Looking for Feedback on Tecnis Symfony

I had a Technis Symfony lens implanted in one eye 3 1/2 weeks ago.  My 2nd eye will be operated on later this month.

Prior to surgery I was -3.25 in eye that got the Symfony lens and I am -2.50 in other eye to be operated on.  No astigmatism.  I am 53 which is still considered young for cataract surgery.  I had good near vision prior to surgery.  I was concerned about losing near vision if I went with monofocals.  I did not try out mini or full monovision with contact lenses prior to having cataracts.  So did not know if I could adapt to that.  Some people can do that could give you intermediate vision if one eye was set for distance and the other for intermediate- you would lose some depth perception which might be important to you given your line of work.  Something you may want to look into.

I think I got the typical result with Symfony lens.  At least I got what my surgeon said I would get.  I have good distance vision - although I do not know how that compares with a monofocal lens exactly.  I used to have trouble with cataracts reading road signs and now with one eye done I can read them fine.  I have only had 1 post op visit day after surgery and vision with Symfony tested 20/20.  Not sure what it is today.  I will be interested to know at next visit.

I read my computer just fine (I work on a computer 80% of my day.  Near vision is further out - more like 16 inches.  Once 2nd eye is done may want readers for up close like reading soup can labels or extended book reading.  I discussed computer reading with my surgeon with monofocals and was told given amount of time I spend on computer I may want 2 pairs of glasses one for computer distance and another for closer up rather than bifocals.  

Contrast sensibility is much better than what I experienced with cataracts.  Not with anything backlit like iPhone tablet or computer.  Outside at night is better than I had with cataracts.  I did notice that in dimly lit restaurants I had greater difficulty reading like with menu.  I show my iPhone flashlight on menu.  Not sure how that is with monofocals.  They would need glasses for that unless monofocals set for near instead of distance.

Nighttime issues:  there is always a compromise to make with whatever lens you choose as you likely already know or been told.  My surgeon said the younger you are the more true that is.  With Symfony due to it's design will give you halo and glare and concentric circles.  Some say as your brain adjusts these will diminish over time.  I don't know as I am just over 3 weeks in.  I wouldn't consider the glare and halos too bothersome.  Streetlights are a little fuzzy and have some glare.  Car headlights have more especially cars with those new LED lights that are very bright.  My husband who doesn't have cataracts find them bothersome too.  It always appears they are on high beams.  I see the conentric circles around certain lights.  Car taillights or yello flashing lights or certain brighter porch lights.  There are about 10 circles and they extend wide but are softer more translucent than glare.  I do not see anything around traffic lights or store neon lights.  I do not see anything inside my home or stores at night or day when inside nor the TV site.  I was concerned about soccer matches with those field floodlights but those have some glare around them like the streetlights do but don't affect driving or watching soccer or football games.

Basically the more troublesome lighting is oncoming cars.  I tend to look to other side till car passes.  As well this is less troublesome in city where there is iverhead street lights.  It is dark highwYs that cars are more bothersome.

In the end it is up to you which compromise you want to make.  If you don't need this surgery I would wait for better technology which will no doubt come.  But today these are the choices.  All I know for my personality and fact I will still work another 10 years at least and have child at home I am pleased with outcome.  Daytime vision is good.  Nighttime driving will diminish as time goes by. LOL maybe my brain will adapt and circles will disappear first .  Fact is there are no guarantees.  

Get a few consults from different opthamologists.  Choose one with lots of experience.  If you can chat with a few of his patients for feedback (I did that) it will help some (each persin's wyes are unique). Also if you have any underlying eye conditions known - take that into account. I asked about that as it would have turned me more towards monofocals.

Good luck.  Please share your decision and results.  It really helps others in this difficult decision.  I came to these forums before my surgery and very thankful for everyone's input.   If nothing else it prepared me for resuktsbI would experience.  The more you know the less surprised you'll be.

Sue - I thought you had the first lens set for close vision?

