Looking for Feedback on Tecnis Symfony

Foureyes,

Sorry I'm seeing this a little late, sounds like you've probably already had surgery. I'm having a hard time finding anyone in my area that has experience mixing monofocal and multifocal lenses so I've been hesitant to get surgery. My current plan is to get monofocal lenses in both eyes and wear either one or two multifocal contact lenses to get a similar result. Let me know how the one eye symfony works out for you.

I am not very knowleadgeabke and still on medical leave with poor quality vision after symphony's Iol

According to my surgeon my other eye ambliopizef to a degree I can't get near vision with contacts or anything ( never realized this before the surgery )

Anyhow I asked that question can you have one kind of lens on one eye and another kind in the contralatetall eye

Vague answer yes but depends on how your brain araos quite scary vague answers

The results you are describing aren't typical, but I'd suggest not panicking too much since being only 3 days out from surgery its possible you are still healing.  Usually most places have a post op the day after surgery, but I'm guessing you didn't have that? If you did, did they tell you what your refraction was?

One likely possibility is that the lens power is off and you were left farsighted, which will cut down on near vision, but stilll leave you with decent distance&intermediate if you aren't. Unfortunately deteremining the lens power to use isn't done using an exact formula. It is based on analyzing statistics of eye measurements of prior patients and the lens powers that worked for them, and the results work well for most people, but they can be off. They tend to be most accurate for those who didn't need correction before surgery, or had low prescriptions. There is more of a risk the power will be off for those with high prescriptions, in part since there are fewer data points and in the case of high myopes they suspect other reasons such as problems with the technology used to take measurements that are less accurate for high myopes.  One of my eyes wound up about +0.5D, slightly hyperopic, and so most of my near vision comes from my other eye that hit the 0D target, but its not something I'm aware of most of the time.

The lens can actually move a bit during the healing process the first few weeks, which can make things better or worse. After it has stabilized, if the lens power is still off, they can consdier correcting it via a laser tweak or a lens replacement, or merely using glasses or contacts. 

If the problem is the lens power, then if you'd gotten a monofocal lens, you'd likely be struggling even with intermediate vision.

Also it can take time for some people to "neuroadapt", for their visual system to learn to work with the different sort of optics of an IOL to figure out how to see better at near. For standard multifocal lenses that can happen right away, or take serveral weeks or a few months depending on the person. I haven't seen statistics for the Symfony, though one doctor that did a comparision study between the Symfony and the AT Lisa trifocal said that neuroadaptation with the Symfony averaged longer, but he didn't quantify how long that was (and I've not seen any statistics on the issue). I was fortunate and had 20/25 at near by a couple of days after surgery in the eye that hit the refractive target, I didn't notice any need to neuroadapt. I don't know if my visual system was used to the need to adapt, since I'd previously worn multifocal contact lenses before my cataract, more than one model with differing optics, so perhaps I'd gotten used to adapting to optical changes. 

The results you are describing aren't typical, but I'd suggest not panicking too much since being only 3 days out from surgery so its possible you are still healing.  Usually most places have a post op the day after surgery, but I'm guessing you didn't have that? If you did, did they tell you what your refraction was? 

One likely possibility is that the lens power is off and you were left farsighted, which will cut down on near vision, but stilll leave you with decent distance&intermediate if you aren't. Unfortunately deteremining the lens power to use isn't done using an exact formula. It is based on analyzing statistics of eye measurements of prior patients and the lens powers that worked for them, and the results work well for most people, but they can be off. They tend to be most accurate for those who didn't need correction before surgery, or had low prescriptions. There is more of a risk the power will be off for those with high prescriptions, in part since there are fewer data points and in the case of high myopes they suspect other reasons such as problems with the technology used to take measurements that are less accurate for high myopes.  One of my eyes wound up about +0.5D, slightly hyperopic, and so most of my near vision comes from my other eye that hit the 0D target, but its not something I'm aware of most of the time.

The lens can actually move a bit during the healing process the first few weeks, which can make things better or worse. After it has stabilized, if the lens power is still off, they can consdier correcting it via a laser tweak or a lens replacement, or merely using glasses or contacts. 

If the problem is the lens power, then if you'd gotten a monofocal lens, you'd likely be struggling even with intermediate vision.

