Monofocal Question

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A. For those who have a monofocal lens at what distance does your vision begin to be HD quality? I have Symfony in non-dominant eye. Currently bothered by the arc edge glare at night. Considering monofocal in the dominant.

B. Also how is the vision in low light?

Symfony gives me clear HD vision from around 20 inches out. This distance and overall vision in low light conditions will be worse somewhat.

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19 Replies

  • Posted

    I have monofocal lenses, set for distance, in both eyes (one was done 10/26 and another one 11/20). I don't know what you mean by "HD vision", but my vision is crystal clear in any light. I will get new glasses soon. Now using +1D glasses for computer and reading. Don't need glasses for watching TV.

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    • Posted

      Hi! I don't need glasses beyond 18-20 inches. I do need glasses to read and work on computer. But I am not a very good example because my right eye is still in the process of healing. It will be one month, on 12/20, since the surgery.

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  • Posted

    I have a monofocal lens in each eye for astigmatism. My surgeries were done with a Femto Laser. Each eye cost US $1,900. The lens is an Alcon AcrSof Model: SA60WF w/Power 21.0 D, Length: 13.0mm and Optic is 6.0mm, with UV. Customized one and my eyes were measured for them.

    My first surgery, left eye, was Oct 4th and other eye Oct 23 of this year. I also have the "black vertical arc" thing on the temporal side of each eye, but it doesn't appear all the time. My OD tells me that I have a pigmented retinal hole, with floater above hole and I'm seeing a retinal specialist for that later this month.

    As far as vision goes, only thing I need glasses (reading ones) for is looking at my iPhone and fairly small print. No glasses needed for driving or using our computer.

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    • Posted

      One other thing, my vision now, in my left eye, which was the very worst with a cataract, is 20/20 and the right eye is 20/25. Basically it's really amazing.......except for the arcs, that is.

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    • Posted

      Hi TRoper.

      The arcs are terrible. My biggest complaint. For SA60WF I would need power 16 for plano. I needed 16.5 for plano for Symfony. That makes me want to believe that I will not get the same good near vision as you. I would really like to know the Symfony diopter power for Sue.An and Phyllis who got great near with Symfony and for Andy and others with monofocal who got great near with Monofocal.

      Are you able to get customized larger IOLs? Like 7mm?

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  • Posted

    Soks,

    Although I have a multifocal, I am going to comment for you as my IOL (Restor 2.5D) has pretty much an identical defocus curve to the Acrysof Monofocals (until it approaches the near focal point).

    I have very clear vision from about 12ft to infinity. I would judge it as near perfect at distance. I do seem to be slightly over corrected and I sometimes wear a +0.5D contact lens which has no reduction in distance vision but improves my vision in the 8ft to 12ft range. This is what I would be getting with a monofocal.

    I'm mentioning this because I seem to have a relatively narrow field of sharp vision. Some people are able to gain what you are calling HD vision from a much closer point out to infinity than others. I've not read about a conclusive way to predict the range of vision in advance but experienced surgeons must have some idea based on your pupil size, axial length, and other criteria.

    Based on my results with eye #1, I can say conclusively that, when the time comes, I will NOT get a monofocal in my other eye. It will be either another low-add multifocal or an EDOF. I've been able to do a lot of tests now and usually wear a multifocal contact in my "good" eye. When I do this I am extremely happy with my vision. However, if I switch to a distance-only contact, then I can no longer read or work on the computer effectively. The out of focus vision in that eye is too much for the Restor eye to overcome and I'm sure I'd feel the same if I had a Symfony + monofocal.

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    • Posted

      hi Derek,

      Thanks for the reply. I would be a bit disappointed if my monofocal plan ended up with HD starting at 8 ft. 2+ surgeons told me that with Symfony I will get clear vision from about arms length and that is where I ended up with. The same surgeons said I would end up with 4 feet with monofocal but I think that was just a guess. I hold my fone about 10 inches at night before sleeping and I need +2.5 for Symfony eyeto see videos in HD at that distance. The other eye sees J1+ for now so I know what you mean by 'too much to overcome' but it still does pretty good job solo.

      The benefit of monofocal though will be that it will suppress a lot of halos from Symfony to almost negligible. Current the natural eye suppresses 70%+ of Symfony halos at night.

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    • Posted

      I know what you mean about the night driving. Those large rings are the only thing that kept me from getting a Symfony but I'm hoping that if I do get one in my second eye, the combination will reduce the effects of each lens (the large, fainter rings from the Symonfy and small, brighter halos from the Restor). It could end up being the opposite though, double the side effects.

