My experience of the Symfony Toric lens

Hi Dani

Because of cataracts, my optician referred me to the local NHS trust. The Trust agreed to treat the cataracts but could only provide monofocal replacement lenses on the NHS. This meant that the astigmatism would not be treated, so I would have to continue wearing glasses. The NHS surgeon explained all this to me but said he would be able to treat the astigmatism privately - and had operated on over 100 private cases to date without complication.

I checked out the surgeon and the medical centre he saw his private patients in and all looked very positive. In the consultation before each op what took most time were the painstaking measurments of the eye and calculations used to select the appropriate Symfony Toric lens.

I felt no pain while the operation was being carried out (which lasted about 20 minutes for one eye). The injection to numb the eye was the most uncomfortable aspect. Had the surgeon not been updating me on his progress, I would have had no idea.

Having had many experiences at the dentist, I would choose eye surgery every time.

Best Wishes

 

Thank you

Am doing research on private hospitals and surgeon, all system sounds confusing.

Hopefully on Thursday I will know more about my options.

Am hoping for general anesthetic and I know they do it on NHS, but getting right lenses is probably possible on privately.

Have you done another eye.

For me dentist sound like holiday .

Both my eyes have Symfony Toric lenses - implanted about four weeks apart.

Is the shimmering you're talking about photopsia? I had that after my first (Tecnis monofocal in April '16). It went away. It looks like some lights at the edge of my vision. I kept thinking it was a piece of jewelry catching the light, so I referred to it as my "bling". It went away after a few weeks. (Google "photopsia" for more.) 

I've now had the Symfony implanted in my left eye, one week ago, and I'm seeing it again. I don't mind it; in fact, I sort of missed it when it went away! 

My near vision in the Symfony eye isn't so great either. I can just barely read an iPad in VERY bright light, like a doctor's waiting room (I discovered that while waiting at the dentist!) but elsewhere I have to use readers. Since I used to have a multifocal contact in that eye, I had a pair of readers made after my 2016 surgery that had different powers for each eye. You may find this a good option if your two eyes don't match up. 

I do have good distance and intermediate in the Symfony eye--better than the Tecnis monofocal eye. I hated losing that intermediate vision the most--not being able to see items in the refrigerator, for instance, really drove me crazy, post right eye surgery. That's why I convinced my doc to do the Symfony--I told him I much preferred having the multifocal contact that gave me intermediate vision, if not perfect reading vision, for which I need +2.5. 

Actually, it's called dysphotopsia after cataract surgery. Sorry about that. 

I know what you mean about the bling.  That has pretty much disappeared.  This shimmering is like you might experience if you were standing under a fan attached to a light.  It diminishes about 3 hours after using drops, and then I have about an hour of freedom before it returns after I use the drops again.  I have one more week of drops in right eye.  Hoping that will improve things.

Overall I am loving my symfony lenses.  With contacts I had very poor intermediate vision.  When I went shopping for groceries I would use my far vision to locate the cans of soup, and then I would have to put on reading glasses and get within 16" of the cans to read the labels so that I could pick what kind I wanted.  Very annoying!  I had begun to wear my glasses (with which I only had 20/60 vision due to cataracts) in the house so that I could function.  I am so glad the symfony lenses were available right when I was [url=file://\ready]ready for surgery.

I so glad you are pleased with the symfony lenses and hope your near vision improves. Before I had my operation my myopia was -12.50 (right) and -11.00 (left), astigmatism -6 (right) and -4 (left) so am very impressed to be walking around in my 70s largely free of glasses after so many years. I've not experienced the shimmering effect you have, but I am easily dazzled by bright light. 

Hi Patricia - sounds like you and I had the Symfony lens implanted same time. I had my op on July 10.. my other eye also has a cataract and that op will be later in Aug. so far distance and intermediate vision are good. My near I have to hold things 16 or 18 inches out. My surgeon did say I may want or need readers for closer than that.

What brand of drops do you use? I live in Canada and was given Prednisolone and Zymar. Perhaps another brand would be better? I also use Systane drops instead of Refresh for in between times.

How is your night vision. Are you able to drive? I have just started going outside in evenings. Right now with summer goes t get dark till 9:30pm.

My drops are Prednisolone and Bromfenac.  I also use Systane for dryness.  Three more days and than I am done with drops in the first eye and down to two times a day in the other eye.

I haven't tried driving at night, mainly because I haven't had anywhere I had to go!  I'll let you know when I try it.

I have been experimenting with readers to try to find the right strength.  Right now 1.25 seems the most comfortable.

I have popped the lens out on a pair of glasses and making do. Once other eye is done ( likely going with another Symfony) will see how reading goes. Been near sighted since 12 so this new distance for reading at 18 inches is strange. I can still read close but it's non operated eye that is doing reading.

Like you figured I would have use of premium lenses for a while.

I was away of downside of halo glare and circles at night. Hoping to adapt with time.

Hey Sue, how is the night vision with the Symfony IOL lens? That's my biggest concern because I'm not sure I would be able to handle bad night time visuals with lights/artifacts.. I'm only 26 and have to get my left eye operated soon and have to choose between monofocal and Symfony... it's a very difficult decision for me because I am still a bit young.

I went outside tonight and discovered I have halos with each eye and with both together.  I watched cars going by on our street and I think I could probably drive okay in areas where I meet an occasional car.  I think I would have difficulty driving on a major highway or in city traffic at night.  I understand that there are glasses (sort of like sun glasses) especially for night driving that reduce halos and glare.  I am going to look into them.

It is a difficult decision.  The difficulty is that everyone responds differently to the surgery and the lenses, so that no one, not even your doctor, can predict what side effects you might have.  That is true of all lenses, not just Symfony.  You haven't said how your vision is now or whether you are having the second eye done later.  If you are only having one eye done, a consideration would be how you will balance out your vision in that eye. 

At 26 you are very young to have to have cataract removal. It is a difficult decision - one I really struggled with. I am 53 and really didn't want either compromise with IOL lens selection . The younger you are having this surgery the bigger the compromise. At the standard age of having this surgery you end up gaining something with your vision. The younger you are you have to make a compromise. I used a spreadsheet of pros and cons and there are some good questions helping you sort out what is important to you in terms of lifestyle. For me given I will be working another 10 yrs min have a child I decided I would like good daytime vision. I could also read without glasses but had worn glasses for distance since I was 12 (although not a high prescription). In the end given what I was currently used to vision wise I thought it would be more of a shock and adjustment to lose my ability to see near and intermediate. Plus I work on a computer 89% if my day.

Some people will opt for monovision or mini monovision where one eye is set for best distance and the other for intermediate. This is done using monofocal standard lenses. I didn't get a chance to try that out with contact lenses prior to cataracts. This may be an option for you to consider.

Night time vision i am only just discovering . In Canada where I live it is light out till 9:30. But I have gone for walks and driven short distances locally. There is a glare around streetlights but these aren't extending wide so not bothersome. Neither are porch lights. Oncoming cars (which were a big problem prior to cataract surgery are still troublesome now with one eye operated on although I have better contrast vision . Some of the newer LED lights are the worst but my husband who doesn't have cataracts finds them blinding too. Last week we had to drive a couple of hours on a dark highway back from my child's soccer match and thinking due to lack of overhead lighting the taillights in front of me had the concentric circles a lot of people notice with Symfony lenses. They were red - which is why I am figuring they were from the taillights. And they extend quite wide - beyond the car. Closer you get to car in front more they diminished. But you see through them oddly enough. It's like watching a movie where FBI or CIA are writing on a glass wall in a war room and although you read the lettering you see what the view behind glass. Hard to fully explain.

I am only 3 weeks tomorrow out from surgery so perhaps I adjust and adapt or these diminish. I will have 2nd eye done later next month. I could choose another lens to minimize this effect but then again I really like the seamless view during daylight and as the years go by I will likely do less driving at night.

I have also read that the younger you are the more your pupils dialate so these visuals have something to do with that too.

I wish you all the best as you go through this process. What is hard is no one will tell you what to do - not even a surgeon as everyone's eyes are unique and you can't test drive these lenses. Hopefully someday. Be wary of any surgeon that hard sells anything. Good luck.

Yes I read there are night driving glasses and also drops to constrict your pupils. Might try the glasses. Going to do some research. Thought I had read somewhere on these forums or a blog from someone in U.K. That had tried these but didn't experience a big difference.