Got a Symfony lens.  I have distance intermediate and near till 16 inches then from there gets blurry. Which is what opthamologist told me to expect.  2nd eye not done yet.  Unoperated eye sees nearer.  May need readers after 2nd surgery for really close up stuff.

So with the Symfony lens you don't have to specify near vs. far?

The Symfony lens gives you an extended focus range of vision.  It is pretty seamless.  It is considered a premium lens and like a multifocal I paid the difference between a monofocal and this lens as our health care system covered the surgery and standard lens.

One can ask for the 2nd lens to be set slightly nearer so that you could read closer in. I can read now but have to hold iPhone out a little more than I use to.  I will not need glasses at all for most things.  Likely will get a pair to read labels on soup cans or pill bottles.  Daytime vision is pretty great.  Only downside are what I described above for night vision.  I knew that was likely the compromise but I use day time vision more and I can manage to drive anyways.  Will adjust to the concentric circles around some lights and glare of headlights

OK sounds good!

Hi Sue... did you have the surgery done convensionaly or with laser. I am trying to decide which has the best outcome for the Symfony lens with experienced surgeons for either way.

Hi Miguel, I had the Symfony implanted in my left eye 2.5 weeks ago--the 20th of July. My distance vision is now slightly better in that eye than my right eye, which had a Tecnis monofocal lens 16 months ago. My intermediated vision is better, too, which was my biggest concern. Close up reading is still not good. I need reading glasses to read basically anything, including this laptop I'm typing on now. I'm 55, had my first IOL at 53, and use the computer daily for writing and reading fine print. I'm not having any problems with halos, or other issues at night. My night vision seems better than before, when I had high myopia and astigmatism and cataracts. Lights are brighter, and I seem to have better contrast vision--it was very poor before (for instance, I couldn't read on a Kindle, including the Paperwhite.)  Have you tried multifocal contacts to see if you like that arrangement? That prepared me for having one eye for near and the other (rt) for distance.

My daughter had cataract surgery when she was about your age, and she went with monovision--intentionally setting the lens for near reading. (Toric multifocal wasn't available at the time.) She is quite happy with that. For distance--driving, etc.--she uses glasses. But she can pick up a book and read it. (Her other eye is -15 after another detached retina, so isn't much help.) She has given up photography, sadly, since her vision is just not good at fine detail. 

Best of luck to you. Dealing with cataracts or other eye issues at your age is especially stressful, I think. 

 

To be honest not sure.   I know it was quick.  After eye was numbed took him about 8 mins.  I know incision was small - no stitches involved.  I will have to ask when I get 2nd eye done.  The Q & A hospital gave me under question about is surgery performed with a laser said 'most surgeons today use ultrasound and vibrations to break apart cataract and remove it.  This process is called phacoemulsification.'  So assuming it was phaco.  

If your surgeon is able to use laser ensure he or she has plenty of experience as I also read there is a learning curve to it.  

I read online where doctors when asked which they would prefer when it comes time for them to choose lens and method that not all of them said laser. Nor did all of them say standard lens.  Google that - I found that interesting.

From my understanding getting the power right is more important than either of these 2 methods.  My eyes were measured using 2 different machines.  2nd reading was taken when I decided on Symfony lens.

When is your surgery Dennis?

Hi MW

Just wondering was your monofocal eye that was operated on 16 months before your Symfony eye set for distance?

I have my first eye operated on with a Symfony 3 1/2 weeks ago. Other eye will be done later this month.  Wondering if the monofocal in your other eye is helps with eliminating the concentric circles and glare/halo.? 

I did not notice these at first but now do in certain situations and with certain lights at night.   

I was planning on another Symfony but maybe should consider different set-up.

I can read at about 16 inches out.  Feels a little unnatural at this point.  I have to close unoperated eye to find out that distance as I still have good near vision st 53.  Too bad I have a cataract in that eye as I would have good close vision at 6 inches away.  Likely I would get used to holding iPhone or book out further.  And if. It could get readers for all the close--up stuff.

