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

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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?

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  • Posted

    In a related post, nina234 has provided the following directly-related material, in which Abbott has finally acknowledged the night vision issues, such as multiple circles or halos related to Symfony lens, in the Abbott official brochure for the Symfony lens under "Warnings":

    "The TECNIS Symfony® IOL may cause a reduction in contrast sensitivity under certain conditions, compared to an aspheric monofocal IOL. The physician should carefully weigh the potential risks and benefits for each patient, and should fully inform the patient of the potential for reduced contrast sensitivity before implanting the lens in patients. Special consideration of potential visual problems should be made before implanting the lens in patients with macular disease, amblyopia, corneal irregularities, or other ocular disease which may cause present or future reduction in acuity or contrast sensitivity. Because the TECNIS Symfony® IOL may cause a reduction in contrast sensitivity compared to a monofocal IOL, patients implanted with the lens should be informed to exercise special caution when driving at night or in poor visibility conditions. Some visual effects associated with the TECNIS Symfony® IOL may be expected due to the lens design that delivers elongation of focus. These may include a perception of halos, glare, or starbursts around lights under nighttime conditions. The experience of these phenomena will be bothersome or very bothersome in some people, particularly in low-illumination conditions. On rare occasions, these visual effects may be significant enough that the patient may request removal of the IOL."

    Well, at least now, more people will be aware of these potential night vision issues associated with Symfony lenses before they decide the best lens choice for their eyes.

  • Posted

    Did you actually get to read the brochure before your surgery at201? I am under the impression that was in there from the beginning, but now I'm not sure since you said they're now admitting it.

    • Posted

      I've had the halos and stab years for 8 months. My doctor is willing to do a free lens exchange and I'll do a toric since they don't have these problems. Only issue is I have to pay for anesthesia and surgical center. I've talked to Abbott as I think they should pay since their product is bad. So far they have said no but now that I've seen  either they do or I see a lawyer.

    • Posted

      I am not sure if the language was the same or not at the time of my cataract surgery.

      Any way, now that I look at the Abbott web site again, may be, nothing has changed. They still claim "Low incidence of visual symptoms, including halos, glare and starbursts." They also combine the "mild visual symptoms" percentage with the "none" percentage to make one think that most people don't have those symptoms. Of course, there is no definition of the "mild" versus "moderate" versus "severe" visual symptoms.

    • Posted

      Thanks to nina234 for bringing another document (US FDA PATIENT INFORMATION TECNIS ® Symfony Extended Range of Vision Intraocular Lenses (IOLs) Models ZXR00, ZXT 150, ZXT 225, ZXT 300 and ZXT 375)  to everyone's attention on another post. I had not seen this new document before.

      It is good that at least in the comparison table (Table 1, page 6) of this document, it clearly states that, "Visual effects occur more often with the Symfony lens than with the monofocal lens. These could be worse at night or in low-light conditions. These visual effects may affect your ability to drive a car at night or in poor visibility conditions."

    • Posted

      Left eye with distance is not quite better since it's still cloudy. I had seen my doctor Monday August 14th, 2017.  He said its common for my age to have this cloudiness I am 58 years old. I have to come back in October for Yag  Capsulotomy. My first eye post op which is right eye same experience not so clear foggy visual acuity about 20-30 feet after Yag it was better . But my brain is still adjusting . 

      Before surgery with prysbyopic eye I can't  see without wearing reading glasses I use 2.25 power for up close . 

      I always think there's a trade off for everything not perfect vision like when we were young. 

      I was very depressed after surgery because of the fact doctor and abbot did not inform consumers about concentric circles starburst glaring when seeing headlight is so bright and blinding when motorist use high beams. I always avoid not to stare but you can't help it.

      I even called abbot Johnson and Johnson 2 days after surgery they said they write my concern and wants me to call them back after a month I did call them but they ignored my call.  I just move on and try to do the best of what I have . I can see fine on day time only driving at night. Distance is better on my right. Left not quite better because of cloudiness. I hope this helps you with my experience.

  • Posted

    I had my right eye done IOL Technis Symfoni Lens inserted in April 3rd /2017. Yag procedure post cataract and insertion in June still seeing Concentric circles halos starbursts hard to drive at night  with white headlights  and red light in front of me.  My brain adjusted to this anomalies. Daylight no problem.  I try not to think about it . Yes low light and raining hard is hard to see.  Haven't driven yet on foggy but I know it is not safe.