In my case I am not too bad local driving (albeit have not driven too much since surgery at night). I found it worse on a dark highway with no overhead lighting for the concentric circles and glare from oncoming car headlights.

Yesterday was my first trip out for a longer daytime drive to the beach. It was good to be able to read road signs again.

I tried switching the order in which I put in the drops this morning and what do you know -- no shimmering!

Also, in the last two days I have noticed that my near vision in the left eye is starting to get better.  Since I am only 1 1/2 weeks out on that eye, I believe that it will be okay.

I noticed that the halos on lights are better than they were initially after surgery, but they are still there.  I am hoping that eventually they will diminish as well.  I have read that your vision can continue to change up to 3 months after surgery.  Some doctors don't recommend getting fitted with glasses until then, so while it would be great to have perfect vision immediately, it seems that we need to be patient and give our bodies/brains time to adapt.  Not easy to do!

Just wanted to add for anyone who is reading this thread, my surgeon told me that the human lens in 4 mm thick, and the symfony lens is only 1 mm thick, so there is empty space in the capsula pouch and the lens can move front and back for a little while after surgery till it settles in and that can affect your vision and side effects for a while.

I agree.

For your drops are you waiting minimum 5 minutes between drops? I think my schedule might be different too. I started with both drops 4 times a day 2 days prior to surgery. I stopped the antibiotic stop one week after surgery. And now on Prednisolone drop just twice a day. Tomorrow is actually 3rd week since operation and last day of drops.

I likely will continue with Systane drops for some time. I also take a capsule of flaxseed oil every day. Really helps with dry eye as well.

I did not know that. Very interesting.

Indeed, good quality omega 3 capsules can help with dry eye - thats one of the things an optometrist dry eye specialist I went to a few years back highly recommended.  I take  a couple high quality Omega 3 capsules a day over 2000mg.

She also recommended using a microwave heated pad on the eyelids once a day for a few minutes as well as lubricating eye drops - she recommended the NanoTears brand over others and I find its a good value from amazon, thicker than Refresh and others but doesn't cause blurry eyes.

I rarely had dry eye symptoms I could feel in the eyes (stinging, grittiness, etc) unless the air was extremely dry. However I did have some eye redness that seems to be reduced quite a bit using all the above.  Mostly the eye doctors when they look at my eyes always commented they look very dry, and it was enough to interfere with when they take cornea measurements for cataract surgery. So I took all that above, mostly for that reason.

While Omega 3 supplements may be “natural” products (albeit in a processed form), this does not mean they are safe or suitable for everyone. If you are thinking about taking such supplements and have existing medical conditions I would recommend that you talk to your doctor first.

A pharmacist is a good person to ask as well. Believe it or not I find them

More knowledgeable than GP / family doctor when it comes to drug / supplement interactions. I had inquire with them re: flaxseed oil as it was suggested to me by a natural path for my eczema. Turns out it's great for dry eye too. Thankful it hasn't been much of a concern. But since I have been in flaxseed since April it helped prepare my eye who knows. Certainly didn't do me any harm.

I also get ground flaxseed from the local natural foods market and put some on my breakfast cereal everyday.

Not sure if it's flaxseed or not. But I haven't had many issues with dry eye

Did get a bruise though come out under my eye. First thought it was dirt. I would have thought bruise would come out over the eye. I have had soreness like a bruise. With my doctor away I couldn't have it checked. Only check was day after surgery. But vision has been stable . Sometimes experience like something is in my eye or a pressure (usually end of day but haven't felt that in last 2 days. This is last day of Prednisolone drops so hoping inflammation is all gone.

Would you know if it's safe to continue that beyond 3 week mark?

My doctor prescribed Prednisolone drops 4 times a day the first week, 3 times a day the second week, 2 times a day the third week, and 1 time a day the 4th week.  Prednisolone is like prednisone in that you can not just quit it, but you have to wean yourself off of it.  If you are down to 1 drop a day, it probably would be okay to continue that for another week.  In week 2 I felt pressure like that (usually end of the day) and my doctor told me I had a bit of swelling yet.  He told me to continue with the Prednisolone as prescribed and if it wasn't better by the time I was done with the drops, I was to call him.  However, by week 3 it had gone away.  I would suggest calling your doc to ask about continuing the drops.

I could call pharmacy to ask. My surgeon is on vacation. Could try his office but he said if I had any problems to call or go to hospital which I don't think this warrants a visit there. My regiment for drops was both drops 4 x a day first week then for 2 weeks after that just Prednisolone drop 9am and 9pm then stop.

This is exactly 3 weeks now. Last 2 days haven't felt that pressure. Hoping doesn't come back. Perhaps I will call to see if I could do 1 drop a day for another 3 days

Myopic writer do you have any night time problems with the Symfony? Regarding bright lights

Sorry, just now seeing this. I had my follow up yesterday (almost two months since surgery). 

My vision is 20/25 in each eye--right eye is Tecnis and left eye is Symfony. I do see halos with the Symfony--it's like a light, with a filmy shadow of light surrounding it. But I hadn't noticed, since the Tecnis doesn't have that problem, and it's in the eye I use for distance. I inadvertently stumbled upon an ideal solution, due to the fact my surgeries were 16 months apart, and in the meantime the Symfony had become available. (Ironically, I lived in Europe when I was first diagnosed, and it has been available there for longer.) 

I can't see to read, except rather poorly at arm's length. Not at all in a reasonable distance, so menus, labels, etc. all require reading glasses. But I definitely have more intermediate vision with the Symfony lens, enough so that if I open a cabinet, I can see what a label says. 

My Symfony eye takes over for intermediate vision, enabling me to see pretty well, and my Tecnis eye handles most of the distance. Last night I drove for about 30 minutes. I still don't feel entirely comfortable, using my bright lights when there is no oncoming traffic, but that is mainly due to the fact I rarely drive at night. Oncoming lights don't bother me, since I mainly don't process them with the eye that is "working" for distance. 

I told all this to my doc--I was his first Symfony patient, his "patient zero", so he took lots of notes. I imagine he will suggest this to any other patients who happen to be in my situation. (It's a military hospital, so he sees a different variety of patients than a cataract-only specialist.) As for paying extra for the Symfony--I would weigh your desire for intermediate vision (you don't realize how important it is until you lose it) with the possibility that it may not help your near (reading) vision at all, and it will likely cause halos at night. I didn't have to pay extra, so all in all, I am better off than if I had two Tecnis lenses. 

Now I just need to work on the dry eye problem, and I'll be set! (I wonder if that's the reason for the 20/25 vision I'm getting instead of 20/20?)

It is interesting that you aren't getting any near vision with Symfony.  I am 10 and 4 weeks out now from surgeries.  Have an appointment on Sept 28 and curious about my vision results.   I honestly haven't needed glasses at all since 2nd surgery performed on Aug 21.  From 12 inches out I read just fine.  The other day needed to read off phone number on back my credit card and had no problem reading it.  Same with modem at neighbor's house to type in my iPhone their Bell FibrOp password.

Computer distance and driving distance are all fine too.  If I didn't have any glare and halos with night vision these would be perfect.   Find same as you with well lit areas can drive fine.  In the dark - oncoming car headlights very bothersome.

One thing I recall my surgeon saying though was with Symfony they work better with both eyes.  My reading was never tested like distance at post op after first surgery - only 2nd and I had to hold phone either 6 inches away so that unoperated eye could read or way out arms length for Symfony eye.  Now I feel at more normal distance of about 11 inches out.

I will be interested at next visit to see if my eyes achieved target at 0D or if off which gave me better near vision.

Sounds though you likely have less night symptoms than I do with Technis monofocal in one eye combined with Symfony?

Sorry another question - at your 2 month check up did they test your reading or offer any reason why Symfony not giving you better reading?

Hmm, I wonder if I'd have better reading vision with two Symfony instead of one? Can you see near if you cover one eye? Or only when they work together? I do notice that when I cover Tecnis eye, it takes a few seconds for my eye to adjust to see to read at arms' length. I have wondered if I could train that eye to get better at reading closeup.

Maybe it's a tradeoff--I have very little halo issues, since I compensate with the Tecnis monofocal, but I gave up reading vision? That would require further study, I think.

Wow just tried that experiment- covering one eye then next and trying to read your last message.  I had to go back to holding iPhone out as far as my arm could extend to read it!!!   Very blurry when I held iPhone to distance I use with both eyes open.  And another interesting find - the contrast is different too.  Lettering not black - more grey.  How odd!