Also it can take time for some people to "neuroadapt", for their visual system to learn to work with the different sort of optics of an IOL to figure out how to see better at near. For standard multifocal lenses that can happen right away, or take serveral weeks or a few months depending on the person. I haven't seen statistics for the Symfony, though one doctor that did a comparision study between the Symfony and the AT Lisa trifocal said that neuroadaptation with the Symfony averaged longer, but he didn't quantify how long that was (and I've not seen any statistics on the issue). I was fortunate and had 20/25 at near by a couple of days after surgery in the eye that hit the refractive target, I didn't notice any need to neuroadapt. I don't know if my visual system was used to the need to adapt, since I'd previously worn multifocal contact lenses before my cataract, more than one model with differing optics, so perhaps I'd gotten used to adapting to optical changes. 

I also had my surgery when I was 52 and had been used to having less near vision for several years due to presbyopia, which I tried to mitigate using multifocal contacts.  At 42 its possible you hadn't really noticed much  reduction in your near vision yet, and so any reduction might be more noticeable at first than it would be for someone older, and more of a struggle while you get used to it.  I tend to view the Symfony as being like early presbyopia, where you notice a reduction but don't usually need correction (e.g. I've had no trouble using apps and web browsing on my phones without changing fonts, holding it a comfortable distance.   I don't know what size screen your iPhone has. I've been using  android phones since surgery, the first had a 4.7" screen, my current has 5.1".

Thanks for the input, softwaredev. I did have a post op evaluation about an hour after my surgery with a different dr (not the surgeon). She said there was swelling on the right side. The formal post op appt is scheduled three days from now and that's where I'll find out my what the vision is for my right eye.

Regarding my phone - Right now I'm using an iPhone 6+. At full arms length I can't read this screen. It only gets worse the closer I move the phone to my face. By contrast, my left eye (20/20) can read it from arms length all the way to about six inches from my face.

I am considering the Symfony lens and I hope you will update us on your experience with it over time.  thanks

Will do. For reference, I did have my post op last week and now I'm about two weeks out from surgery. The post op went well. They told me everything's my looked good. However I still have no near vision. . She told me it might take up to 8 weeks to see if it gets any better. However she said that if it's not better by then - then I probably won't have any near vision. Very upset by that.

I don't know if they told you what your refraction is, your refractive error, since I'm suspecting the issue is that you were left farsighted. Although the lens does sometimes move during the healing process for the first couple of months and change the focal point, it could either make it worse or better. Its possible it is just taking a long time to adapt to the new lens, but I'd guess the odds are that the issue is refractive error. That can be corrected via a contact lens, glasses, laser, or less likely an ICL (implantable contact lens or implantable collamer lens).

I had the first eye done on 12-8-16 and it was a disaster.

Think looking through a glass gallon jug.

I have a appointment 1-6-17 to see what if anything they can do about it.

The second eye was done on 1-22-16 and far and intermediate is almost as good as pre cataract but near isn't good enough to read.

 

Wow, that sucks.  I truly hope it improves for you.  But I gotta say...you guys are scaring the crap out of me!  I'm ready to schedule, and all the scary stories are freaking me out.  I keep telling myself that even partial correction is better then nothing (I am -13d right now), but for $14000, I  hope for perfection! An out of pocket expense, as I do not have cataracts.

There are over 20 million cataract surgeries done worldwide each year, > 3.6 million in the US the last figure I'd seen. Those who have problems are more likely to post than those who don't, so even a tiny fraction of people having problems can lead to a fair number of posts. Many people who do have issues initially see them resolved in a fairly short amount of time.

Lens replacement  surgery is considered very safe, but no procedure is 100% guaranteed to be without risk. That said, even wearing contact lenses has risk of eye problems like infections, which accumulate over the years of wearing them. Even wearing glasses has a minor risk e.g. wearing progressive glasses while driving has been shown to slightly diminish reaction times (compared to good unaided vision) which can increase slightly the risk of accidents, as can the slight reduction in peripheral vision around the edge of the lenses. Such risks might be trivial, but then so are the risks of cataract surgery.

btw, I suspect if you shop around you can likely get the surgery cheaper than that even from a high quality provider, though I don't know where you are located. 

