IOL exchange surgery due to challending Symfony lens night driving dysphotopsia
Posted , 16 users are following.
I had Symfony lens implanted in both eyes one years ago when I was 58 and like many on the many of you on these discussion boards suffer from huge starburst from on-coming headlights and street lights, perfect, large concentric circles from red break lights and other lights, glowing ghost-like shadows of the moon, and white lettering/objectives with a black backing. Diving safely at night is becoming a big issue and the exhausting need to concentrate due to these distractions. If I had known that this level of visual artifacts problems were possible then I would have never gone with these lens let alone pay the high price. I read the clinical trials and the package insert and these side effects were not specific and appear to be underestimates and underreported. I reported these adverse events to Johnson and Johnson and encourage others to do the same. My vision is generally excellent at 20/20 and only have to were reading glasses for fine print. The risks of explantation/replacement/exchanges lens surgery are far higher and scarier than the first implant surgery. I am strongly considering having this surgery and am fine with trading off using reading glasses all the time if I can get these untoward effects to go away. Since I see so well now I am nervous about the risks of this exchange surgery and the risk that the dysphotopsia artifacts would still not go away. My questions are, have any of you with this situation had your lens replaced and what was the outcome? Did you use the the same surgeon? And how many just decided to live with the artifacts and why? Did get a second opinion? Help!
1 like, 25 replies
phyllis31515 paul07903
Edited
I had Symfony lens implanted approximately 18 months ago; a regular Symfony lens in right eye and a Symfony Toric lens in left eye. I am very happy to report that I have great vision at all distances. The one thing that I see at night are the starbursts from oncoming lights. I just make sure not to look directly at them and they have not been that big an issue. I have much more confidence in my night driving than before my surgery. Prior to my surgeries, the oncoming lights appeared as large bright blurs of light, so seeing the clear starbursts are better than what I saw before. For me, it is a small price to pay for the great vision I now have at all times without glasses and would never consider doing an exchange.
paul07903 phyllis31515
Edited
Thank you Phyllis. I think my biggest issue is that I had a rare, posterior fast progressive cataract in one eye not caused by aging but thought to be caused by concussions from when I was younger and I never had any glare or artifacts before the lens were put it. They did both eyes even though the other was normal because my surgeon said that I had to because these type of lens to work they must be the same ones as they work together. So not having any type of glare issues before and seeing them like I'm in a video game after has been a real problem. I'm worried that with age my night driving will only get worse and I want to give up the ability to drive at night for many years to come. Paul
Guest paul07903
Posted
Hi Paul
Sorry to hear you are bothered this much.
I have not had an explant/exchange, so I have no experience to share.
I do have edof one eye and trifocal in the other eye.
Before surgery i read about these side effects, and I also read a surgeon that said, in the few cases where lens exchange was needed due to dissatisfaction, he only had to change one lens to monofocal, then with brain adaptation it became well enough even for those who was really bothered.
I don“t know if it is true in all cases, but I guess it would be something to consider for you.
I have had the same side effects from the edof that you are mentioning, but in my case never that bad that is was a problem driving at night or anything like that.
But my two lenses are making different side effects, and funny thing is, now 6 month after surgeries, the eyes seems to cancel each other out, the brain chooses the best it can get. Side effects from both lenses are almost gone now, starburst from the edof is only a very slight mist, just as an example.
So I think there could be some truth to the statement from the surgeon, that you probably "only" need to change one of your lenses.
In any case I wish you the best of luck!
paul07903 Guest
Posted
Dear Danish Viking, Thanks for this idea. I never thought I may only need to do one eye! I was told that these types of lens needed to be in both eyes to work. I'm from Boston but my company is based in Copenhagen! What a wonderful city and I love the hygge! Paul
betwixt paul07903
Posted
Sorry to hear about your problem. I have a symfony on my non dominant eye. The star bursts, concentric circles were way more bothersome than the "halos" I had read about and dealt with daily with contacts. My surgeon mentioned NOTHING about night artifacts. I was ticked! I looked at the FDA information and found that these artifacts were something like 4 x more likely with the symfony. I considered having it replaced, but was fearful of added consequences, and the surgeon would send me three hours away. I also understood that the farther out from the original surgery that you had it done, the more problems you could have. My surgeon wanted to put in another one in my dominant eye-- said the brain would work it out. Oh hell NO! I opted for a regular, no extra $$ on medicare, monofocal lens. Like the previous poster, this worked well enough for me to allow me to drive at night. I really do think you should consider replacing one, and see how that goes.