    After  the Yag  cloudiness was resolve on this eye. I can see better with my iPhone computer and close up vision. 

    Left eye is the same.  Procedure was done on June 21st, 2017the same issues. I have presbyopia. I don't want to wear glasses for up close vision and reading. 

    I had made lots of thinking and decided to use same IOL Symfoni.  Anyways  neuroadaptation  is my way of accepting . 

    • Posted

      Do you have distance vision in either eye?  I too have a Technis Symfony in one eye.  No daytime issues at all.  Good distance untermediate and near vision at about 16 inches.

      Night time have glare and circles - however more pronounced in dark highways.  City driving with overhead lights there is less night issues driving.  I do not know if 2nd eye with Symfony will bring more night time issues, less or remain same.  Will know soon as 2nd surgery is next week.

      How is nighttime driving for you with 2 Symfony lenses?  Thanks for feedback.

  • Posted

    Out of curiosity does anyone have any solutions/aids that help when driving at night?   Do night driving glasses help?  I also read tonight online a suggestion to drive with car'sinterior dome light on.  I may give that a try.   Not sure how that helps except maybe keeps eyes from dialating?

    Anyways I would be interested in knowing if brain does adjust with time, if there are brain exercises I can do to help with this nuero adaptation.  Any other suggestions?  

    I do notice that it is better with streets with overhead streetlights vs dark roads/highways.  I plan my routes now and note roads that have them.   

  • Posted

    I have contacted a few people who are lens (Glasses) specialists.  Other than non glare lenses, which really don't help, they had no solutions...  But were aware of the issues with lens.  Dark roads with single cars approaching are definitely the worst case scenario.  With well lit areas being the least effected.  I'll try the dome light on, but it  seems like too easy of a solution.  :-)

    • Posted

      Let me know how you get on with Interior dome light on.  Waiting for an opportunity to try it out on darker roads.  And this time of year sun doesn't go down till 8:30pm.  Challenge will be winters as the drive home from work will be after sunset.

      I have googled for solutions and haven't found much.  Maybe someone will come up with a solution some day. 

    • Posted

      Came a Ross a website for glasses claiming to help with night vision for those experiencing glare and halos due to multifocal iol implants.  If this cut and paste does not work - google refocus specs. Pricing starts at $39.95 .  Not sure if anyone has tried these?

      REFOCUS

       

      Designed Specifically to Minimize Night Time Halo and Glare In Patients with Multifocal Lens Implants after Cataract Surgery.

      If you have had cataract surgery with a multifocal lens implant, such as the Rezoom™ (Advanced Medical Optics) or the Restor® (Alcon), then spare-specs Refocus may be the ideal solution to conveniently and inexpensively minimize night time halo and glare that you may experience.

      State of the art multifocal lens implants are an excellent choice for patients desiring minimum dependence on glasses after cataract surgery. A very high percentage of patients with bilateral multifocal lens implants will not require any glasses at all.

      Some patients, however, will still want minimum strength reading glasses for certain very fine or prolonged visual tasks at near.

      In addition, some patients may notice halo and glare at night. It is important to note that not all patients with multifocal lens implants see halo and glare at night, and those that do usually report that it diminishes greatly over 3 to 6 months. Nonetheless, halo and glare are occasionally noticeable by some patients on a long term basis.

      Starting at only $39.95, spare-specs Refocus are designed to minimize halo and glare at night in patients with multifocal lens implants.

      [expand all topics]  |  [collapse all topics]

      What are spare-specs Refocus?

      How do spare-specs Refocus work?

      Are spare-specs Refocus 100% effective in eliminating halo and glare with multifocal lens implants ?

      How effective are spare-specs Refocus ?

      How do I know if spare-specs Refocus are right for me?

      A - Refocus

      A - Refocus

      B - Refocus

      B - Refocus

      D - Refocus

      D - Refocus

    • Posted

      I will be interested in knowing if such lenses work for anyone.