Thank you for your concern. The near vision in the second eye is the same and I have a appointment the 7th to see about the first.

I had cataracts on both eyes so had to do something and the tecnis symfony seemed the best way to go. I'am sure they will correct the first one and so far I think that was the best decision.

$14000 seems like a lot, I was quoted around $5000 for the lens and $4000 for the rest. I would shop around and see if I could get a better deal.

Good luck

Please let me know how it is going

Useful while praying I beuroadaptation bought the iPhone plus and increased brightness to full and super big font size is helping some

Still horrible headaches when I try and work in a computer for more than 30-40 min

How are you doing?  Hope it is getting better!

I have a cataract in my left eye.  Needing glasses a lot more than I used to, but nothing really serious, but probably time to do the left eye.  I play golf and tennis and do a lot of photo editing on the computer.

The Symfomy lens seems like a good option....but your experience and that of others has me very worried that Symphony might not be the best choise.

Why aren't there any "it is great" reports?

Any, and all, advice or comments would be welcome....seeing the doc next week.

thanks

All, I had my cataract surgery Dec 2 with a symfony lens.  Quick background is that I am in my mid 50s and already had cataract surgery in my right eye with a mono lens 4 years ago (the symfony wasnt yet available, and I didnt get the bifocal lens as I heard too many horror stories about halo's). The cataract in my left eye was quite bad, and while my combined distance was fine given the mono lens in my right eye, I needed reading glasses 100% of the time for reading and the computer. I COULD NOT BE MORE PLEASED with the symfony lens.  My recovery was quick, and I had great vision almost immediatelty.  My distance vision isnt as good as that of my right eye, but its still good and 20/20 with both eyes.  I no longer need reading glasses at all.  My intermediate vision is great, as is my reading vision.  I have an iphone 6+ and do set my setting so that the font is large, but still, I can read a book, etc. with ease and no glasses.

I was hesitant to add my comments because of the issues a # of you have experienced with this lens.  However, if I read the above comments prior to surgery, I would have had serious doubts about proceeding with the symfony lense, which I would have been unfortunate for me.  A couple of items which will hopefully be helpful:

 - as someone astutely pointed out, only a fraction of those who have had the implant will comment, and likely it will be those who have had issues.

 - every outcome, situation, etc is different.  Perhaps I was just lucky, etc that my outcome was so favorable

-it's CRITICAL to have a great surgeon.  My surgeon is one of the best and busiest in NYC, so I was fortunate here as well as he has a lot of experience in general as well as with this lense specifically (even though it was only recently approved in the US).

 - the 14k above seems exhorbitant.  I paid MUCH less than that in NYC, where prices are likely the highest.

Hope this helps...

Thank you SO much for letting us hear a good result! Also referencing the cost in NYC. I'm near Chicago, so I went straight for the best here. Although it does seem ridiculously high, and I am usually a bargain hunter, I'm sticking with my choice. id rather pay more on the front end to be safe, than pay later to fix someone's errors.

I'am glad Foureyes had good results and I hope you do too.

A update on my 1-6 appointment. It's been four weeks and the dr. says there has been some improvement and want's to wait another four weeks.

I look at a ten inch clock at fifteen feet and don't see any improvement.

I hope I'am wrong but I don't think another four weeks will make much difference. We didn't go into what the next step would be but I expect them to make it at least as good as the other one.

Can you please share your NYC surgeon name/contact info?

Sure.  Dr Grayson of Omni Eye Surgeons.  20 East 46th ST; 212-353-0030

I agree with Claudia....I appreciate hearing your report.......I supposed I am biased to hear good reports.......seeing the ophthalmologist tomorrow.......Symfony has good specs for me.......but always wary of new technology..

helpful to know that all reports aren't negative........thanks

Hi, I am planning on getting cataract surgery done on my right eye soon, did you see any halos or glare after your surgery with symfony lens ? How about nght driving ? Did you try night driving with Symfony lens ? would appreciate your feedback

Great to hear!  Likely your excellent near vision is because the surgeon managed to achieve slight myopia, something that's more difficult to achieve in certain people (especially those who start out with high levels of myopia).

