MID- COURSE CORRECTION?

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I Planned to have two Symfony toric lens placed in on November 30th & December 14th,  beginning with non-dominate left eye.  Prescription is +3.75 in both eyes and 1.87(L) and 1.57(R) stigmatism. Cataracts measured 3 in (L) and 2.5 in (R)   

?Although surgery went well, and intermediate vision is very good, I'm concerned my distance vision won't equal even what I am seeing in my right eye with progressive glasses. That's important to me as when I drive I have trouble reading signs, particularly green and white expressway exit signs.  I tested 20-40 in the new lens (ZXT300) the morning after surgery. I'm seeing the glare, starbursts, and halo's but not too bothersome at this point, and no concentric circles yet.  

?What I'm wondering is, if this concern on distance vision continues for a couple weeks, should I consider a toric monovision lens set at distance in my dominate eye?  Would I be losing any symmetry in not having two toric symfony's? Would having only one Symfony be less glare, starbursts, and halo's than two Symfony's? 

?Have appreciated previous advice I received on this site, God bless you all. 

 

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  • Posted

    I originally planned on two toric symfony lenses but after the first one (ZXT-150) was implanted (october 27) in what was my dominant eye, I changed my mind. I was happy with the 2015 vision but very unhappy about the glare and starbursts. I think I am more sensitive to light than others but it's hard to tell. I had a toric monofocal for distance implanted 4 days ago Nov 29)  in the other eye. I am having no problem with the symmetry issue. My doctor said this combination is not uncommon at all. I have 2015 in my second eye also, so far. I don't see a big difference in my vision between the two eyes, just a difference in the starbursts. The toric monofocal for distance is tempering the glare, etc from the symfony. 

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    • Posted

      Thanks for your prompt reply, will be most helpful for my talk with the surgeon tomorrow.  You experienced  the same 20-15 results, with both the Symfony toric and monofocal toric, do you know if its normally the case to have the same outcome?
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    • Posted

      I think my brain is adjusting to the new lenses, choosing which eye to use as is the idea with monovision- a near and a far. Today my left eye with the monofocal was focusing better on the television closed captioning than the symfony eye. That surprised me. 

      I expect this to change over the next few weeks- the surgery on the left was 4 days ago. My doctor told me to make sure I wasn't covering or closing one eye as I had been doing prior to the second surgery. 

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  • Posted

    The 20/40 vision in the left eye may improve a little bit in the next few weeks, but probably won't get any better than 20/32.

    Did they also check your prescription at the same time as they checked your overall vision in the left eye?

    Any way, with the available information, my strong recommendation at this stage is for you to get a monofocal lens for distance vision for the right eye. Even though originally unplanned, you will end up with the combination, which based on my experience, I have been recommending on this forum for some time. Unless you still have a lot of astigmatism left over in the left eye, with this combination, you should end up with good vision at near, intermediate, as well as far distance with minimal night vision issues. You will also have a lot less glare, starbursts or halos (concentric circles).

    By the way, if one sees the starburst, glare etc around the lights, those overwhelm the concentric circles and thus one does not see the later.

    Finally, I have had no issue due to mixing a monofocal lens and a Symfony lens, although because I had the monofocal lens 18 years back (and had set that for reading), my Symfony lens was set for far distance. My day vision is great at all distances, but have the annoying night vision vision issues such as seeing concentric circles.

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    • Posted

      It appears that Symfony set for near with some distance correction left reduces the incidence of concentric circles. 

      If you match Symfony with monofocal would you put monofocal in dominant or non-dominant eye?

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    • Posted

      Always grateful for your insight and recommendation, If my vision doesn't improve beyond 20/32 I now plan to request the toric monofocal.  The surgeon said they don't give a prescription until a month after both eyes have new lens. 