No, he only informally tested my vision by holding out a paper, which I could make out pretty well at a distance--except for the smaller print. 

And he didn't speculate on why, I guess since I was his first Symfony patient. Will be interesting to get more feedback as the lens becomes more commonly used. 

Oh wow. Thanks for reporting back. I now wonder if that's why I don't have better reading? I also wonder--would having a multifocal contact in the Tecnis eye improve things? When I go to the optometrist I will ask about that, though she hadn't had any patients with the Symfony either, so she might not have any idea. 

Yes I guess a trade-off.  My earlier posts prior to any surgery or lens decision I said this was like the game 'would you rather....' and neither option ideal.  Night vision or reading...

I think if I were older and retired I would have gone with monofocals (which may mean I regret my trade-off some day).  However it has been great to work with computer and spreadsheets with no issues.  One of my colleagues commented how close even with glasses I would lean over close to my computer to read the screen and how now I sit back in my chair.

This is something each person has to decide for themselves and not base the decision on someone else's choice.  Nice to share and compare but only you know what you'll want to live with.

Maybe worth trying out a MF contact.  It isn't permanent and most places allow you to have free trials.  

Definitely, it's each to his own. For me, giving up intermediate vision was the worst. Others might not be bothered, and it does depend on your stage of life. Younger cataract patients have different needs, and will live with their new eyes for a long time! 

Yes agree.  For now longer road trips at night - my husband does the driving - lol.  I told him he can choose different lenses when it's his turn.  With him in his 50's hopefully better options available then.

Let me know how MF contact works if you end of trying it.

I am retired and I discovered that I spend a lot of time using intermediate vision, needed for things like gardening, computer work, baking, crocheting, etc., which I didn't have with my contacts.  I started wearing my regular glasses all of the time except when I went out, and then I had to wear reading glasses for menus, shopping, etc.  Not what I wanted, so when I had my first appointment with the surgeon I told him that I was okay with reading glasses but I MUST have good intermediate vision.  He suggested the symphony and I am very pleased.  My far vision is sharp, and I can read if I hold things at arm's length, but the thing I most love about the symphony lenses is my wonderful intermediate vision!  

Me too!  I have Symfony targeted for plano both eyes (see surgeon on 27th so will know then what was achieved).  I haven't worn glasses (except regular sunglasses) for 4 weeks!  Not only can I see distance to drive and have intermediate for computer but my near isn't too bad.  Can read iPhone, newspapers, ingredients, serial numbers - haven't once struggled).  

Just thrilled with my new vision.

I have night issues with driving in the dark.  How is your. Igbo vision?  Do you get glare and halos and see concentric circles around lights (like car brakes)?

This is why I'm pretty scared of taking the plunge and finalizing my choice... I'm only 26 years old and have to get my left eye fixed soon because that cataract is severe and blinds my vision (right eye have a cataract there as well but it's mild) Like Sue.An said, it's an intense game of would you rather.... I keep hypothesizing the different outcomes/scenarios of my possible different IOL lens choices. Monofocal set for distance? Or distance but shoot for slightly nearer, monovision/or mini-monovision if or when I eventually do right eye as well; or just go for equal powers in both eyes. Or Symfony IOL and deal possibility of night time side effects. Reading everybody's comments on the forums makes my decision even more so difficult but they are very helpful. regardless of what I choose I know my vision would be significantly better for that left eye, it's just that i am driving myself crazy about what to do. 

Must be really tough given your age.  Is your other eye fine - no cataract forming?

Something my surgeon discussed with me is the younger you are the more night vision  issues you'll have due to fact younger eyes dialate more.  

If I hadn't needed both eyes done (20/70 right and 20/60 left) I may have chosen differently.

I would assume driving is more important to you st night than myself and I also have my husband that does the driving.  

Just my thoughts - if your other eye had not hint of a cataract you'll have great vision near intermediate and far in that eye for years.  You might not to risk night vision issues and decide on a good monofocal for distance and rely on other eye for rest.  Years down the road there may be  a lens that is better without night vision issues for the other eye.

Do sympathize as the younger you are the more difficult this decision.

Sometimes I had to comfort myself with the fact that years ago people did go blind and lived with very poor vision.

Aside from night glare etc I see very well in day and have resumed everything I used to do - more .  Can't wait to go snorkelling in Caribbean this Jan and SEE.  Used to have a better view watching it all on playback on my  GoPro.  

One thing for sure afterwards you'll get on with the living again.  It is just this period of deciding that is the worst.  Hang in there!

I do have some glare and halos at night but they have continued to diminish over the last 2 months.  I don't know if they will ever go away completely but I don't have any problem driving.  I had terrible night vision before surgery.  I don't know whether it was the cataracts or just age, but it is certainly better than it was.

 

How long have you had the Symfony lenses?   Hoping with time mine too then will diminish.

I drove myself crazy too trying to decide.   I decided on the sympfony because that was my only chance to have the full range of vision -- far, intermediate, and near--as opposed to only having one, such as far or near.  Fortunately I did get it all so I do not have to wear glasses at all except for reading small print.  The issue is that we can all tell you our experiences but there is no way to predict how YOUR eyes will respond.  All you can do is decide which parts of your vision are the most important to you and choose the type of lens that will give you the best vision in those areas.  Unfortunately the technology is just not yet able to give you a guarantee of perfection.  Best wishes for your success.

I'm thankful for your sound advice, it is indeed a very stressful time right now for me and I do understand that sometimes other people just have bad luck and end up with even worst circumstances. I guess I am fortunate that I live in a time where I still do have options and they are pretty decent.

As of my right eye, I do have a small cataract in that eye as well, but it's not as severe as my left which completely impairs my sight (it's extremely cloudy in left eye I can not see my hand when I wave it in front just staring with left eye). Although I am starting to Notice my right eye is starting to deteriorate in sharpness of vision especially at far distances. And also as of now, I'm also getting bad halos/flaring/starbursts in the right eye at night making it difficult around bright lights.

My biggest concern is that going with a monofocal IOL I might lose my intermediate range and worried how my near is going to end up. I'm preparing myself to expect that everything would be blurry 2 feet inwards which is kind of scary.  and also need different multiple prescriptions of glasses. I am pretty sure that bifocal/progressive glasses is a no go for me because I would just get annoyed from different viewing strengths in my field of sight. Reading posts here it does make things really complicated worrying about prescription glasses at different distances especially for seeing near/intermediate. With some people saying that different powers in IOL and prescription glasses changes the size of shapes which Make me not want to go with any differences in both eyes. Having them be = the same so to speak. If if I have good distance/intermediate and need glasses for near with monofocal I think I would be fine. My surgeon recommended aiming for distance with shooting slightly nearer for my left eye so hopefully I won't lose that range. But I may need to wear distance glasses.. along with readers for up close 

With the Symfony I would be really happy if I got similar results like yours in that you can see great distance to near. That in itself is very useful for me because It would help with playing sports and mountain biking. I am already experiencing pretty significant halos/starbursts in both eyes right now so I may be used to the Symfony IOL if I do get that implanted. And I do really like the Symfony a lot because i know I'm going to be working on a computer/desktop for my career and from everything that I am hearing that's where Symfony excels at. I want to eventually become a digital artist and seeing that detail without glasses seems great. Although I'm a bit worried about viewing light/dark contrast environments/concept when viewing detail work on a computer. I know some people mentioned that they see slight highlights around white/black pictures etc. with the Symfony.. I think one said their was glow around white lettering in black background on the tv screens. If monofocal might be sharper in that factor than the Symfony in those circumstances than I may choose monofocal. But I was wondering  how your experience is in that setting? 

I know I can't have everything when choosing IOL options. And that perfection doesn't exist. That There are trade offs with everything. And i know nobody can make the choice for me as I am the one that will have to live with the results, I just want to make a right choice that I'd be happy and at peace with.

Miguel - if you do end up selecting Symfony lenses find a surgeon that has a lot of experience implanting these.  I had one that had lots and I haven't had to have any tweakings since.  Exactly what he described as outcome had been spot on in my experience.  

Regarding white lettering on dark background.  I see a very slight shadow or highlight around the white lettering when it is in a distance like TV or PVR clock.  When that is closer like iPhone tablet or computer I see no highlight.  Vision is sharp.  And with more distance it is very slight - not ghosting where one would see double or that I cannot see time or read the words.