Hi. I'm still here. I'm about 10 weeks out from surgery at this point. My results still are not great and we've yet to determine why. I've had a lot of problems with eye pressure and they think it might be affecting my vision through the lens.

My pressure has been going up above 30 and staying there, so I'm on drops to control it. The drops keep it under control but they're becoming less effective. My surgical eye is cloudy every morning due to pressure, so the drops help lower it so I can see again. That used to be happening once a day but it's now three times a day. Vision is still blurry throughout the day.

I'm visiting with the surgeon again today (sitting in his waiting room right now). They want to check that the healing is done and steroid patch has dissolved.

At this point i still do not have "good" vision be it near, intermediate, or far.

I've had more complications than expected for my relatively young age (42). However I do agree that my results are not typical.

Will see what the surgeon says today.

Hi...thanks for your info

I had surgery Wednesday.  No WOW yet, but steady progress.  I'll report back in a few days when I have better information.

I am scheduled to have my first Symfony Monday... left eye, then mid March my right eye is to be done. I am excited, and yet disturbed by the posts on this thread. I must keep my hopes up as I have fully committed to doing this. I will be traveling a fairly short distance for the surgery, as the laser center is just 47 miles from our home in Michigan. I have worn bifocals for about 30 years and cataracts have formed and are making it very difficult for me to see well. I must stay hopeful. The cost per eye is roughly 2800.00. The drops that need to be given for about two weeks are not entirely cheap... I understand most insurances may cover part, but not all, they are somewhere in the neighborhood of 100.00.

Good luck Sharon, I hope all goes well. I am scheduled to have a second Symfony lens implant this afternoon. Hopefully it will be as successful as the operation on my right eye.

I will say a prayer for you... let me know how your surgery goes 😉

I am wondering how  your surgery went?  Mine was this morning around 7:30am.   It seemed to go as good as hoped.  The Laser that broke up the cataract was spectacular...  it looked like the 4th of July as it was working...  I saw red fragments just busting apart and flying all over.  No pain what so ever.  I was taken to the second part of the surgery where they sucked out the particles and placed the symfony lens in...  I was placed under for about 10 minutes for this.  I woke up and it was done.  I came out of recovery in about 20 minutes and walked out to my car. No side effects at all. I Went out to lunch,  came home and took a one hour nap.  My post operative appointment is tomorrow afternoon.  Still no pain today.  I am glad to be rid of the cloudyness in my left eye,  and the right eye will be done March 13th,  unless rescheduled.  My eye is now 6 hours from surgery,  still dilated,  so vision isn't what it will be by tomorrow.  It was much easier than I had expected.

Hi Sharon, glad to hear that your surgery went so well. Mine was also successful. I was consious throughout but the aneasthetic injected into the eye tissue (the most uncomfortable part of the procedure) meant there was no 4th of July effect.

I have provided a fuller update on my discussion "My experience of the Symfony Toric lens"

Please excuse spelling. This was down to too much haste rather than my eyesight!

I do not see a link to your additional progress. Please keep us posted. Did you have any problems the first or second day of surgery?

I don't think this site allows links to be posted. If you look at the discussions within the Eye-Cataract forum, "My experience of the Symfony Toric lens" is currently listed third from the top of page 1.

Thank you! I will check it out.

Foureyes, it is so good to hear someone have good results!  I am living in NJ, and looking for an experienced doctor, do you mind tell the name of the doctor?

One more thing, I hear for Symfony iol lens, if you look at the mirror carefully, can see the refractive rings, is that ture? also Symfony iols has strong external reflection? Most of the person said it is not big issue, I just worry a little about it. thank you

Updating my Symfony surgeries...

