Posted , 6 users are following.
patient experience suggests so. reason given for synergy are lens material and closer vision. but in my opinion it is based on EDOF design and EDOF is a failed product especially where the IOL has rings.
0 likes, 19 replies
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rwbil soks
Posted
You still deciding. I know the feeling.
"EDOF is a failed product"
If you feel that way you probably aint going to like Synergy as it is basically Symfony combined with a close add MF.
I think the drawback with Symfony was it did not provide, in general, close vision yet you still got the dysphotopsias. And most people paying for premium lens do it to get rid of needing glasses.
I am sure you have watched all the videos, but IMHO you have to be careful of a single person's experience and really have to go with the clinical trials where there are controls. And yes after time additional data will come out and something prove the clinical trials to be in error. But right now the clinical trial results to me shows Synergy to be a better product.
Of course if you watch Dr. Wong's video his Optometrist preferred PanOptics, while he preferred Synergy.
I would guess and it is a guess that the Synergy will have worse dysphotopsias as the closer the vison the more dysphotpisa in general, but have superior close vision.
It would not surprise me if in the not to distance future there will be the Clareon PanOptics, so you do not have to worrying about Glistening. And maybe some lower add Synergy IOLs, so not as close vision but small halos.
BTW you are lucky as you are by Vance Thomas Vision who I think were involved in clinical trials of both IOLs. If anyone can give you a professional opinion it would be a doctor from there.
soks rwbil
Posted
is glistening due to damage to lens material?
rwbil soks
Edited
Fluid-filled microvacuoles that develop over time in the IOL. Alcon material susceptible to glistening, which is one reason for the new Clareon.
But it seems like glistening, in general, has not been a big issues.
Quick search looks like PanOptics Clareon got PMA on 4/23/21.
RonAKA rwbil
Posted
The problem can be that approval and availability is not the same timing. Just talked to the surgeon who is doing my wife's upcoming cataract surgery in November. He said only the basic monofocal IOL is currently available (at least in Canada) in the Clareon material. He speculated that they want to get the basic model into public use first and then determine if there are any issues with it that need correction. Since my wife needs a toric in both eyes, we backed off on getting the Clareon and will go with the AcrySof IQ models.
RonAKA soks
Posted
My thoughts are that it is a Coke vs Pepsi choice, and you take your chances with either. That is why I have decided on monovision. It is more predictable and if your vision is good enough you can trial it with contacts before you jump in.
kathleen07994 soks
Posted
i will soon have real world experience to share. I'm having a Synergy lens implanted October 20 in my right eye. I was really glad to hear Shannon Wong's recent thoughts about PanOptix v Synergy. My Houston ophthalmologist has been implanting Synergy for a couple months now. He's implanted many PanOptix lenses and says he loves both the PanOptix and Synergy lenses. He's getting excellent results with both. He's very careful about selecting patients for these lenses. My measurements were excellent for a premium lens and my ophthalmologist says I should get an excellent result. In particular the astigmatism in my right eye is just 0.17. Anything under 0.20 is good for this lens. Of note, the Synergy lens has 15 diffractive rings. Symfony has only 9 rings. PanOptix has 26 rings. Per Shannon Wong's PanOptix v Symfony video, 88% of light entering the eye reaches the retina with PanOptix; 92% of light reaches the retina with Symfony. I haven't seen a figure for Synergy, but it must be about 90%. Light is split by the diffractive rings, so more rings equals less light. It's not a huge difference, but something to consider for patients like me who only have good vision in one eye. I am legally blind in my left amblyopic eye.
rwbil kathleen07994
Edited
Your doctor seems to be more knowledgeable than most. I wish we could get him or any expert to answer basic question, like why does the PanOptic trifocal have more rings than the EDOF / MF Synergy. Also if the Synergy has a MF close add component how much light is going to that close vision?
And BTW I agree 100%, if anyone has any eye condition other than cataracts and minor astigmatism (and I now include both extreme short and long eye on that list) forget a diffractive IOL. You need to go with least risky IOL.
RonAKA kathleen07994
Edited
The thing to watch with the light transmission numbers is that typically the Alcon lenses use blue light filtering, while the Tecnis lenses are clear. I believe Tecnic has ventured into this approach with the Synergy and use what they call violet light filtering. But, in a simple monofocal lens the Tecnis will have quite a bit higher light transmission than the blue light filtering Alcon. The question is whether or not that extra blue light helps or hurts vision...
soks RonAKA
Posted
the US version of pan optix may not have the blue light filter. it is clear.
RonAKA soks
Posted
The FDA approval documents and package insert suggest both the standard and toric versions of the PanOptix are blue light filtering, but perhaps they have a clear version available. In the basic monofocal lens series there is a clear version available, but the common one used is blue light filtering.
soks RonAKA
Posted
i dont know if the yellow is the blue light filter but both wong and omar krad say in their yt video or comments that US version of pan optix is clear. wonder if the yellow is available as an option.
was your lens yellow?