Yes before surgery I had awful time with night glare and halos in some respects worse than what I have with Symfony.  I definitely have a lot more contrast at night after cataract surgery so driving around at night definitely easier now than when I had cataracts.  Especially in rain which was the worst.  However when there is no streetlights a car with those new LED headlights are blinding- although my husband said he finds them hard too and he doesn't have cataracts.

With your 2nd eye eventually needing surgery I can understand your anxiety about losing near vision 2 feet in.  There are a lot on this forum that like mini monovision with monofocals to give you more near vision with monofocals.  Hopefully more will post and give you their perspective.

One thing I learned just today.  I found it surprising that I got better near vision once 2nd Symfony was implanted.  I tried closing one eye and then the other today to read a text and found it more difficult- had to hold it out further.  So I find Symfony for near vision works much better if both eyes done with that lens.

Something to keep in mind - I think due to your age you'll adapt to whatever the outcome is and you'll find you can function either way.

Although most surgeons don't like to do a lens exchange it is possible - so if you find yourself unable to cope after a few months you can go that route too.

One more thing some on this site say a monofocal will provide distance and intermediate- perhaps some brands are better than others in that regard.

We are all wishing you the best.  

Thanks to all for posting your latest experiences!

I'm planning on a Tecnics monofocal toric IOL for my first eye (dominant right) set for good distance vision, but in the future for my left eye I'm going to consider either a Symfony toric or another Tecnis monofocal toric depending on the results I get with the right eye.

Only my right eye has a cataract that affects my vision, so the left eye could wait for several years if necessary I could use a contact until then in that eye.

I do a lot of computer work, so intermediate vision along with distance vision is my priority.  Would be nice to have near reading vision too, but thats lower priority to the others for me.

I am discovering new things each day.  Someone earlier asked me to check my reading with one eye closed and then both eyes open.  I definitely have to hold book or phone further out to read with either eye closed.  That was a surprise.  It would be interesting to see for those with one eye done with Symfony how much near vision they have (unless targeted for closer - both mine were targeted for plano).

Tonight just finished my nighy walk with friend who doesn't have cataracts and wears small prescription for glasses (distance only) and doesn't wear them for walking.  I asked what halo or glare she sees from approaching car headlights and it appears it is same as I see.  I would ask how far the glare extends and both of us described same size of glare and the fact if a person were standing beside the cat we would likely not notice.  Also streetlights in the distance for me have slight halo around them (no conentric circles with streetlights) whereas due to her eyes needing glasses for distance and not wearing them those distance streetlights had big glare/glare.  The streetlights closer to us for me had a glare around them (not huge though) and she saw those with the slight halo like I saw for distant streetlights.

So wondering if everyone sees a certain amount of glare/flare with headlights and it is only the concentric circles I see around brake lights or amber turning signals that's a result of the Symfony lens.  Some porch lights do as well (LED ones).  The circles although odd and obviously due to lens design aren't bothersome.  They are translucent.  Almost like movies where there is a glass wall someone is writing on and you see everything going on behind it.  It really is strange.  

I had night driving issues with cataracts and never really liked night driving anyways due to glare that I could be attributing more to the lenses than what is normal.  Something I will continue to research.

I've heard the glare from oncoming headlights bothering people is very common even without cataracts or IOLs, especially with the newer type lights in cars.

When you compare your Symfony eyes individually for near vision, is one eye any better than the other or about the same individually?  About how far away can you read a smartphone comfortably with only one of your Symfony eyes?

I see my surgeon on 28th so will get more precise information.

I seem to see about equal with and about same distance when I close one eye.  Might be just a tiny bit sharper in right eye but it had been 12 weeks since surgery in that eye as opposed to 4 in other.   I would say iPhone has to be pushed out 5 or 6 inches more to read with just one eye -  closer words start to blur whereas with both eyes open iPhone can be brought closer before words start to blur.  Not a big deal on iPhone however with smaller print it makes a difference.  

Yesterday could read fine print on back of credit card and serial number off Bell FibrOp modem.  

Also at grocery stores can read can

labels fine - ingredients too. Something I did not think I would be able to do without cheaters.

I will be really curious on 28th to find out just where my vision is.  

Do you think it is possible the OD target my surgeon aimed for wasn't achieved and that accounts for my close vision?   I was able to read with 1st operated eyebat 6 weeks (day after 2nd eye was done) the 20/20 line but not sure that means OD achieved or not.  

I am compiling a list of questions for my check up on 28th.  

This is my first entry; I was reading to check on these starbursts that I am having....was wondering if anyone else had same problem.  Sure enough, it seems to be a  trend.  Since I had my first eye "done" four weeks ago (with Symfony Toric lens)  and the second eye (Symfony lens, no astigmatism correction due to tiny amount of astigmatism), two weeks ago, I need to relax and see if some of this dissipates.  My husband cannot drive so I am the chief driver day and night.  I am VERY careful, but I find the starbursts are preventing me from being certain about the distance an oncoming car might be from me as well as how fast he might be driving.  Also, the starbursts are so large, I cannot always see the median, and if I am turning left, well....I jumped the median once!  Prior to having cataracts removed, I didn't have that problem.  

The pros?   I have fantastic near, intermediate and distance vision.  Amazing.  No more hunting for my reading glasses.   I can even read the telephone book (if I needed to...)  When playing the piano, no more trying to focus on the music and then hunt for the keys on the piano.  I can read the unit prices at the grocery store, and they are small.  My distance vision is very good.  I can pass the Texas driver's license test according to both my optometrist and the surgeon.  20/20.  All in all I am very pleased.

My surgeon did give me good advice that might help you Miguel.  He said that in the past anyone who drove for a living - i.e. taxi driver, truck driver, etc. would be fitted with the normal (whatever that is) lens so that they would have the best distance vision possible.  BUT, he said, this Symfony lens is a game changer.  People in the UK have been raving about it and very pleased with results.  My surgeon said I would have halos, but he didn't say a word about starbursts.  I think only a few people seem to have them.

Also, my optometrist had just had a cataract removed the week before I saw him and Symfony lens implanted in that eye when I went to see him.  He was due to have the next eye done the very next week., and he was so pleased with the results that he was eager to have second eye done.

I quizzed him unmercifully.  I mean, if the OPTOMETRIST trusted this particular surgeon, then perhaps, I, too, should trust him.

Two questions you need to ask your surgeon:  HOW many of these Symfony lenses have you implanted?  How many cataract surgeries have you done?  The more, the better!!!!!  Actually with any surgery, you should ask that question.  I think the surgeon has more to do with the results than the other participants have indicated.

As for my optometrist?  He does not have starbursts...although he does have little halos around the tail lights at night.  For me that is almost insignificant.  I'm hoping the starbursts go away.  If they don't, and I feel uncomfortable driving at night, I guess I'll just get a taxi or not drive at night.  Right now, I can handle it by concentrating on what I am doing and not on what is going on around me.

Best of luck in your decision.  I totally understand as I was terrified of making the wrong decision....and I'm 76 years young.  I'm typing with no glasses!  And, I could be doing this on the iPhone with no glasses.  Truly amazing.  

 

Also, Miguel, since you are so young, I would procrastinate about having the surgery done if you can.  So much progress is being done that you might find some of the current problems will be eliminated in time.  If I had had my cataracts removed a year ago when my optometrist suggested that I do so, I would never have chosen the Symfony as I don't think I would have even known about it.  After all, the Symfony lens was only approved in May, 2016 in US.  I probably would have chosen the basic lens.  Am so happy to see close-up, intermediate and distance.  Make SURE you have a great surgeon!

If you could read the 20/20 line at 20feet that eye must be fairly close to 0D, could be a little off but not much to achieve that.  Would be interesting to know if you can actually see better than 20/20 at distance, like 20/15.  From the defocus graph I've seen on the Tecnics Symfony webpage, you would probably have to be down to -0.5 or more to get worse than 20/20 distance vision unless the eye had other issues.

So if you are getting 20/20 (or better) distance vision and still get excellent near vision you are doing very well indeed.  Both eyes working together should improve vision at all distances, sounds like from your description you get better contrast sensitivity (gray vs black) with both eyes compared to one eye.

In my own case, my right dominant eye in addition to the cataract has mild glaucoma which can reduce contrast sensitivity in that eye a bit, so all the eye surgeons I've talked to have recommended only a monofocal IOL in that eye because all other types of IOLs including Symfony will reduce contrast sensitivity somewhat and I can't risk that in that eye.  However my left eye has no such issues, so I could go with a Symfony in that eye in the future, but sounds like I wouldn't get the best possible vision with it in only one eye from your experience. However even with only one Symfony eye I would suspect that eye alone could still get a larger focus range than a monofocal.