Yes, Sue.An, it was set for distance. I tried monovision with contacts and didn't really adjust. 

I haven't been out at night a whole lot, so maybe I just haven't noticed, but I am sure I can see well enough to drive now. It seems possible my non-Symfony eye is compensating. 

I had specially made reading glasses made before, when I had a multifocal contact in my left eye, so those work well for me now. 

Regardless, having intermediate vision with the Symfony is worth it to me, since fixing that with reading glasses is much more problematic. But the contact did offer better close up reading vision, but not great since I still had the cateract and low light issues. 

Hi Sue.An, 

I am at 55 and just had my right eye implanted with Symfony 3 1/2 weeks ago. My results are quite similar to yours and that was what I had targeted for. Currently, my near-sighted -2.0D left eye is responsible for near distance (somewhere from 20 to 60cm) and my Symfony right eye is for intermediate to far distance (from 60 up to 25 meters, car license plate in parking lot under sunny day). In day time, I am able to drive without spectacles on both eyes. In night time, I wear spectacles (left eye corrected, right eye not corrected) for safety reason. Glare/flare and starbursts are annoying but bearable since my left eye will automatically balance with my Symfony right eye to reduce the effects, which can be further reduced by putting 1-piece of grey-tinted sunglass over the right part of my spectacles. 

Your sharing and comments are very helpful. Thank you very much. 

As for your forthcoming second eye op, I would like to offer you some of my thought. 

. Once an IOL len is implanted, one gets presbyopia at 3.0D (because the ability of the IOL to move forward or backward like our natural eyes). 

. In Abbott Tecnis Symfony website's homepage (), on the left hand side, there is a graph called "DIOPTERS OF DEFOCUS". The graph is used to show the effect of  the Symfony refractive power for near, intermediate, and far vision. The Symfony lens can be set to shift the curve to achieve either near, intermediate, or far vision.

. According to the graph, if the Symfony is set to -1.5D (near-sighted) one will get 20/40 vision at distance 26cm (1/3.8), 20/25 at 33.3cm(1/3.0), 20/20 at 66.7cm (1/1.5), 20/25 at 111cm (1/0.9), and 20/40 (1/0.35) at 286cm.  I found the graph though not totally accurate but is close to my experience in my case (set to -0.5D for intermediate and far vision).

. Therefore, the -1.5D (or even -2.0D) might be the target for your second eye since you already have an eye set for intermediate and far vision. 

. In, the Dr. use biometry to determine the appropriate lens power for his patient.

Of course, all the above comments have asuumptions such your eyes don't have other problems except cataract. You will have to talk to your Dr. to see what's the best for you.  As for the type of op, femtolaser is still kind of new and has not proved to be without problems, as far as I know. Phacoemusification with CTR (Capuslar Tension Ring) which I chose for my Symfony implantation, might be safer at this moment. 

Some notes: 

My natural left eye's contract and sharpness is superior to Symfony.

My 55 years old left eye sees the world with yellowish tone while the Symfony right eye sees world brighter (over-exposed about 0.5 stop) and with a blueish tone. 

Without night glare/flare and starbursts, I think AMO Tecnis Symfony is a good alternative to multifocal or monofocal IOL. However, I don't have any experience with monofocal or multifocal IOLs. My comments are based on the clinical research reports I had read. Finally, everyone's eyes are different and the choice of IOLs is really dependent on each individual's condition. A doctor who is willing to communicate with you, give you options, and tell you the pros/cons of each option is your best help.

Wish everyone well. 

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Thank you for your feedback.  I am wondering how much my unoperated eye is (with glasses) balancing the night time glare, etc and whether it will be worse once it is operated on.  

I have not had good distance vision since I was young so it's hard for me to compare sharpness and contrast sensitivity etc.   But because I have good near vision in unoperated eye I do know there is better contrast in low light conditions when reading a menu in a dimly lit restaurant.

yes light makes a big difference in how one sees.  Wondering if all IOLs have that in comparison to natural eye.  Most people by the time they need cataract surgery can't likely remember what good eyesight is.  It is those who are younger that end up the most unhappy as we can compare.