      However, I have serious doubts about these will work for multiple circles associated with Symfony lenses. The circles are formed by the diffraction circles on the lens after the light has already entered the eye. Reducing the ability to detect contrast between the lighted areas and the dark bands will probably result in seeing these circles less, but that is probably not a good answer. One needs to have good contrast capability for night driving!

    • Posted

      Yes I would be curious as well.  It's actually not the concentric circles for me that are the more annoying (bothersome) when driving at night.  It's headlights of oncoming cars.  If I could reduce that glare (as those blind me to the road) I'd be able to drive more comfortably at night.  The concentric circles are not a strong light - very thin - spider-web like.  

    • Posted

      On the spare-specs website you can contact them with questions- going to see if they deliver to Canada.  As they aren't expensive I may be tempted to try it out 

    • Posted

      I opened up the Q&A section.  They aren't claiming these glasses remove glare and halo but reduce them to acceptable level.  What do you think of claim that some of that is induced by small amount of nearsightedness?

      Are spare-specs Refocus 100% effective in eliminating halo and glare with multifocal lens implants ?

      NO!  

      Compensating for the small amount of nearsighted power of a multifocal lens implant at distance will help, which is how spare-specs Refocus work.

      The multifocal lens implant is designed with alternating rings of far and near power which may induce halo and glare as well. spare-specs Refocus will not alter the basic design of the lens implant nor overcome 100% of the potential side effects.

       

      How effective are spare-specs Refocus ?

      Most patients with bilateral multifocal lens implants who notice halo and glare say that spare-specs Refocus significantly reduce, but do not totally eliminate, halo and glare at night.  You should not expect spare-specs Refocus to totally eliminate halo, glare, blur or starburst, but rather, to reduce these symptoms to an acceptable level.

    • Posted

      I found an interesting online article on this subject, do a search for:

      "Tips to reduce halos, glare when driving at night"

    • Posted

      it is seriously a hard choice for me to make regarding what IOL lens i end up choosing..... If i do end up choosing a Symfony IOL for my cataract surgery i might seriously just wear sunglasses at nighttime when driving if halo, glare are an issue.

       

    • Posted

      Hi Miguel,

      Sunglasses don't help driving at night. I also bought glasses made for glares night driving it not helping at all. I am not happy with night driving is very very challenging. I have to drive at night time because of my job I work 7a-7p and also very very hard to drive when it rain and pours hard driving at night it is dangerous like zero visibility to me. Raining I have be very extra careful. Haven't driven foggy yet but not looking forward to it.

      Daylight driving no issues. Right eye had Symfoni lens and yag done 2 months after. Better vision on day time but night same problem with giant concentric circles with head lights, red lights and trouble driving seeing police,ambulance any emergency vehicles with red white light flashing is blinding bright. I have to focus not to stare in front of me but to drive safely. It makes me nervous when I see them on the freeways and roads. Same issues with my left eye. 

      Left eye was done on June 2017 no yag done going to wait for a while.  Maybe you can go to optometrist and have them made specially for night driving just a thought. I have not done that yet but going to wait for yag on my left eye. Hope this helps you with my experience.

       

    • Posted

      Symphony IOL is approved by the FDA for Canada & the USA markets. Don't know their criteria in approving IOL's -- politics? Financial? By the responses in this blog, it makes you wonder.

      I have a multifocal "Oculentis Mplus X" IOL that is produced without concentric rings thereby nightime glare or ghosting is minimal. There are no glaring rings since it's multiple focal points are an integral part of the mold.

      This IOL is available Western and Eastern Europe and Asia. It's a small German company (IOL's made in the Netherlands) and probably doesn't have finances or political clout to break into the North American Market.

    • Posted

      To be fair all the multifocal and Symfony have more issues with glare and halos.  Trade off for eliminating glasses.  I was advised of this prior to surgery.

      I will be interested in knowing should you choose your other eye for 0D whether your lens provides full range of sharp vision.  Admittedly I have not found very many reviews on that lens online - but a few I found from patients indicate the full range wasn't as good .  Perhaps they've corrected that in a newer model - don't know.

      But please post the results afterwards as it would be very helpful to learn about a different lens than what we have available.

    • Posted

      It is great that you are happy with the Oculentis Mplus X IOL.