I will wait until my right eye is done with a good monofocal toric IOL that should give the best possible distance vision with best possible contrast sensitivity and then judge based on its result after a month or more to decide further on my left eye. I've got plenty of time for the left eye since it only has an early stage cataract that hasn't affected its vision yet, but I would still need correction for the -2D cylinder astigmatism in that eye with a contact lens probably since eyeglasses might be difficult to use if the right eye gets corrected well to near 0D and astigmatism nearly eliminated. I really just desire good distance and intermediate vision (for computer and a large smartphone use) and if I only need glasses for reading closer than 20" or so, that would be OK.  Might be able to achieve that with simple mini-monovision using monofocal IOLs and not risk the night vision issues  of a Symfony IOL.  But having more and more experiences reported of people who got the Symfony IOL would be great!

Nice to hear another success story.  I think you'll likely see some improvement with starbursts overcoming months if it's only been 2 weeks. Do you see the concentric circles around circtain types of lights?  These are lighter and more like a spider web.  I am 12 weeks and 4 weeks past my surgery with Symfony lenses and I did see a glare (or starburst ) but now that those subsided see more of the conentric circles.  I find night driving fine as long as there are streetlights overhead.  More bothersome on dark roads with the glare from oncoming cars.  Have to look away to my right (in Canada - likely to your left in U.K.).

I too have wry good vision in the day and inside (lights are no trouble inside home or other buildings) at all ranges.  I haven't worn glasses in 4 weeks and loving it.

Could not agree with you more about finding the right surgeon who believes in and done lots of surgeries using Symfony lenses.  They may not be the lens for those who have to drive a lot at night.

Miguel something I should mention.  Are you able to chat with your surgeon's prior patients?  I was able to chat with a few of mine and found that helpful in making my decision

Ok - hopefully at the surgeon's office they test line below 20/20 . At post op it was done at the hospital and they are seeing us cataract patients one after the other so don't spend a lot of time.  I suspect if target of 20/20 achieved 'good is good enough.'

Yes choose a good monofocal- some of the reading I have done suggests they are not all equal.  Some materials used are more susceptible to glistenings (hadn't heard of that till just this week). It doesn't appear to affect daytime vision but does for nighttime vision - and affects contrast sensitivity.  Glistenings is not like PCO where it can be fixed by YAG.  There really is no fix for it and if it gets bad enough people undergo a lens exchange.  I think that apply to all lenses not just monofocals.  Anyways might be worth looking into.

Yes I read about the glistenings, that appears to be an issue with the Alcon brand of IOLs, whereas the Tecnis IOLs (includes monfocals and the Symfony) don't have them.  Tecnis also claims their IOLs have great contrast sensitivity, so thats why I want a Tecnis IOL.  The first eye surgeon I consulted with only did the Alcon for monofocal torics, so I went elsewhere. Now I've found a surgeon that specializes with the Tecnics IOLs including the Symfony and seems willing to mix them too which the other surgeons would not do.  From what I've read the glistenings issue comes into play some years after surgery, it builds up slowly. I want an IOL that can last for decades since I could live for another 30+ years if I live as long as my parents did...

Some years ago I downloaded an eye chart PDF file that I printed out at full size and keep on a wall to easily check my distance vision from 20feet at home.  It goes from 20/50 at the top to well blow 20/20 lines at the bottom (20/15, 20/12, 20/10) - though checking now most downloadable eye charts seem to stop at 20/20, but there are probably some available since I got one a few years ago.  Don't have to wait to have an eye doctor test your distance vision with a chart at home.

Thought I would share something I had read about online as a tip for dealing with night glare/starburst driving at night.  Seemed an odd solution but I gave it a go and found it did help a bit.

On dark roads turn your car's interior dome light on.  I had my daughter as a passenger and she would turn the light on for a few minutes and then turn off for me to compare.  It did seem to help me see better - thinking this prevents eyes from dismay as much in dark.

The last time I was on these dark roads was 3 weeks ago - a week after 2nd Symfony implanted and it was a frightening drive.  Did much better this time.  Now to be honest been noticing some changes on night vision.  The starbursts/glare have calmed down a bit and because they aren't as intense I see the concentric circles more (my guess anyways).   So hopi g night vision continues to get better.  Although this was just a 20 min drive in the dark I was a lot more calm.

Thanks going to see if I can find a chart and test out myself.  I do suspect I can see at 20/15 in first operated eye.  At post op on 2nd surgery which was 6 week mark for 1st eye the hospital tested it and I could read line below even though not asked.  2nd eye missed 3 letters on 20/20 line but I had missed letters at post op 1st around too.  It was still awesome to see even 24 hours after surgery.

Glad you know about the glistenings.  Some can experience them within weeks of surgery but they can get worse over the years.  It would be to me a real disappointment to trade up opportunity for vision a multifocal would offer only to get night vision issues with monofocals anyways.

Good to know Technis will stand the test of time as I may have 50 years with them.   

So glad your surgeon has e perience with many lenses and doesn't just have a limited offering.  Kind of a testament to their skill in my opinion.

I'm curious.....facing surgery on Wednesday. What did you go with for lens'?

I'm young, too. Drive for a living. Very worried about. Ugh this vision issues, but I have them already with cataracts. 

I've just stumbled upon this board.  I hope your surgery went well by now. How did it go? What did you choose?

*worried about night vision issues. As you can tell....I can't see well enough to double check the auto correct. 

Hey Caroline,

I actually have not gotten the surgery yet as I find myself bouncing back and forth between the IOL lens options. i do plan on getting it done very soon in the near future, but It's incredibly difficult choice and I have been visiting with opthamologist/surgeon that will be doing my cataract operation for the past several months.

 He is strongly suggesting that I stick with a basic monofocal IOL lens because of the nature of my cataract in my left eye- Which has now grown really dense and cloudy white as of now. He is also saying the monofocal is a lot more "safer" in has less associated risks with things that may end up offset compared with the Symfony IOL, although he did say he would implant a Symfony if that's what I really wanted. I'm a bit upset because at first he was recommending a toric IOL lens and now he is saying he wouldn't recommend that anymore because my cataract is going to make it difficult to get accuracte measurements because apparently It has become too cloudy/dense. He never told me that before. But regardless is saying the Symfony is an option. 

What are you thinking about choosing for you & your cataract surgery? I think with monofocal iols- a lot of people seem to be pretty happy with their results. Although the extended range of the Symfony is very appealing to me and my active lifestyle. But if you are worried about driving safely at night with the least amount of visual artifacts than monofocals are the best option to avoid those problems hands down. I'm having a hard time seeing if it's worth the trade off for me but I don't drive for a living so it may different priorities for you. 

MyopicWriter, your eye configuration sounds exactly like a possibility for mine as well!

I got my right eye cataract surgery 5 days ago with a Tecnis monofocal toric IOL set for good distance vision (target -0.25D) - its still settling and healing but looks like it may achieve that target and at times I get the vision I'm looking for in that eye 20/20 or better with decent contrast, though for now it varies a lot.

My left eye only has an early stage cataract, but eventually for it I plan either a Symfony Toric or another Tecnis monofocal toric IOL.  From your experience, if I went with a Symfony Toric in my left eye in the future I would have the same configuration as yours, so I'm very interested in your experiences particularly that the monofocal distance eye seems to help reduce or eliminate noticing the night vision effects around some lights in the Symfony eye.  I realize that with only one Symfony eye that reduces the near reading ability compared to both Symfony eyes, but with improved night vision with the combo, that sounds like a good tradeoff since I mostly desire excellent distance and intermediate vision (at least down to 20-24" or so) and am willing to use reading glasses for closer or for fine print.

With only one Symfony eye and a Tecnics monofocal distance eye, can you read a smartphone comfortably as well as use a computer display for longer periods without glasses?

With the Symfony IOLs, do you see anything odd around point light sources indoors, like around LEDs especially blue LEDs on devices like cable modems, etc.?

How about on the TV display, around white text/captions on a dark background on the screen?

I'm curious if the Symfony only introduces artifacts noticeable outdoors at night, or if there also some artifacts visible indoors.

