturer. "Halos", "starbursts", "night vision" exist in both the multifocals and the monofocals. As one SFO ophthalmologist says that these issues are "closely related to near vision these lenses provide."

I will have to check that out.  When I was considering my options I checked out flyer talk forum of pilots.  At the time they were saying commercial pilots could only have monofocal lenses.  No mention of Symfony.

Sue.An, The first thing the eye-surgeon told my husband was the "concentric circles" etc. As it turned out, these were non-issues or quickly became non-existent. Perhaps we have stricter regulations and medical ethics.

Thanks Sue-An. The first doc said that the IOL's would cause a loss of contrast due to splitting the light 3 ways. This was incorrect and so I discounted his suggested treatment.

I got the Zeiss Tri-focal IOL AT-LISA in the end. That was available in Australia. I did query about the AT-LARA model that was newer and the doctor replied that it would still require reading glasses.

I wanted to be glasses free and the doctor explained that a trifocal was the only way.

With autumn just around the corner, I'd better go and touch the dogwood tree before all the leaves fall.  

You have a wider selection of lenses than us Canadians Joe.  

Yes I have heard the trifocals provide good all round vision.

Do you mind my asking how the contrast is?  Given a trifocals splits the light I read that it may be a bit lower than Symfony.  I got lucky with my Symfony lenses and see well a distances - don’t need glasses at all.  But do see concentric circles at night though around certain light sources.

Wow, I have a pilot's license and if my pilot sees what I see at night I would not want to fly with them, but maybe I just had a bad outcome.  My current doctor says he does not recommend the symfony for pilots and I am glad I don't fly anymore or I would be even more upset than I already am.

I was told by my surgeon about the halos but not specifically concentric circles.  Those I learned about here from at201 when I was trying to decide on lenses.   So I am grateful to find out and make an informed decision.  I wouldn’t say they are a non issue though or non existent.  I haven’t noticed them diminish over the year.  Would prefer if they did - lol.

Does your husband drive at night much?  They are hard to miss.

I still can’t see any commercial pilot being allowed anything but a monofocal lens.  I think we had someone on these forums a while back that confirmed it.  It would be way to dangerous landing at night with all those runway lights with 10 concentric circles around them!!!   

Don't you all have to fill out the yearly FAA Eye Evaluation Form 8500-7?

If you see well during the day you have a good outcome.  All multifocal and EDOF lenses like Symfony have night vision compromises.   It is the trade-off to not needing glasses.  That is why it is especially hard on those whose daytime outcome did work out well.  To spend all that money and still need glasses is tough to accept.  And on top of it you get the compromised night vision.  That’s why I advocate for doctors having open honest communication with patients clearly outlining the pros and cons of the IOLs.

Contrast is excellent. The only difficulty is with small things like screw heads on electronics. Due to a light reflecting on them it is hard to see the details needed.

 

Interesting as I thought it wouldn’t be.  I find with Symfony I have to use my iPhone flashlight to read menus in dimly lit restaurants.  I need good lighting to read.  But I have fixed

 my sunglasses when the tiny screw fell out!!!  It was broad daylight though - impossible task otherwise.

Also had to go 6 weeks between surgeries so was able to compare the 2 eyes for awhile.  Even with cataracts contrast was better in eye with natural lens vs Symfony eye.

Not long distance driving though. In winter, it gets dark around 3 pm in the afternoon here. We went to the airport to look at the landing lights. Cool.  All international and major airports have automated landing systems.

FYI it did cost $8400 AUD to do this.

Yikes - but many spend more than that on a vacation and eyesight lasts longer than 2 weeks!

Glad I live in Canada - medicare completely covered the cataract surgery and credited me $300 for standard lens that would have been covered so ended up with an expense of $900 per eye for Symfony

The multiple circles around lights at night seen with the Symfony lenses.do not exist with the monofocal lenses. Those are a result of the diffraction circles in the Symfony lens.

Regarding the statement that "As one SFO ophthalmologist says that these issues are "closely related to near vision these lenses provide."", that is exactly the point. It is the design of the Symfony lens to enable it to provide extended vision which cause the multiple circles issue. So, why just talk about the pros of the Symfony lenses only, while minimizing those issues!

Hi at201, I wasn't promoting Symfony, just sharing what I read from AOPA's site. The risks and cons of the premium lenses have been well covered, so I won't be going there.