Thanks for posting.

Hi Sam.My, I too am 55 and had the Symfony lens put in about 3 and a half weeks ago. I'm having similar experiences to you--my left (Symfony) eye is doing all the intermediate vision, while with reading glasses, my right (Tecnis) eye is responsible for reading. I have special glasses made with two different + reading prescriptions in each eye. I'll probably get new ones made as soon as I am sure the vision has settled in each. 

So far no issues with night vision, but I haven't been out too much after dark. The real test will come as the days get shorter, I am sure. 

Thanks for your helpful information. 

Hi MW - do you have a Symfony lens for distance which gives you that and intermediate and a Technis monofocal set for near for reading close?  

Do you like that set-up?  I am someone that suffers from migraines and when I go on cruises only one in family that gets seasick (which is a vision perception thing) so having lenses set for 2 distances worries me. Certainly don't want to get that feeling all the time.  I deal with cruises taking medication and it works well.  I am so seasick need to take that med for a week after cruises or everything still swims around me.  

My 2nd surgery is Monday and I guess I am emotionally exhausted going back and forth with options.  I think I will just go ahead with Symfony and if I need readers for close up that won't bother me.  For night time there is still chance I would experience night vision issues.  You are right challenge will be when days are shorter.  Winter is depressing enough - this will bring another layer to it.   I have been driving at night short distances in the city.  I can manage - hopefully it is like that with 2 eyes done.  

Fact is nothing is like the eyes you are born with.  I have chatted with many seniors with monofocals too and they have issues too.  Was at a neighbor 's father's birthday (85).  Lots of seniors to discuss this with.  Most had standard lens.  Many told me they go for yearly cleaning as eyesight blurs.  I asked what they meant and they just said lens needs cleaned like glasses every once in awhile .  Time to get it done when eyesight not sharp anymore.  Guess this means PCO and laser treatment.  I thought that could only happen once.  But apparently. It with these seniors.  

Oh the joys ahead.  Guess time to put worry behind me and start living life.  I can't be thinking of everything that could go wrong.  It will rob me of today's joy.  Honestly dYtime vision is just excellent and I am hoping 2nd surgery turns out as well.  I really haven't had to go out much at night.  Long drives for soccer games I get my husband to drive.  When his time comes - hopefully better options but if not he can get monofocals and between 2 of us we will manage life.

Hi, no, my right Technis is set for distance, which left me with no intermediate vision until I got a multifocal contact for the left eye, and then the Symfony in that eye. So now I just use reading glasses for close up reading. 

My daughter has her monofocal IOL lens set for reading though, and the other eye has a contact (it's currently -15, after another retinal detachment). She really likes that situation. She uses glasses (on top of a contact) for driving. 

 

Glad there are solutions to help.   Do with your Symfony lens do you see the concentric circles and glare?   I wonder if that lens was set for intermediate so that you got near and intermediate vision if you'd get less glare halo and circles.

I don't think I see either halos or concentric circles, but I'd have to go out again and see for sure. Maybe during the eclipse  

I didn't see them till I was driving in certain conditions.  I am likely going to be fine driving in the city.

That is good.

Based on my experience, one tends to see the concentric circles around lights only at dawn, dusk or night at distances more than 30 yards or so, provided the glare due to the light does not overwhelm the circles.

Your combination of the monofocal lens for distance and the Symfony lens for intermediate (and near) is what I have been suggesting on this forum to minimize the chances of seeing the multiple circles. Am glad that it has worked out well for you.

I would have thought that if your left eye were set for the best focus at the intermediate distance of about 32 to 40 inches, you should be able to read reasonably well with that eye. What prescription have you actually ended up with for the left eye.