Symfony lenses do not cause for me any weird visual artifacts inside.  TV tablet iPhone are very clear.  Been to the movies and a concert and haven’t noticed the concentric circles anywhere.  The only thing I think may be due to lenses is white lettering on black screen at certain distances.  Slight glow (highlight?) if room is dimly lit or pitch dark.  I can read the words though just fine.  

Last night we had friends over - very mild night for eastern Canada forvthis time of year.  We were outside - clear night.  Moon very bright.  I am only one in group with IOLs - no one in group had cataracts.  2 people wear glasses and 3 don’t who were younger.  I asked if any saw a glow around the moon as I thought it was just me with IOLs but others in the group see a glow too to varying intensity.  We determined that some people have naturally an issue with light refraction and see more glare.

It has now been over 2 months since 2nd surgery.  Although I don’t expect he concentric circles to go away the starbursts and glare have diminished a lot.  I no longer hesitate to drive at night.  Night driving is getting easier.

I haven’t needed glasses at all.  In fact my near vision is now better than my husband’s.  I can read quite fine print now.   Overall still pleased with Symfony lenses.  I really feel like I have gained a lot.

I've been looking at the moon the last few nights as well and see a little glow with my right eye.

The moon looks brighter to my right eye (the one with the IOL) compared to the left eye as well, I figure thats due to the right eye now letting more light in and perhaps the glow is due to the receptors in that eye's retina getting a bit overloaded, that will probably lessen as the eye gets used to the new light level it receives.

White lettering on black screen on some TVs can cause "blooming" as you describe, some types of screens can have that artifact by itself too.

With the cataracts I couldn’t read lettering on TV anymore - couldn’t even read time on PVR so not sure what was normal and what wasn’t.  I did google the white lettering on black backgrounds and it causes a number of people issues with blooming or highlighting. Reason optometrist offices always use black lettering on white.  Do you see that with your monofocal iol?

Do you see concentric circles? First you said no but then you say you don't expect them to go away.

I can't say that I've seen that type of blooming, but since my right eye is still kinda blurry its not a good time to judge that yet.  But I'll be sure to look for that if my right eye stabilizes sharper in the next few weeks.

Yes I do see concentric circles.  From others posting don’t expect these to go away (outside lights).  Don’t see them inside.  Glarevand starbursts have really settled down and they were more distracting than the concentric circles.

Hi Night-Hawk, yes, that would be very similar to mine. I waited 16 months between surgeries while my left eye cataract got worse. Is your right eye your dominant eye? I think that's one reason I don't see the night vision issues with my left-eye Symfony. My right eye is doing all the work. 

Unfortunately, my near vision isn't good enough to read a smartphone without glasses. Even with enlarged text, I still need glasses for anything other than a quick glance to see a text. Anything more would involve lots of straining to make out the text. 

Same with a computer monitor--although I definitely see better with the Symfony eye than with my Tecnis eye. I do have pretty good intermediate vision--it's nice to be able to open a refrigerator or cabinet and see the contents, which I couldn't do with just the Tecnis eye. 

Your results may be different. Most people seem to have much better close-up vision, but I don't know if that is because I only have the one Symfony. 

In the meantime, a multi-focal contact in your left eye may prepare you for the vision you'll have later. I also had reading glasses made with a +1.25 in the left eye, and a +2.5 in the right, which work really well.

Indoors at night, if I close my right eye I can see a bit of distortion while looking at a light on the tv, but it doesn't bother me at all with both eyes open.

Hope this helps! 

 

Was your Symfony targeted for OD?  Could be one of the reasons for not being able to see near enough.  When I had one Symfony had to hold iPhone out 18 inches - with both done and 2nd is nearer .50 diopter off I can read at 10 inches so all distances are very good.  My doctor did say Symfony near works best with 2 eyes implanted but I am also thinking king having one targeted .50 near will give better reading distance.

I too wonder what MyopicWriter ended up with refraction wise in diopters in each eye. Might even be little farsighted in the Symfony eye that would reduce the near and intermediate focus capability? Or perhaps too much residual astigmatism.

I would get a full refraction test with an optonetrist for an eyeglasses prescription at 1 month after surgery as my surgeon suggests to know exactly where it ended up. From my tests at home with various eyeglass lens I have (-0.5, -0.25, +1.0, +1.5, +2.0) my right eye with the Tecnis monofocal toric IOL appears to be very close to the target of -0.25D, I'd say its within 0.25D of the target right now.

My distance vision is much more stable today (its exactly 7 days from surgery) getting 20/25 to 20/20! I moved taking my eyedrops to night time only an hour before I go to sleep, to avoid the blurring effects from the drops during the day.

Sue.An, I'm not sure what it was targeted for. I was the first Symfony patient my doctor had--in fact, I suggested he try it with me, as he at first wanted to use another Tecnis. But I hated the lack of intermediate vision so much with my right eye that I convinced him to give it a try!

I do know that my distance vision is no better than 20/25, or even 20/30--I'm having a lot of trouble with dry eyes and excessive tearing, so that might be making it worse. I'm currently trying to get that fixed before going to get more glasses. I may just end up with glasses to correct the last bit of nearsightedness and also a varifocal (progressive) lens to give me good near vision. 

Have you had a refraction eye test since your catatact surgeries?

I would be very interesting to know exactly ehere the eye Rx has ended up including how much residual astigmatism there is. Might explain your focus results.

Sounds like you will end up right on target.  But yes best to wait 6 or 7 weeks for complete healing and then see optometrist.

Dry eye could be affecting your vision for sure.  I know after a day at work staring at my computer my eyes get dry and words can blur.   Time to walk away get my Tim’s (Canadian thing) and after that break computer is clear.

Systane make a gel drop - you might want to give that a try - nighttime.   I use the Systane Ultra during day.  Tried all the brands but find that one really good.

I know my right eye hit target at 0D and I see distance 20/20 - sometimes can readine below 20/15.  But definitely comfortably the 20/20 Line.  Left eye is 20/30 but I know it allows me to see things much nearer.  Target was plano for it too just didn’t wind up that way but no complain as I wasn’t expecting to see quite this near.

No, but that's a good point--hopefully it's something like that, and can be fixed with a pair of specs. 

I need to schedule an appt with the optometrist, probably for next month.

Hey can you please describe how your vision is starting to pan out after now several days since the surgery? Do you get any intermediate range-near with your IOL implant and do you think you will need multiple glasses to function with your operated eye? I like monofocal but I'm scared about the possibility of losing intermediate vision. Seems like your pre op is close to what you wanted in having best distance with a monofocal which is something I may consider... 

So you don't trust the tests that Abbott (maker of the Symfony lens) did that showed 95% of people didn't need glasses for intermediate distances after getting monofocals set for distance? You're going to base your decision on one single person's experience? Why do you not believe my experience then?

And not only did I post my results and mention that I read about a bunch of other people who had the same results including my own brother, but I also posted 3 studies done by the maker of the Symfony lens that showed 95% of people can see fine without glasses at intermediate distances of 2 to 5 feet after cataract surgery with IOLs set for distance. I hope you are not going to base your decision on whether or not Night-Hawk has the same result, because he could end up being one of the 5% who need glasses, plus those studies didn't include toric monofocals, only regular standard monofocals like what I have.

Plus my brother also had regular monofocals and all the other people I read about online had regular monofocals set for distance and could see fine without glasses at 2 to 5 feet. There are 2 other people on here - michael and another person (can't recall her name) - who got toric monofocals set for distance who could see fine at intermediate distances without glasses.

Anyway, if you plan on getting toric monofocals, I don't think you can go by those Abbott studies or by my results, since I have regular monofocals set for distance and the studies were for regular monofocals set for distance, not toric monofocals. Toric monofocals can create other problems that regular monofocals don't cause, so you probably can't compare both types equally.

And I also have some astigmatism but my doctor didn't try to talk me into getting toric IOLs or limbal relaxing incisions and my vision is just fine with the regular monofocals set for distance (and I also had LASIK a long time ago and that makes the calculations even harder to do for the IOL power and my vision still came out great for all distances without glasses, except very small print).

Please post your refraction results here after you see an optometrist, I would be very interested in how that correlates with your Symfony and toric IOL vision results.

Its still pretty early (only 1 week since surgery) and my distance vision is just starting to clear up and stabilize.  I expect intermediate focus will take longer as the eye and brain have to get used to it.  For now I need about +0.75D glasses to read the computer monitor from 24" comfortably - I can make out a lot of the text without glasses but for a longer stretch the eyes would be straining too much. Same with reading a smartphone screen at arm's length.