      Better and better lenses are being developed every day which makes it better for us consumers. However, I have also learnt that the manufacturers ( and the physicians associated with them and pushing for the new lenses) often tout all the advantages of the lenses without saying anything about the potential disadvantages.

      Just going by the description of the multifocal "Oculentis Mplus X" IOL on Oculentis web site, you are right that these lenses don't have any concentric circles. However, they do have different focus zones. In that sense, I would compare them to the Progressive Lens glasses, which many people use. I have never used Progressive Lens glasses, but I know that many people switch back to bifocal or trifocal lenses after using Progressive lens glasses.

      I would not be surprised if the following statement for Progressive lenses  also applies to the Oculentis Mplus X IOL.

      "When you are fitted with your first pair of progressive lenses, you may need a short adaptation period to become fully comfortable using the lenses. This might take only a few minutes, or it could take a few days.

      Minor peripheral aberrations are unavoidable in progressive lenses. It is impossible to create a seamless (line-free) multifocal lens that has multiple powers for different viewing distances without also creating unwanted aberrations somewhere in the lens.

      Lens designers and manufacturers have made significant strides in minimizing these aberrations and "pushing" them to the periphery of modern progressive lenses. But peripheral aberrations will be present even when progressive lenses are flawlessly produced using the latest manufacturing equipment and processes — they are an unavoidable optical limitation of all progressive lenses.

      Because of these aberrations, if you glance to the far right or left, especially when looking down, you might notice your vision is slightly blurred. Peripheral aberrations also might cause you to experience a sensation of "swim" when you make quick head movements."

      If you experience these problems when you start wearing a new pair of progressive lenses, you usually can eliminate them by making slight head movements to look more directly at objects. Most people who notice peripheral vision problems when wearing progressive lenses find that these issues are relatively mild and disappear as they adapt to wearing the lenses over a period of a few days."

      All I am saying that one should take Manufacturer's sales pitch with a grain of salt.

      Regarding the certification of the lens in USA, FDA does require more clinical test data before they approve its use in USA. This does delay the introduction of the new lenses in the USA even if the manufacturer is financially capable to conduct these tests. I think that the Symfony lens was approved in Europe about 2 years before and in Canada about 1 year before it was approved in USA.

    • Posted

      more people have great results from symfony.This site has those who are not happy which is a small segment.I love the vision with symfony
    • Posted

      That probably won't help you. It just makes things darker.

    • Posted

      Dont think sunglasses will help even the light yellow tinted ones.  On a positive note the strong glare I was getting has substantially reduced.  I am not sure mine is any worse than what one normally experiences now.  I was planning my driving around well lit roads but now don’t really think about it.  The concentric circles are still there and those I don’t think go away as a few here post they still do see these even with a year’ time.  Although I wish they too would disappear they are not as bothersome as the glare was when driving st night.
    • Posted

      mild fuzzy transparent halos.Night vision so sharp i see past halos..i did have a major streak at first.It was from a fold in  back of capsule.the yag eliminated it nicely..It does take time for lens to get settled in the capsule..kind of shrink wrapped
    • Posted

      Hey Sue.An, did you ever get the Refocus night driving glasses? Curious to see how they worked for people.
    • Posted

      No I didn’t get any night vision glasses.  Read differing opinions- most say they don’t help.  And they reduce contrast even more.

      I have learned to ignore the circles.  Once glare reduced the circles are much lighter and I focus on what I need to see.  They don’t appear on all lights either.  For example only see them around car brakes when the car applies the brakes and red lights get brighter.  Travelling behind a car at night there are no concentric circles.  See them on red traffic lights but not green (odd eh?). Don’t see them around street lights or football floodlights (a good thing).  Whether it is a brain adjustment or whether things do get better with time (maybe a bit of both).  But I don’t hesitate to drive at night anymore.

    • Posted

      I also tried "the best" polarized night vision glasses with a yellowish tinge for night driving. Did not sense the slightest difference in seeing the concentric circles. All it did was make all the white lights yellow, which I did not care about (fortunately, I could return the glasses)

    • Posted

      Thanks that’s what I thought as well.  

      In early weeks I found it easier to drive with interior dome light on in the car.  I think it helped keep my eyes from dilating as much in the dark when driving.  Don’t do that now but for me that helped in those early months.

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