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Is IOL exchange worth the risk in my situation?

Posted , 8 users are following.

sunny68454
sunny68454

If I got Symfony in one eye 4 months ago, and that eye needs -1 for distance, +2 for near and I see halos with it too..is the outcome bad enough to get IOL exchange to monofocal? I almost went ahead with the lens exchange surgery and then backed out last minute fearing what if the result is even worse?

My other eye does not have cataract but I need -3.5 for distance. Accommodation for near still works for near with this eye. 

I am 40 years old. 

Tried progressives but can’t adjust. 

0 likes, 23 replies

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  • donna_51780
    donna_51780 sunny68454

    Posted

    I understand about progessives but ive had halos circles since my surgery 2 years 

    ago. Unfortunately I had yag done I am not able to have my lens replaced and. Would give anything to get it replaced. Depression from not being able to drive is taking its 

    toll. Oh I forgot to say I’m blind in other eye so I’m screwed. So I can’t tell you what to do but they never go away whatever anyone says! I would love to ware glasses if halos and circles would go away.

  • robert20416
    robert20416 sunny68454

    Posted

    Wow, how could a Symfony lens ending up like this? It's almost acting like a monofocal. This is a head scratcher for me. An IOL exchange may allow no distance correction and the issue of halos. It is a tough call, indeed. Sorry to hear this. I hope you find a good solution.

  • sunny68454
    sunny68454

    Posted

    yes, the outcome is not what I expected. the question really is how risky is the lens exchange surgery itself? I've read about capsule rupture and other issues that is making me afraid of going for an exchange. anyone with experience in getting IOL exchange can chime in?

  • Sue.An
    Sue.An sunny68454

    Posted

    Hi Sunny - I too cannot understand the outcome of your range of vision with a Symfony Lens.  Did it start better than this or has been since surgery.  I have 2 Symfony lenses and have not worn glass since surgeries.  The glare and starbursts were strong for about 5 or 6 weeks but they’ve calmed down considerably but do see multiple concentric circles around certain lights at night.

    What target was your surgeon aiming for.  What is puzzling is that you need -1 for distance which should give you excellent near vision with Symfony but you are needing +2 in that eye for reading?  Makes no sense.

    Perhaps you should get an exact prescription for that eye to find out what is going on.  

    If nothing works a lens exchange would be something to consider.

  • at201
    at201 sunny68454

    Posted

    I am sorry to learn about the very bad results with your Symfony lens.

    Seeing the very annoying halos or multiple circles around lights at night is unfortunately quite common with Symfony lens, but the resulting eye prescriptions for distance and near (as stated above by you) don't make much sense. Please make sure that there is not an error in that.

    Also, do you have significant astigmatism in the operated eye and if so, what is the cylinderical correction?

    How well can you read at distance with the operated eye with the best distance prescription?

    In any case, based on my excellent experience with LASIK on both eyes (after cataract surgery), my personal choice will be LASIK (or PRK) enhancement to correct vision instead of exchanging the lens. However, that won't fix the halos. So, you are the only one who can decide if that is worth the lens exchange.

    Whether you have LASIK enhancement or a lens exchange, having an excellent surgeon is a must!

    • Nizza594
      Nizza594 at201

      Posted

      Hey!

      Just wondered if you could share a little more about your situation with having LASIK after RLE surgery? I am almost 6 months post op with the Carl Zeiss trifocal toric lenses. Overall the results are fantastic, my last eye test (2 months after surgery) should that I had a residual prescription of +1.00 with -1.00 astigmatism but also with an ADD 2.00 on the prescription? I feel like my vision is very good but I know then when I have an eye test, it can still be corrected to better, I think I'm at 20/25 for distance, I can read my phone etc with no problem at all but I actually find that pictures and videos always need to be made slightly bigger or zoomed in.

      I was wondering if you think LASIK can give and ALL ROUND improvement, or whether it's just used to adjusting the range, for example compromising the distance to get better near vision? 

      LASIK is included in my package so even though I am getting by just fine now, if there is improvement to be had then I would definitely like to take advantage of that! 

      Thanks! 

    • at201
      at201 Nizza594

      Posted

      I think that if your stated prescription is correct (+1.0D spherical, -1.0D cylindrical) you should find the LASIK enhancement beneficial not only for distance vision, but also for the near vision.

      With LASIK enhancement, your astigmatism should be reduced to less than 0.25 D, which will be beneficial at all distances.

      Right now, your eye is farsighted (+1.0D). Being farsighted does not help vision at any distance! Reducing that to the 0D to -0.25D range (that is plano or very slightly myopic) should provide better-than-current vision at all distances.

    • Nizza594
      Nizza594 at201

      Posted

      Thanks so much for the response! I have my 6 month follow up with my surgeon next Monday so if there is improvement to be had then I am definitely going to push for that!

      Can I ask, how was your vision after your implant surgery, was the LASIK something that you felt was essential due to the initial surgery being unsatisfactory or was the LASIK more of a 'bonus' improvement?