paul07903 betwixt
Posted
Thank you Betwixt. It seems like the surgeon have not clue what we are talking about with the artifacts! They keep saying I have halos but I don't. I had to draw them out to show him. They seem to care way more about my successful vision than my side effects and feel that their only answer was to live with it. However, I have finally convinced him that these are causing real safety issues at night and has agreed to replace them for free. I like the one eye at a time plan. Paul
RonAKA paul07903
Edited
No personal experience but I have been doing research on lens options for my upcoming cataract surgery. I am strongly leading towards mini-monovision using aspherical monofocal lenses. However, one interesting option that seems to be used in particular with younger (<60) users is monofocal in the distance eye, and EDOP or MultiFocal in the non dominant eye. The strategy seems to be based on the brain's ability to use the better eye for distance and ignore the distracting side effects from the multifocal lens, while still using it for reading and better light situations.
If you do decide to go for an exchange using a monofocal lens you will get the opportunity to select the eye you want done, and evaluate what you get before you decide if the second eye should be exchanged or not. I suspect one eye will be corrected for distance now better than the other. One strategy would be to replace the one better corrected for distance, and leave the one more corrected for closer in. That may make it easier for the brain to ignore that eye for distance. The ideal situation would be that the non dominant eye is better for nearer, and the dominant eye better for distance. That also may help the brain ignore the eye that is not ideal for distance.
Just my thoughts from someone who is still evaluating my personal options. I will do my first eye for distance with a monofocal lens for sure. Then I will evaluate what to do with the second eye when that time comes.
paul07903 RonAKA
Edited
Dear Ron, You seem like you have done your homework. I'm so frustrated with these lens I was only thinking of going with monofocal in both because although my brain can sort out the vision fine it can't sort out the dysphotopsia side effects. When my first eye was done my other eye was normal (no cataract) and with a contact lens I still saw all the artifacts for the 2 weeks between surgeries so I'm not sure if i want to keep or go with a multifocal in one. Of course I was told they would all go away but they are as bad as the first day. If I go through with this then I will take one eye at a time no matter what. Paul
ayeaye RonAKA
Posted
hello... I also looked into monovision but after reading about losing some depth perception, I changed my mind..you know. stairs, curbs etc
Chris53317 ayeaye
Posted
Are you in a position to do a test with contact lens over at least a few days? I believe some/many people adapt quite well to depth perception and the automatic switch of eyes for near and distance usage. But you need to be fairly sure before if you want complete elimination of glasses.
RonAKA ayeaye
Posted
I have done monovision (-1.25) with contacts, and never really found depth perception to be a big issue. It is more that the near eye is slightly out of focus at distance, and the near eye, may not allow reading the smallest print.
elizabeth87225 paul07903
Posted
I had to have lens exchange because one of the lenses did not work. When the lens was replaced, the one I had on was loose and it was the wrong power. I see 20/30 now but this was not due to lens exchange or to any other medical condition . I have wet macula but the day before the surgery I had no vision problems. My cataract was thick and the ultrasound I think did something slight to my vision. I see fine for distance as well as for most near vision but as I asked the second surgeon the new lens is not for reading so I use glasses. I can use contacts too. My second surgery for replacement was done by Dr. Shatz and it went really well. I did not want what you did because of the halos. Hope you find the right solution for your case. My situation was different .
paul07903 elizabeth87225
Posted
Thanks Elizabeth, even though a different situation, I'm glad to hear your lens exchange surgery went well! I must say it makes me nervous to take the chance and am looking for more positive stories. Paul
Tramontj paul07903
Posted
i will be interested to read replies! I had cataract surgery with mono focal lenses 5 months ago, I'm 68 . I have had starbursts and halos which interfere with night driving. My doctor says that there is not another lens that would be better than what i have. Aside from drops to make my pupils smaller when night driving ( which has not helped enough) the only suggestion he has is the Yag) which may or may not solve the problem. I asked him about piggyback lens surgery as Ive been researching solutions and he said this might cause other problems and might not solve the issues.
I have heard that mono focal lenses have a lower risk of halos and starbursts,, but that is what I have and still have this problem. I continue to research and pray for a solution!
Best wishes and prayers!
adamadam Tramontj
Posted
Now imagine that I am in a very same situation but am 40 years younger than you.
ayeaye Tramontj
Posted
do you have astigmatism?