RonAKA soks
Posted
I didn't actually see my lens of course, but from the serial number card that that came with it, and that they gave me, my lens was the Alcon AcrySof IQ Aspheric monofocal, SN60WF, and for sure is tinted yellow for the blue light filtering. There is another model which is clear, but as far as I know not very popular - SA60AT.
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On the PanOptix everything I can find shows it is yellow tinted for blue light filtering. The most detailed information is at the FDA site. If you google this, you should find it.
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FDA Alcon Laboratories, Inc. AcrySof® IQ PanOptix® Trifocal Intraocular Lens (Model TFNT00) and AcrySof® IQ PanOptix® Toric Trifocal Intraocular Lens (Models TFNT30, TFNT40, TFNT50, TFNT60)
Sue.An2 soks
Edited
Glad it wasn't a failed product for me. Especially now that I have Epiretinal membrane in LE.
for me I have good close vision with Symfony.
soks Sue.An2
Edited
Aren't you an exception more than a norm? perhaps you would have gotten the same acuity at all distances with a monofocal?
I compiled a list of synergy experiences and 90% are unhappy. I do not buy into the argument that people come here only when they had bad outcome. There are many people here who come before making a selection and after a positive outcome.
rwbil soks
Posted
90%. Maybe here, I don't know, but I am a big believer in the market place. If 90% of patients implanted with Synergy were unhappy I think it would be known and blasted all over the internet. And those Wong Optometrist would have been like, "OMG Synergy is a disaster".
The doctor I used is a clinical trial doctor and does all the lens and has no stake to push any IOL. Heck he still recommends monofocals over premium lens. He has only done 5 Synergy so far, but he says they have all been happy with their results.
I will add he was a Symfony Clinical trial doctor and was not a fan of the Symfony because you got dysphotopsias and yet did not get great close vision.
I will also add if you went by this site I think Vivity would also show a strong negative results and I do not believe that is the actual case.
The only thing you can at least sort of trust are clinical trial results. And the Synergy clinical trial results were very impressive. I will add one note to that, clinical trial doctors I imagine set standards to qualify, where a doctor might take anyone and if you have any eye condition other than cataracts and slight astigmatism you should not be getting a diffractive IOL; PERIOD!!!!!
People who have great results don't search for options, so this place IMHO is biased towards the negative. And I don't thing there are many people here like myself that are planning on Synergy that have had them implanted yet.
soks rwbil
Posted
And those Wong Optometrist would have been like, "OMG Synergy is a disaster". -- i think they are being polite and don't want to bet against their boss. but i think they are pretty much saying that when they say pan optix patients are blown away and synergy are like ok we ar ehappy.
i think the forum is still a random sample so probably not as biased but it isn't a large enough sample. 30+ would be a large enough sample.
rwbil soks
Edited
PanOptics has also had great results for most people that implant them. I don't think you would go wrong implanting that IOL over Synergy.
But a quote from Dr. Vance Thompson below. If you have not yet done it make an appointment with Dr. Vance and get his first hand opinion and let me know what he says.
"My cataract patients are getting younger, have more active lifestyles, and want to be able to see their smartphones in the day and their menus at dinner," said Dr. Vance Thompson, Vance Thompson Vision in Sioux Falls, South Dakota. "They have high expectations for their vision following cataract surgery, and the patients I've implanted with TECNIS Synergy™ IOL have not been let down. This new lens has provided the wide range of continuous^^ vision patients are looking for, with great image contrast throughout the day, even in low lighting conditions."*
Also from the studies:
The TECNIS Synergy IOL is built on the legacy TECNIS platform and delivers excellent performance, image contrast, and patient outcomes:
Widest^ range of continuous^^ vision among leading PC-IOLs — 93% of patients achieved 20/25 or better binocular distance-corrected visual acuity.
Best near vision — patients gained an additional line of visual acuity at near distances versus a leading PC-IOL.
Superior image contrast — achieved two times better image contrast in low lighting conditions compared to IOLs of comparable range
High satisfaction with nighttime activities — 97% of patients were able see steps or curbs, 96% were able to see a menu in a dimly lit restaurant, and 90% were able to see objects and read street signs
Reduced need for glasses — 9 out of 10 patients studied didn't wear glasses after surgery.
Sue.An2 soks
Posted
I may be an anomaly for getting good range of vision with Symfony. Sure wish I could know if a monofocal would have given me same vision.
My point though is due to my rare eye condition it is a good thing my RE can see well at all ranges. If i had a monofocal that was targeting intermediate vision in one eye and distance in the other I would not see so well.