    • at201
      at201 Nizza594

      Posted

      For the right eye, I had ended up with a need of about -1.0D cylindrical correction because of the toric lens rotation (also had a need for -0.25D spherical correction, I knew that the vision could be improved by re-rotating the lens to the correct position or by LASIK, Both of the options were free to me. Based on my LASIK  experience with the same doctor on my left eye a year earlier, I felt comfortable with the LASIK procedure (I had used a contact lens in my left eye for 17 years after cataract surgery to get my desired vision for that eye, before getting the LASIK correction done).
  • sunny68454
    sunny68454

    Posted

    unfortunately, the prescriptions are correct. it makes sense for what I can and cannot see sad

    to be exact, I got symphony toric with 1.5 astigmatism correction which indeed is corrected because my -1 for distant is just spherical. 

    yes, it started that way from right after the surgery. I could barely read unless at full arm's length in bright light and I couldn't see perfect distant either. however, initial distance prescription was -0.5 spherical with +.25 cylindrical but it has now settled at -1 spherical, no cylindrical.

    overall so disappointing that most of you can't even believe it. 

    I considered lasik to improve the distance vision but when I simulated it with a contact lens, it took away whatever little was remaining for near. so I chose not to go for it because that would mean the results of a monofocal with halos added.

    so, the options I have are -

    1) do nothing, get used to progressives

    2) do nothing, wear single vision glasses and use only right eye to read.

    3) get lens exchange to monofocal and get lasik on right eye and wear glasses only to read

    4) get lens exchanged to monofocal and live with monovision - distant with left, near with right

    5) anything else?

     

    • Sue.An
      Sue.An sunny68454

      Posted

      From what I have read you can get a lens exchange up to about 6 months.   It might be worth looking into and considering what is best for you.  It is such a personal decision and not a one solution Best or fits all.  But given it is only 4 weeks you definitely have time to consider these options.  

      I know some surgeons provide a lasik package along with premium lens.  Would you know if your surgeon included that with your pricing for premium lens?   

      It is really unfortunate you did not get a better range of vision.  This still puzzles me.

    • michael74313
      michael74313 sunny68454

      Posted

      You said you got a symphony toric lens.  If your toric lens shifted even just a few degrees, it can throw your vision off at all ranges (near, mid-range, and distance) which would explain everything.  The doctor should be able to adjust it back into the right position if that is the problem and if it is done soon after surgery.  If that's the case, then it should also be easily corrected (or tested) with glasses or a toric contact lens. As others have said, it's very important to make sure you have a great doctor.  If your doctor has no solutions, then perhaps it's time for a second opinion.

       

    • at201
      at201 sunny68454

      Posted

      1. Am glad that you don't have any astigmatism needing cylindrical correction.

      2. My guess is that: you had a prescription of +2.0 for reading (at 16 inches reading distance) when your distance prescription was -0.5 spherical with +.25 cylindrical, but is now only +1.25 or +1.50 when the distance prescription has changed to +1.0. There should be only +2.25D or +2.50D difference (and not 3.0D difference) between the prescriptions for distance or reading. It is not a big thing in view of the other vision issues you are having, but it still may be better to make sure that there is no error as you consider your choices.

      3. If you decide to use glasses (and do nothing else), please do not try to get the distance prescription in both eyes. With a difference of 2.5 D in the 2 eyes, the difference in the image sizes seen by the 2 eyes will be too large for your brain to handle (that problem should not happen with contact lenses or without any glasses).

      4. If I were in your shoes and only wanted to use glasses, my first choice will be to get glasses with -1.0D for the operated eye and -1.75 D for the unoperated eye (based on the prescriptions which you have quoted). You will have a slight amount of monovision or (minimonovision), which you should be able to handle. With that, you will be able to see well at distance as well as intermediate distances. For reading purposes, I would then just add +1.25 D to each eye. With that you will have good intermediate and near vision. Please note that a vast majority of optometrists never suggest monovision or blended vision, but they will go along with that if you ask for it.

       

    • sunny68454
      sunny68454 at201

      Posted

      Hmm..interesting take. I will talk to my optometrist on this thought. Thank you!
    • at201
      at201 sunny68454

      Posted

      Yes. Hopefully, the optometrist will look favorably at the blended vision approach.

      You may want to try this approach with slight variation in actual numbers to see what you feel most comfortable with.

      For example, in addition to the one in my post above:

      My new first choice:     -1.0D (operated eye), -2.0D (unoperated eye); Add +1.0  (both) for reading

      or

      -0.75D (operated eye), -2.0D (unoperated eye), Add +1.0 (both)

    • sunny68454
      sunny68454 at201

      Posted

      at -> my complete prescription for unoperated right eye is -3.5 sph, +1.25 cyl. and for left operated eye is -1.00 sp. knowing this what do you recommend? I am asking again because your above recommendation is without the knowledge that there is a cyl part to the right prescription too. thanks in advance!

    • at201
      at201 sunny68454

      Posted

      In view of the cylindrical correction in the right eye, my recommendation will change slightly. (although it is still mini-monovision or blended vision)

      My new first choice will be:  

        -1.0D (left eye), -2.25D sph, +1.25 cyl (right eye);

      Add +1.25  (both) for reading

      You can try 0.25D variation from those values to see what works out best in practice.

       

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