As I have mentioned above... I had my first cataract removal & Symfony Tecnis lens put in my left eye about 3 weeks ago.  My first, second and third post visit to my surgeon went well health wise,  healing excellent, but vision poor in my left eye.  Doc said that the lens that he put in may need to be removed and a replacement put in.  I had double & blurred vision as well as seeing through a film of blue. which didn't seem to show signs of improvement between visits... and just not good enough to satisfy my surgeon.  I have to give him major credit as he is determined to make it work.  So we went ahead and moved the surgery up on the right eye... from the extended second week in March, and it was done yesterday morning.  This time my total in clinic surgery, eye tests etc., took about 3 hours.  After the laser was used to break up the cataract, and then removed... I went into a room for additional eye measurements to be taken before the lens was put in.  Once that was done... he determined the proper corrections,  eyedrops being given during the waiting time.  Then into the room to have the lens fitted.  This was all different than the way the surgery prep was done three weeks ago for my left eye... measurements were all done at his office days before the surgery.  Anyway... I was awake through everything except the insertion of the lens.  I have not had any pain... other than when they put in the drops to dilate my right eye.  I went home being able to see quite clearly with my right eye.   Today I had my post operative visit, and my right eye sees 20/20, no blue haze, even with the swelling that is common the day after surgery.   My doctor will reschedule me for removal of the lens in my left eye, measurements again will be taken and a astigmatism adjustment, new symfony etc.,  in a month.  So for me... having him measure my eye after removing the cataract and before putting in the lens... made a difference,  which he will do on my left eye as well.  He explained the reasoning and how he came to change his proceedure.  All I know is I can see as I should with my right eye.  The cost of the second surgery on my left eye, I am not being charged for...  Inconvienient,  yes,  but i am liking the results.

 

NOT a big desl

What doctor did you use? I'm also in the Chicago area and my doctor is not recomending any multifocal lenses but I'm not sure he's up to date with the newest.

Hopefully someone from there will reply, I'll just note that In a huge metro area there are likely lots of good docs, googling:

Chicago Symfony IOL 

shows a number of surgeons using it there , though of course you want  to find a good one. Many cities have lists of "best doctors" in either local newspapers or city magazines that are based on who doctors would go to if they needed treatment, and I'd seen someone mention Castle Connolly as a site that does something like that also. I tended to look for high volume surgeons (practice makes perfect, or better at least), ideally those on the leading edge suggested by participating in clinical trials (partly I also figure companies wish to use docs with good surgical skills so the results are good), those who are either associated with a medical school indicating their medical judgement is respected, or are asked to give their opinions in trade publications or at conferences suggesting their judgement is respected.

I used Dr Foulkes in Lombard.  I would recomend him.

As a health professional myself in need of 2 lens implants; I agree with you that it is critical to have a good surgeon; someone who uses this product & does alot of them. I am looking for advice as to where would be the best place to go & what the cost variables are. I live on Long Island; would be willing to travel anywhere; of course would like the best price & someone with lots of experience with Symfony. I actually called the company in CA & called a local sales rep, but he never returned my call. Any advice would be appreciated!

Don't know what to tell you

I am still struggling

Lost all my Katie te unable to go back to work with horrible headaches every time I am

In front of the computer over thirty minutes

Can I ask what Dr you went to in Chicago?  

Do you work for Abbott (the company that makes Tecnis Symfony) or just own a lot of stock in the company?

I have terrible halos with the Symfony, and by halos I mean about 10 bright concentric rings around light sources that extend out many feet depending on how far away the light is and how bright.  I read how Symfony is comparable to other multifocals when it comes to visual aberrations so maybe I am one of the unfortunate few.  Be prepared to see singles haloes around light sources insight your house at night too when the background is dark. I can drive at night but it is disturbing even after about a year now, so be advised.  You can read about some others that have also experienced what I have with the Symfony at medhelp[/b].org[/b]

Jihn sounds like your halos may be a bit worse than mine.  I am ok inside the house with light sources.  The only thing are overhead clicks - in pitch black I see a slight glow around time.  If ceiling light is on there is slight ring (highlight around click pvr.   Might be the contrast that does it as my bedside clock which is green doesn't have it.  

Concentric circles are actually not the bothersome thing when driving as they aren't bright.  It is the starburst/glare from oncoming traffic that is the worst - more blinding.  With cataracts I had even less contrast in night time conditions and headlights too were blinding - guess I have not known good night time driving for awhile and it prepped me for life after Symfony.

Hi Sharon,

?I read your comments regarding the symphony lens and noticed you are from Michigan.  I am also from Michigan and have surgery for lens scheduled for February 12th.  Just wondering what surgeon you used?

Thanks,

Jennifer

 

Hi! just wondering if you ever got the Symfony lenses put in. agreed, it's kind of scary when you read these.