Sue.An, I heard the Aussies have better healthcare than us, but of course CLS or RLS is out-of-pocket expenses.  SNEC (Singapore National Eye Centre) a government outfit, also has Zeiss atLisa lenses amonst their stocks (they call it "AT lisa toric multifocal IOL". Cataract surgery in Singapore can cost from S$2000 up to S$20,000 depending on whether it is done at a government hospital or a private one, and on the seniority and reputation of the eye-surgeon. So Joe's A$8,400 is quite acceptable in that tropical region, where people in their late 30s and early 40s have cataracts.

i doubt software was a schill for tecnis.I communicated with him once after his posts stopped..He was deeply involved in some software endeavor in colorado.He had given all the symfony i fo he had and was done.Obviously a very intense sort.

I do not think most eye surgeons are the scummy types who run dubious money making schemes..deceiving people about halos and having them pay more.

I wax measured well over twenty times between the 2 eyes.Corneas,oct and goodness knows what other  mysterious machines...good drs want the best results.Cataract surgery is so common many so hundreds plus a year.

One thing i watched was a meeting of refractive and cataract surgeons were quizzed on use of muktifocal/ edof lenses and their use was minor..maybe five percent if i remeber right.Far simpler to use monofocals covred by i aurance, wear glasses, and be content.Why would they want to have to replace , or touch up or whatever the unhappy monofocal.

My brief chats with other patients was that some wanted to forget glasses in their senior years and have clean crisp vision..and put up with shortcomings.My dr said he has a collection of lens that never worked out from developers.

Personally i am still fascinated by the elegance of the surgery these days.In a short time with exact measurements one can open eyes after surgery and see a whole new world.And yes with good light can fix tiny screws..just fades in poor light

 

Glad to hear software developer wasn’t working for a manufacturer and yes he was intense and very sold on Symfony.  I am happy too with the outcome but would never want anyone to substitute my research and experience / judgement for their own.  

Therein lies the issue with surgeons ‘I do not think most eye surgeons are the scummy types who run dubious money making schemes..deceiving people about halos and having them pay more.’ I agree they don’t appear to but from the ads I see everywhere on social media they are definitely pushing for clear lens exchange etc.  And they don’t discuss the cons not even with lasik surgery.  Their equipment is pricey and so is their overhead and salaries (talking about private clinics). They most definitely do promote it.  Yes there are good ones in the mix but how many times here on the forums do people complain about aftercare service.  Doc doesn’t want to address the cases with them or even acknowledge there is an issue.  (honestly I think they should be paid half prior to surgery and the other half once person is satisfied. )

Currently in us there is discussion about the high prices hospitals charge, and actual amount  insurance pays..It varies amongst insurers but the well insured pay reasonably out of pocket...I imagine in canada the national health pays perhaps a few hundred dollars and if a surgeon does fifteen cataracts a day he can manage...tho i am no expert...i saw  bill for my eye surgery at over 30k where insurance covered it except for 345.United health care negotiated a mysterious amount unknown as ro what rhey pay for  catara ts .Heaven help the uninsured.

I have learned lasik surgery to correct vision greatly messes up the measurements for later cataract surgery..Big topic at rhe meetings amongst surgeons.I have not seen much in way of refractive lasik advertised except in dubious ads where a person can have it done cheaply etc..those are suspect..a Board certified opthalmologist my have too much pride in his work .and these may well be somewhat less than fine doctors.Your dr. sounded very competent.and your results as expected..You did your research as a proactive patient.

I kind of liked software..I could see him evaluating in a nerd like way what he was to do with his eyes.I found him helpful as my knowledge of eyes was rather non existent until i had a retina issue , cataract etc..interestingly my research into symfony found the israeli study where the symfony was jsed with orior mild retina relajr with excellent results.Both surgeon and retina specilist said  i opened the door for some people to get a symfony ( not multi focal) ....i had read every clinical trial and they had not.

please excuse typos..This is the worst forum in terms of writing anything.I want to add here in city many opthalmologists have minimal peivate practices and work thru hospital affiliates groups.their overhead is covered.No insurance, staff, exquipment , rent to pay but hospital bills and they receive a sort of salary.If private practice they have high rents, staff, and endless upgrading of equipment, operationg room etc..becoming very hard to do these days except for plasric surgeons who do not take insurance and charge lots of money for cosmetic stuff

Yes these forums sometimes change your words around and looks like you can’t spell for beans!  No worries- my own posts are horrible too for spelling!