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    • Posted

      Symfony halos bright halos and no concentric rings for light sources nearest to me. For example the next 2 street lights. Or the oncoming cars that are the nearest. My Symfony concentric rings are also not large they are quite moderately sized and not distracting. But I get lens edge glares (maybe I will get this for any type of IOL due to pupil size) which is one large circle.

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    • Posted

      So you are getting bright halos too? I thought that that was not common with Symfony?

      How large are they (the brighter halos)? With my IOL, the halos from something like an LED headlight are maybe 2X the diameter of the headlight which isn't large enough to impact my vision past the car itself.

      I know that if I went with a higher-add multifocal that the halos would get larger and I don't want that. Right now, I feel 100% safe driving at night and that's still very important at my age (51).

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    • Posted

      yes the halos are these and they are 2x or more than then the diameter. the closer the car the smaller the halo but more brighter. the farther the car the larger the halo but fainter.

      when k wear a +2.5 in the symfony eye the vision is clear only from 10 to 18 inches. everything else get blurried.

      i am 43 and also need safe night driving especially in winter months. i took the 2% brimodine tartrate drops today and the lens glare is gone even in dark. i will try driving and report back.

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    • Posted

      Hi Soks / Derek

      Unfortunately with most IOLs at 6mm I don't think type of lens will eliminate the arcs if caused by pupil dilating beyond the lens but your surgeon should be able to confirm that.

      After my 2nd surgery I asked for the wallet card I kept hearing about bit my surgeon said they only gave those put if only one surgery was needed so that years later when 2nd eye needed surgery they could match or complement that lens implanted with 1st surgery. I still wish I had it so I could give you the diopter used. If report went to my optometrist I could inquire in Jan when I see her.

      In reference to night driving I am perfectly at ease driving now. The concentric rings are actually very light - they are fainter the further away I am from the light source but also bigger.

      How did you find the driving after using the drops?

      Soks have you considered having Symfony targeted half a diopter nearer to get better near vision when time comes?

      I recall holding things further away after first surgery but it was much better after 2nd.

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    • Posted

      +0.5 glasses do not improve my near as much but worsens distance considerably so that may not work for me. also my unoperated eye is my dominant eye.

      driving glare is gone 70% too. side effect was a bit headache after taking the drops for a few minutes. but it seems to be a workable solution for now.

      my pupil may have been constricted for few days after surgery cause the vision with drops is like few days after surgery.

      prescribing surgeons says to use them for an year to permanently decrease pupil size.

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    • Posted

      That's interesting that the drops could have permanent effect after pronged use for a year on pupil size. I gather with glare reduced driving was more manageable? I wonder if that happens naturally as well with time. Glare was my worst side effect and took several months to diminish. Wondering if the surgery has an impact on pupils and if it takes several months for them to go back to pre-surgery condition.

      Soks have you tried a contact in your unoperated eye? I found glasses - even with one lens poked out less than optimal. In fact only distance I kept them on was computer distance - and even that the 2 eyes fought each other. For reading my unoperated eye took over as it was better seeing close for other distances symfony excelled. If it was going to be a long wait between surgeries I would have experimented with contacts lenses.

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    • Posted

      the drops reduced most glare. surprisingly even the concentric circles were more defined. night vision became very clear.

      the effect was supposed to last 6 to 8 hours. but even now 18 hours later my pupils are still constricted.

      i dont do well with contact lenses. i do have a prescription for them but i cannot get used to them.

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    • Posted

      In reading others experiences I think glasses cannot simulate what we want them to. Eyes need to work together and one operated eye with lens poked out or plano lens in it won't give you a plan for 2nd eye. Are you able to tolerate contacts even as a trial?

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    • Posted

      my eye gets dry with contacts pretty quick. i do have contacts for the unoperated eye but dont like them as my near gets compromised in addition to the contacts irritation.

      i dont need glasses for computers as both eye are good for that distance. symfony eye is good for distance but bad for near. unoperated eye is good for near but bad for distance.

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    • Posted

      i experienced the same after first operation. In fact the glasses would end up bothering me and I would wear them for computer mostly. When driving relied on symfony but didn't it did much reading ad unoperated eye took over. All changed after 2nd operation reading much improved. My surgeon only tested reading distance after that 2nd surgery.

      I still think glasses are much more difficult to cope with with one surgery.

      I had trouble with contacts too. Wore them most of my life but after birth of my daughter my eyes were too dry and contacts irritated them.

      I do hope you find a much better workable solution than I did.

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