I have a similar combination as you. That is, I have the monofocal lens in the left eye set for the best focus for reading at about 17-18 inches and the Symfony lens in the right eye set for distance (and providing me good intermediate vision). As I have noted before in this forum, that provides me a good day-time vision at all distances beyond about 15 inches. I do see the multiple circles at night, but have to learnt to live with them and drive at night without any glasses (although I don't really drive that much at night). Haven't used glasses or contact lenses for months.

I'm not sure what my prescription is--I was waiting until my eyes settled to see what sort of reading glasses I should get (possibly even another contact, although they've got my distance close to 20/20 now). My next appointment isn't until Sept 15 so I will see then. I may have noticed a brown shadow or two, which means a YAG surgery to clear that up. I wish I could read better with that eye, but I always knew if I at least got intermediate back I'd be happier than I was with the old Technis monofocal. 

Some corrections: 

Line 4: Should be "from 60cm  up to 25 meters, car license plate in parking lot under sunny day)."

Line 12: Should be "because the INABILITY of the IOL to move forward or backward like our natural eyes)."

Sorry for the typos. 

I just read all of your postings which are very helpful, thanks.

Regarding to the flare, starburst, and concentric circles (spider web), I agree with you that most of them happen at certain distances. I don't have problems with them at dawn, dusk or night when walking simply becuase I will NOT look at them at all. When driving at night, I find the traffic lights or lamppost lights tolerable but the incoming cars' headlights annoying, especailly for thoese with Xenon or LED lights. Because my left eye is still healthy, I can compare my left eye to my Symfony right eye to tell the effects of glare/flare and starbursts. It is hard to describe in text accurately but in simple words it looks like this "the diameter of starburst in Symfony is about twice of that in my natural eye; the intensity of starburst drops gradually from the center outwards in my Symfony eye while that drops sharply in my natural eye; putting a green lens G-15 on the Symfony eye will reduce the glare/flare and starbursts to a level close to the natura eye."   

There are some posts in MedHelp forcum discussing the glare/flare, concentric, and starbursts effects in Symfony. 

I think you set the Symfony for near and intermediate is a very good choice since in this way the glare/flare, concentric, and starbursts effects could be reduced to certain degree, certainly not as prominent as I have currently. Hope everthing works great for you. 

just weighing in for Sue.An as well.  I have similar experience as you, 52 years old with Symfony in non-dominate eye 10 months ago, natural in other with pretty good vision during the day.  I have major concentric rings and glare at night but I am still able to drive, but they are very disturbing.  I also get single rings around small light sources inside at night against a dark background.  I wonder if getting a monofocal would help as I would think my natural eye which doesn't have rings would have the same effect, yet the rings still dominate. The literature states that incidence of halos is similar to other multifocals but I do not think that a single ring or two vs. 10 or more bright rings should be considered "similar".  Had I known about this problem, I probably would have traded less near vision for fewer issues at night and haven't ruled out exchanging the lens.  One doctor nailed it--these IOLs are really about the paradox of choice in that no lens is perfect and even if a perfect lens existed it probably wouldn't be perfect for everyone.  Hope your decision works out for the best as it may help me what to do with my natural lens when needed.

Thanks John.  Will be looking forward to reading your updates to hear how you get on with your 2nd eye.  I wavered back and forth.  Wish I could have waited and researched more but with vision 20/70 in right and 20/60 in left and needed to be able to function at work had to have 2nd eye done.

In my case going with a 2nd Symfony gave me much nearer vision than anticipated (without any mini monovision done - both eyes targeted for 0D).  Great vision during day.  Trade-off is night driving.  I manage to drive in the city in lighted streets.  Get my husband to drive on longer trips on dark highways.

I agree the visual effects explained pre-op aren't descriptive enough.  You'd think they'd hand out a photo simulating what you'd see around light sources.

Overall I haven't thought about exchanging the lenses - if daytime vision weren't good I would be thinking that way.

John if you do a monofocal for 2nd eye would be interested to know if it mitigates the glare starbursts and circles.  Thanks.