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    • Posted

      In my opinion, it is better to have the monofocal lens set for distance and the Symfony lens set for intermediate to get good vision at all distances and to minimize the chances of having night vision issues. Further, if the choice is still available, it is better to have that monofocal lens (set for distance) in the dominant eye.
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  • Posted

    I originally planned on two toric symfony lenses but after the first one (ZXT-150) was implanted (october 27) in what was my dominant eye, I changed my mind. I was happy with the 2015 vision but very unhappy about the glare and starbursts. I think I am more sensitive to light than others but it's hard to tell. I had a toric monofocal for distance implanted 4 days ago Nov 29)  in the other eye. I am having no problem with the symmetry issue. My doctor said this combination is not uncommon at all. I have 2015 in my second eye also, so far. I don't see a big difference in my vision between the two eyes, just a difference in the starbursts. The toric monofocal for distance is tempering the glare, etc from the symfony. 

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  • Posted

    I had a Tecnis toric monofocal implanted in my right eye almost 6 weeks ago.

    Be aware some of us take longer than others for the eye to heal and to get the best distance vision.

    Some get near 20/20 the next day, but I tested only about 20/40 the day after surgery.

    It improved very slowly and varied a lot for the next 2 weeks when it reached 20/25 some of the time.

    The most improvement I noticed didn't happen for me until nearly 4 weeks after surgery when I finally reached 20/20 and I've been between 20/15-20/25 for the last couple weeks mostly.

    So my advice is to wait at least a month after surgery before you may know where they eye's distance vision will settle.  I think my right eye is still healing and still may change a bit, especially the amount of residual astigmatism, over the next month or two.  I got an optometrist refraction eye exam at 4 weeks after surgery and the result was PLANO power (not nearsighted or farsighted) and about 1D cylinder astigmatism, the latter I believe has reduced over the last week and a half since the exam.

    Also be aware even with a toric monofocal you can still get slight night vision artifcats.  I notice outside on dark nights a half circle of light above some bright light sources, but thats only with my pupil at his largest size.  If I can look at say a flashlight for a second the pupil shrinks slightly and thats enough for the half circle artifacts to disappear.  I think it may be caused most likely by light scattering at the incision spot only noticeable when the pupil is large enough, and perhaps that will reduce and disappear eventually as the cornea heals more.

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    • Posted

      So you can read fine print with a monofocal AND see distance 20-20? That’s remarkable. Congratulations! Makes me want to get my Symfony exchanged for that. 
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    • Posted

      No I didn't say I could read fine print with my right eye. The toric monofocal is set for good distance vision. I am starting to get decent intermediate vision at 2 to 3 feet, but for nearer than that I need at least +1.25D or higher reading glasses. But it could still improve in this area over the coming months, its still early in the process.

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    • Posted

      Ok, when you said “I got an optometrist refraction eye exam at 4 weeks after surgery and the result was PLANO power (not nearsighted or farsighted) ”, I misunderstood. 

      Anyway, it’s still not too bad. I need -1 for distance +2.0 to read fine print with Symfony. 

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    • Posted

      Sunny I really don’t think you received typical results for Symfony.  Just came from my first optometrist check up since surgeries and for distance I have plano - right eye actually sees better than plano as I can read 20/15 line.   And although I can read tiny print J1 on snellen chart having +1.50 readers for extended periods of reading the optometrist said would be better.  

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    • Posted

      Thanks for sharing your experience, I'm planning on postponing the 2nd eye for at least a month, even if the vision comes in at 20/20 I think I would be happier with the overall combo of Symfony/monofocal than dual Symfony. 

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    • Posted

      Hey are you not getting a variety of range with your Symfony? Also your nighttime issues aren’t improving afterwards since the begginning of Initial surgery? What exactly are your problems with nighttime vision with the Symfony IOL lens?
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    • Posted

      No, I am not getting good range of vision. Only intermediate is good, near and distant need glasses. I see glare around anything bright and concentric circles. The only reason I can still drive is that with both eyes open, my other eye (unoperated, no cataract) can help cancel some glare and halos. With what I see with just symfony eye open, I would dare not drive. 
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