But I expected this intermediate vision result, so if it gets better I'll be very pleased - otherwise my plan forward is unchanged, the left eye would either be a monofocal toric set for about -1.0D or so for good intermediate vision or a Symfony Toric to get good distance and intermediate out of that eye.

Today I again tried an old RGP contact lens in my left eye that corrects it for distance vision similar to the right eye's IOL with similar results.  OK for driving, but I needed glasses for intermediate and reading of course that was frustrating.  After a few hours I took out the contact and its actually easier around the house that way or with my old progressive eyeglasses with the right lens removed.  So currently I would definitely want an IOL in my left eye that gives me more than just distance vision.

Can you try a test with each of your Symfony eyes again to compare the good focus distance to a smartphone and a computer screen separately with each eye alone?

If one eye is -0.5D vs the other 0D, there should be a difference in that focus distance -  the -0.5D eye should have a closer focus distance I would expect.

I've read that combination is a common target (one Symfony eye a little nearsighted) to expand the both eyes together focus range to include most reading, and that sounds like what you are getting with effectively a mini-monovision combo.

Its also recommended while at the computer for long stretches, to be sure to blink often since staring reduces the blink rate and that makes the eyes dry too.  Also I use a computer software timer to remind me every 10min or so to look away from the screen 20feet+ away to rest the eyes for a few seconds.

A dry eye specialist optometrist I went to a couple years ago also recommends Systane Ultra or Nanotears, I tried both and like the Nanotears since its a thicker gel than Systane or Refresh but doesn't blur the eyes like some other types.  I get Nanotears cheaper online thru amazon they have several types, last time I got the one for "serious" dry eye I think its a little thicker maybe.

At work and doing the computer eye test with closing one eye and then the other.  Would say I’m about 2 feet from computer.  I cannot see a difference in reading computer with one eye vs the other.

The only time vision differs between the eyes is near reading I see better to read through left eye but not as sharp at 20 feet for distance from that left eye.  The right eye isn’t as good for really near - having to hold iPhone out another 3 or 4 inches if I try to read with just that eye.  However right eye for 20 feet away is better.

That kind of makes sense with Symfony lenses though as there is no dip in vision with it’s range of focus.  I think if both were equal and hit target at 0D then I likely would see equally the distance at 20 feet but near vision would likely be 18 inches and get blurrier from that distance in.

Although the target was 0D for both I am actually happy it turned out this way.  With both eyes open I see great at all distances.  I suppose one eye then the other must take over depending on what I am looking at.  To test I hold my iPhone at my now new normal confortable distance of about 10 inches and then close one and then the other and have to blink a couple of times or brain takes a few seconds to adjust but left eye reads the iPhone but it is a little blurry trying to read iPhone with right eye.

Hope this helps. 

Thanks for trying all that!

Those results totally make sense if indeed one Symfony eye is about 0D and the other -0.5D.

The Symfony at 0D should still result in excellent intermediate vision at 2feet+ so what you are getting for computer vision is what I expected. The one poster here that isn't even getting good computer or smartphone distance vision with a Symfony must have ended up with a farsighted result is my best guess.

Even with your 0D Symfony eye sounds like you can still read your iPhone just a little farther out like 18" instead of 10" like with the -0.5D eye?

This gives me hope that eventually if I go for a Symfony Toric IOL for my other (left) eye, if I target -0.25D to -0.50D it could be great for a mini-mini-monovision to go with my right eye which currently is only really good for distance vision with its monofocal toric IOL.

Today I'm still getting similar to yesterday with m right eye, about 20/25 at 20feet with periods it improves to nearly 20/20 and not worse than 20/30. Still a little flucuation, but not as much as last week.  Still have hope it can continue to improve over the next few weeks, especially after I can stop the Rx eyedrops at the 4 week point.

Yes sounds like a Symfony Toric would be an option to seriously consider. 

You are right even at 0D I can read my iPhone just fine with that one eye open - just further out at 18 inches.

Excellent!

I must measured my comfortable smartphone viewing distance and its about 20" or even a little more.

I need to use +1.0D (or higher) reading glasses for very clear viewing at that distance with my right eye currently.

Since the Symfony IOL is supposed to provide about a 1.5D focus range, that works out even at 0D.

With -0.5D Symfony should provide the equivalent to about +2.0D reading glasses with a 0D eye. Thats enough for most reading except in dim light or extremely tiny fonts.

Yes good lighting is a must.  Easier with iPhone and tablets being backlit.

I think that goes for all IOLs.  

Are you considering getting 2nd eye done sooner vs later?

I'm hopeful if my right eye stabilizes at good distance viewing, that would allow it to reduce any night vision artifacts from the left eye if it used a Symfony IOL, especially if the left eye was set to -0.5D or so.

That assumes my brain can get used to having the right eye as the dominant distance eye again.

It used to be several years ago, but the past 3 years my brain has gotten used to the left eye primarily since the right eye got blurred and more nearsighted from the cataract. Of course thats changed now, but my left eye still has the best corrected vision with my eyeglasses with the right lens removed.

I might need to not use my eyeglasses a lot so that the right eye is the better vision eye to get my brain trained to use the right eye more?

I needed good lighting before surgeries- lol

I would definitely consider doing my 2nd (left) eye sooner than later if my right eye continues to improve and stabilizes well in the next month or so.

However my left eye only has a relatively early stage cataract so it could take years to become "medically necessary" since it still corrects well to about 20/15 with excellent contrast.

Though there may be a possiblity if there is considered an imbalance now between the eye's different prescriptions that could also qualify as medically necessary to get insurance coverage for the basic part of the surgery like I did with my right eye.

It would be a question of extra out of pocket cost otherwise. But might still even consider that against the alternative of waiting years for good vision in both eyes without glasses.  That might be worth the estimated $2000 extra cost without insurance.

From my testing just now, my right eye needs about +1.0D or more, for comfortable smartphone viewing at my usual distance. My left eye needs about +1.25D or more above the best corrected Rx - that makes sense since my right eye is about -0.25D now compared to 0.0D for best corrected in the left eye. 

So for mini-monivision with a monofocal toric in my left eye, I would appear to need to go -1.25D or -1.50D to get that good smartphone vision in one eye.  Thats a bit more of a difference between the eyes I would like, since it would leave the left eye probably worse than 20/40 at distance viewing which I'd prefer to not get worse than the minimum driving vision in both eyes.

But with a Symfony toric IOL in the left eye, even at 0D it might get that same -1.25D to -1.50D effective close focus as a monofocal set at that spot, but of course the Symfony would still get me good distance viewing as well.  Even if it was set for -0.25D or -0.50D still would be a great range, maybe even better to get reading range in most cases! 

Weighing the night vision issues vs the obvious focus range improvements with the Symfony, nowadays I don't drive often at night anyway - maybe once or twice a week at most.  So perhaps the night vision effects for me may not be a major issue whereas I could take advantage of the focus range improvement very often!

Funny you should say that.  I thought I was left eye dominant- did those little tests.  But now that both eyes have implants it really is my right eye that is dominant.  The cataract was worse in that right eye so I think left eye took over prior to surgeries.  After 1st eye operated on that right eye felt a lot of pressure - almost like at times it would pop out of its socket!  Took a week or two after the surgery for that sensation to subside.

Yes that sensation sounds like what I experienced years ago when I experimented with different monovision setups with contact lenses.

Back then my right eye was dominant, but if I tried to put the distance contact in the left and the near contact in the right, I got that similar sensation - trying to go against the dominant eye. When I swapped the other way around, it was much easier.

But from your experience, indicates after a week or two you got used to it so maybe its possible to switch dominant eyes relatively quickly then!

Yes I figure as one ages driving at night isn’t something I would do more and more of.  Although here in Canada between late November to Feb daylight hours are less and I am driving home from work in the dark.  However I must say on that front things have improved. First 5 weeks I got my husband to do night driving.  Had to once and it was a little scary.  But the strong glare/glare/starbursts have greatly diminished.  I do see the concentric circles however they aren’t as bothersome to drive with.  I would rather have my daytime vision the way it is.  Spend more hours needing that than driving at night.   But as said I drive several evenings a week with a teenage child that needs lots of drives here and there and I don’t even think about it now.

Sounds great that your night driving has improved now and thats with two Symfony eyes, should be less an issue for me if I had only one Symfony eye.

