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

Your experience seems to be similar to be mine in that we are pleased with our day vision, are not happy with the night vision issue of seeing multiple concentric circles around lights in the distance, but have learnt to live with that issue.

I am glad that unlike me, you were aware of the multiple circles issue before the surgery as a result of this forum. it is nice to know the pros and cons of the choices which we make instead of learning only half-truths.

I'm considering a Tecnics Symfony Toric in my left eye with a slight nearsighted offset (-0.5D) and a Tecnics Toric monofocal set for good distance (0 to -0.25D) in my dominant right eye. 

I hope that this could give good distance vision and decent night vision with the right eye helping to mask out the effects (halos, circles, etc) of the Symfony in the left eye at night.

Currently my right eye has the cataract that affects my vision enough so it doesn't correct to better than 20/40 while my left eye still corrects well to 20/15 or better.  I see halos with the right (cataract) eye but with both eyes I don't see them since the better left eye takes over for distance vision - I hope that would be the case with one Symfony IOL too.

Also since my left eye corrects easily to 20/15 or better, I'm thinking even with a -0.5 nearsighted target it could still probably get 20/20 or at worst 20/25 distance so I would have decent distance still.

The alternative is a toric monofocal in both eyes again with the slight nearsighted target for the left eye, for mini-monovision. But with a Symfony in the left I could hopefully get great intermediate vision (computer, smartphone, etc) and even some near vision?

How was your eyesight with the right eye before you develeped a cataract in that eye? If that was 20/20 or 20/15 earlier, my suggestion will be depend on it even more for distance after the cataract surgeries (setting it for 0 to -0.25D, as planned by you should help you do that) If you then have the Symfony lens targeted for -0.75D (not that different from the -0.5D planned by you), you will have still have very good distance vision, but have a better chance of reading without glasses.

I believe my right eye (dominant) used to get 20/20 or even 20/15 some years ago before the cataract made it more nearsighted. I wore RGP contacts for good distance vision in both eyes for decades until about 4 years ago, when I switched to eyeglasses. Both my eyes glasses Rx were similar (only -0.75D power) until 3 years ago when the cataract started making the right eye more nearsighted.  My main correction was for astigmatism (-2.00D cylinder left eye, -2.75D cylinder right eye).

I have a pair of eyeglasses I've been using for intermediate (computer) distance vision with a +1.00 add to my distance eyeglasses Rx.  I just tested my left eye with those glasses from 20feet and I could easily read the 20/25 line and could barely even make out the fuzzy 20/20 line even with a +1.00 add.   So I think -0.75D nearsighted target for the left eye might have a good change of  still getting 20/20 in the left eye and that gives decent intermediate vision (24"+ to my computer monitor) too.

I just looked thru my old set of eyeglasses and I found I had one from a couple years ago that now is equivalent to a 0.75D add to both my eyes.

R: -1.75  -2.75 x170

L:  0.00  -2.50 x180

(current distance Rx is R: -2.50 -2.75 x170;  L: -0.75D -2.00 x180)

With this pair (0,75D nearsighted) at 20feet my left eye can read the 20/20 line quite well, only the F and P letters are hard to distinguish from each other. 20/25 line and above is very clear.   I also get decent intermediate (computer 24"+) vision with this pair.

I normally use a 2.00 add for progressive pairs for reading but could actually use a little less than that for my typical reading distance with smartphone, newspaper, etc.  I only need 2.00+ add for extremely small print like on a medicine bottle.

So if Symphony provides a 1.25D range, with a -0.75D target I might get effective 2.00D for reading? That would be the same as my current progressive eyeglasses add.

L:  0.00  -2.00 x180

By the way, are you using Toric lenses or some other means to correct the astigmatism in the eyes? The nice thing about my surgeon was that he offered free LASIK vision enhancement when he put in Symfony (toric and non-toric) or toric monofocal lenses.

For now my eyeglasses correct the astigmatism in my eyes with the cylinder and axis in the Rx.  When I wore RGP contacts for many years they were a type called "bi-toric" that worked great for eliminating astigmatism.

The first place I got my cataract consultation at a couple weeks ago also does LASIK but to get effectively a 1 year insurance (no extra cost for LASIK touchups) you have to pay for an extra "premium package" that adds about $2500 to the price.  Not really a bargain if you turn out not to need the LASIK touchups.  In my case I don't think I could do LASIK anyway since I have dry eye and glaucoma in the right eye, its not recommended in those cases.  So I am hoping the couple other places I have appointments over the next month will have a cheaper plan without the LASK insurance extra cost. 

The first place is the most hi-tech though, they do femtolaser and ORA, while the next place has no femtolaser but has ORA. However the first place doesn't do Tecnics toric monofocal IOLs, they do Alcon which I don't want (blue filter, glistenings, etc). They do the Tecnics Symfony IOLs, but I wouldn't want to mix a Symfony (no blue filter) with an Alcon IOL (blue filter) in the other eye!  The other two places I believe do both types of Tecnis IOLs, so I am more hopeful there for the combo I'm thinking of.  I also prefer Tecnis over Alcon since the Tecnis monofocal IOLs are supposed to be superior in contrast sensitivity which is very important for my right eye which may lose a bit due to the glaucoma.  Left eye has no such issues, so a Symfony in that eye should be OK even with a little loss of contrast relative to a monofocal IOL.

It is great that you are looking at all the options and weighing their pros and cons before making final decisions.

If you can't have LASIK done, then toric lenses will definitely be a good option, although as you probably know, even if they are installed perfectly, they can rotate from the desired position. So, make sure that the surgeon commits to rotating them back to the correct position if that happens (it could have been done in my case, but I just went with the LASIK enhancement).

Also, you always have the choice of picking up  different places for the 2 surgeries. That is not ideal, but it may still be the best choice.

Yes I have a list of questions prepared for each eye surgeon including what they have done with certain complications such as toric IOL rotations. The next consultation I have is with a surgeon that lists his expertise with "complicated cataract surgeries" and that patients have come to him to fix issues that happened with other cataract surgeons, so thats sounds promising in that I want an eye surgeon that will do followup procedures if needed after the original surgery.

I am taking the liberty of replying to your post from about 8 hours back at this place, so that it does not get lost in the posts from 4 months back (where your post is).

Firstly, I am very sorry to learn about all the issues which you are having with the Symfony lens installed after the first cataract surgery. It seems that not only you have the night vision issues unique to the Symfony lens (multiple circles or halos around lights), but also various other issues which can happen with many other lenses.

Starting with the Posterior Capsule Opacification (PCA), for which a YAG laser capsulotomy seems to have been suggested to you, I agree with your optometrist that you should not have that done at this stage. PCA seems to be the least of your problems. Moreover, a capsulotomy will make it much more difficult for any lens replacement, if you choose to do so (because it makes it possible for the lens to fall behind the capsule during the replacement since the supporting structure has been taken out.)

You have mentioned that your uncorrected vision is rather bad at all distances. What is your corrected distance vision and what prescription do you require to achieve that? I would not be surprised if you are farsighted as well as have a significant amount of astigmatism.

If your corrected distance vision is fine, then i will suggest using something like LASIK enhancement to not only correct the astigmatism, but also to bring the best focus distance to about 40 inches (corresponding to a prescription of -1.0). This will enable you to have good intermediate distance vision as well do most of the reading without glasses.

If the above works out well, I will suggest getting  a monofocal lens for distance vision in the second eye. The 2 lenses together should provide you good distance vision at night (with the halos much less noticable) because you will be seeing in the distance mostly with the second eye.

Please clarify your request. I can't put any link on the Abbott web site.