Canada is very different - insurance does cover complete cost of cataract surgery regardless of lens.  And that bill may vary between provinces but is roughly $3,500 per eye.  As stated I paid out of pocket $900 per eye for the Symfony lens.  One of puke have to pay out of pocket for the drops too - although those were covered by my health plan through work.

$30K is outrageous for a necessary surgery.  If people want to off their glasses and pay that amount I have no sympathy (nor should this surgery for that purpose be taken lightly).  They should be well cautioned about the lenses and outcomes so they are fully aware of what they are about to do.

Not sure which system is better.  In Canada we have long waits for any type of surgery.  Only way you get prioritized is if it’s life threatening.  But it is completely Gov’t paid for.

When it is a system like the states you pay high insurance premiums (and #1 reason why your surgeons charge so much) or it’s covered by national health but you are forced to hospital and no lens options.  But you get served much faster.

wow what typos!us healthcare a mess.. edicare is for those over 65 and pays for cataract insurance..I think i read somewhere about 400. to dr or to hospital if that is where dr practices..a major mess..the wall st journal last week had an article on knee replacement costs..see if you can google it...

there is no wait here though mymhusband said very overweight people may no longer get elective surgery..risky so bariatric surgery is now being covered..other than proactive types so many are over weight, eat poorly and just do not take care of their health..high blood sugar levels and retinapathy

I do not doubt they are clueless about cataract surgery and just take the cheapest monofocal

i looked at my horrendous bill...itemized to a piece of guaze.do look for wall st journal article..one cannot do links here

Not just plastic surgeons charge a lot of money. LOL.  There are a dozen dental clinics around a Mall in my neighborhood, and over half of them are offering botox injection, skin laser etc. with huge ADs strewn over the walkways.  If you google "Clients of unlicensed B.C. cosmetic surgery showed up in fancy cars ...", you will get the idea that this is not just one isolated case but is an underground medical industry. One victim of botched face jobs complained that our local GH's ER sent her off without treatment. She spent some C$5000 in all to have some stuff applied on that removed the top layer of her facial skin. What a horror!

Coming back to Lasik operators, not all of them are practicing surgeons with expertise in treating eye diseases, but are performing a cosmetic procedure. All the consumers have to do is to look up the relevant Directory.  Also, most ADs are written by unskilled support staff.  Anyway, hired professional marketeers in this cut-throat business have given way to remunerated anonymous posters on social media to swing a dog and pony show, vaguely presented as opinions and nondefamatory.

both to you and sue.If you are really interested go to facebook.Then search for Eyeworld and click on the one in fairfax va..they sponsor all the video interviews at the meetings.The latest has a dr crandall speaking on upcoming lens and how he works with patients as to night effects etc,,

Theae seem to be the well known profesors and tou can watch i terviews at all the meetings in us, asia, europe etc...hes i am afanatic..

i know how to spell

I don't fly anymore but I have heard stories about pilots knowing "good" flight surgeons who will approve/overlook just about anything.  I imagine they can pass the eye test and fly fine at altitude but like Sue says the runway, approach and other plane lights must be awful.  I could probably do it if I had to just like driving a car but I would think pilots would keep this to themselves so they can continue flying and nobody would be the wiser, and again, maybe mine are worse than usual.

I would really like to watch this but can't find the video in their video section--can you tell me the date of the video and if it is in their video section or somewhere else?  I searched for Dr. Crandall there but did not get any results either.

ok  it is at the cos meeting combined in austin texas last week.Once you find any video save the site as an app ...on the upper left is “ video” archives and you can go over them to find various meetings..the hawian one in 2017 was good..there is also a topic area

These are the professors, researchers etc and one may even have been your surgeon..mine was..

p,ease let me know if you find it..dr crandwll apoke in ausrin and acrually other places..He is i terviewed to go over his talk for those not attending..i found it so useful..dr sonnenfeld, jack holladay worth watching

whoops u i tential typos....donnenfeld, holladay,crandall, kleinmann worth watching altho lots more if you are an eye geek

whoops..it was dr koch at same meeting in austin tx