Yes - Glad we hat sensation is gone.

I did my first short night driving trip to a couple local grocery stores early this evening.

I noticed only slight halo effect around traffic and car lights, but it was the same to me in both eyes and not an issue.

Night vision in my right (IOL) eye seemed a little worse accuity than in the daytime as expected, so probably instead of 20/25 in the day was closer to 20/30-40 at night. My left eye corrected with eyeglasses however was still excellent clear vision at night, 20/20 to 20/15 corrected so that takes over using my old eyeglasses with the right lens popped out. 

I could drive with no glasses but then I was limited to my right eye, harder to read signs until I got up fairly close, not what I'm used to. So I felt much safer driving with my eyeglasses. Yesterday just before it got dark I took a short drive with a contact lens in my left eye which gave me similar 20/25 vision in both eyes. That was ok to drive with, but again not as good as with the eyeglasses where I can read signs clearer and further away.  I might be spoiled by that excellent vision I can get with my left eye corrected with the eyeglasses since I'm used to it for years.

Yesterday with the contact lens in the left eye around the house and at a store shopping was very difficult however since I had to keep fumbling for reading glasses often like to read a shopping list, items, etc.  Might as well have my progressive eyeglasses on the whole time, so thats a better solution for me until I ever get my left eye with an IOL.

Also today at a store I tried no eyeglasses with no contact lens, effectively giving me a type of mini-monovision since uncorrected my left eye was about 20/50 with astigmatism combined with my right eye with the IOL around 20/25.  That was a bit harder for me around the store compared to using the progressive eyeglasses. Driving in that state was more difficult as well of course.  So I don't think I'd like a similar monovision with monofocal toric IOLs in both eyes, partly because I would miss the excellent corrected vision in my left eye since my right eye isn't doing as well as the left (at least uncorrected currently). I of course could probably get new eyeglasses to get similar excellent vision as I have now with a monovision setup, but that wouldn't be any better than what I can do now with progressive eyeglasses.

So the best setup for me seems to be going for a Symfony toric IOL for my left eye eventually, if it works out ideally to give me close to the excellent distance vision I can get in that eye corrected now, plus get good intermediate and perhaps some near vision too.  That would be the closest without glasses setup to what I can get now with my old progressive eyeglasses. Driving glasses could still be used for sunglasses when desired to improve distance vision further if needed too.  But ideally wouldn't need glasses indoors while shopping, etc. and for computer and smartphone use, only rarely for very fine print and/or dim light reading could use a credit card size magnifier or reading glasses for a longer reading session.

 

I did my first short night driving trip to a couple local grocery stores early this evening.

I noticed only slight halo effect around traffic and car lights, but it was the same to me in both eyes and not an issue.

Night vision in my right (IOL) eye seemed a little worse accuity than in the daytime as expected, so probably instead of 20/25 in the day was closer to 20/30-40 at night. My left eye corrected with eyeglasses however was still excellent clear vision at night, 20/20 to 20/15 corrected so that takes over using my old eyeglasses with the right lens popped out. 

I could drive with no glasses but then I was limited to my right eye, harder to read signs until I got up fairly close, not what I'm used to. So I felt much safer driving with my eyeglasses. Yesterday just before it got dark I took a short drive with a contact lens in my left eye which gave me similar 20/25 vision in both eyes. That was ok to drive with, but again not as good as with the eyeglasses where I can read signs clearer and further away.  I might be spoiled by that excellent vision I can get with my left eye corrected with the eyeglasses since I'm used to it for years.

Yesterday with the contact lens in the left eye around the house and at a store shopping was very difficult however since I had to keep fumbling for reading glasses often like to read a shopping list, items, etc.  Might as well have my progressive eyeglasses on the whole time, so thats a better solution for me until I ever get my left eye with an IOL.

Also today at a store I tried no eyeglasses with no contact lens, effectively giving me a type of mini-monovision since uncorrected my left eye was about 20/50 with astigmatism combined with my right eye with the IOL around 20/25.  That was a bit harder for me around the store compared to using the progressive eyeglasses. Driving in that state was more difficult as well of course.  So I don't think I'd like a similar monovision with monofocal toric IOLs in both eyes, partly because I would miss the excellent corrected vision in my left eye since my right eye isn't doing as well as the left (at least uncorrected currently). I of course could probably get new eyeglasses to get similar excellent vision as I have now with a monovision setup, but that wouldn't be any better than what I can do now with progressive eyeglasses.

So the best setup for me seems to be going for a Symfony toric IOL for my left eye eventually, if it works out ideally to give me close to the excellent distance vision I can get in that eye corrected now, plus get good intermediate and perhaps some near vision too.  That would be the closest without glasses setup to what I can get now with my old progressive eyeglasses. Driving glasses could still be used for sunglasses when desired to improve distance vision further if needed too.  But ideally wouldn't need glasses indoors while shopping, etc. and for computer and smartphone use, only rarely for very fine print and/or dim light reading could use a credit card size magnifier or reading glasses for a longer reading session.

A lot of new firsts!  In a couple of weeks will be interesting to see what your optometrist suggests for best solution.

In bigger places like grocery stores prior to cataract surgery used to feel a little dizzy - could not see anything clear.   It is when I noticed something was ‘off’ first with my vision - that and not being able to read road signs.

Got calls from a couple of friends yesterday that they could see huge halos around the moon!  Being a full one on a clear night.  I am always asking people about light sources at  ight wondering  if it is a lens design or what everyone sees too.  So I think other than the concentric circles which is a lens design most people see some glare from car headlights - especially the newer ones.

Well Night Hawk looks like you will at least have some time to consider various options.  Hopefully there will be a liveable solution in the interim.  If not I am sure insurance would cover if the imbalance is too great.

Hey nighthawk, 

Was curious about why you are now leaning to choose the Symfony for your other eye after having your right eye with a monofocal?  Is your right eye compromised really enough to enhance clarity from distance to intermediate? Like what are some things that you can see clearly until it starts to get blurry towards near? Can you read your cellphone with your right eye alone? And your dashboard of your car? Also I thought you had your right eye aim for best distance. It sounds like you aren't satisfied of how your right eye distance wise is ending up. Would you consider getting lasik to "sharpen" things up in that eye to make distance better? I would also think that since it's not quite 20/20 but 20/25 you were induced just slightly near sighted which would help improve some intermediate quality?  

Also not quite understanding regarding your situation with your left eye. When you say that progressive glasses are working out the most efficient for your case- are you also wearing contact lens underneath? I understand With contact lens in that eye you still need reading glasses to see near. but using your distance correction eye glasses to help you drive better (is sharper/clearer than contact lens?) but you'd still need a different pair of reading glasses to see up close? And to clarify when you said you don't think you'd like mini monovision of what both eyes are as of now isn't yours on the more extreme side of monovision because right now your left eye is 20/50 vs 20/25? I thought mini monovision is more closely grouped toghether than that. Sorry about all the specific questions was just confused about how things were worded. 

Well my right eye is still changing, it improved today to the best yet reaching 20/20 most of the time so far today and for short periods I could just barely get the 20/15 line.  Thats the vision I had hoped for from the start since before cataract, that eye could do at or near 20/15 best corrrected and thats what my left eye can do now best corrected with eyeglasses.

When I was talking about my progressive eyeglasses, thats for no contact lens at all.  I haven't used the contacts for about 4 years until I tried one in the left eye a couple days ago to see how it would work with the right eye now.  The contact lens in the left eye gave me similar 20/25 vision, but not as good as I can get in that eye without the contact but with my progressive eyeglasses. Though that contact lens is almost 10 years old, so probably with a new prescription it could get close to what the eyeglasses get, but it was just a test.  The test showed I didn't really like having both eyes set for distance, too much fumbling around in stores for reading glasses too much - easier to use the progressive eyeglasses the whole time.

Mini-monovision would be about -1.00D or so in the left eye which would probably mean 20/40-20/50 distance vision for that eye.  But that doesn't appear to be quite enough to get what I want, which is good enough intermediate vision at 20-24" for comfortable computer and smartphone use. It appears I would need at least -1.25D to -1.50D to do that and thats a bit too much for me difference for monovision with monofocal IOLs, hence the alternative a Symfony toric IOL for the left eye would be more attractive for me for the results I'd like to achieve since it could potentially get me the 1.50D range for good intermediate and a little near focus while still getting good distance vision - even set slightly nearsighted -0.25D to -0.50D would probably work well or even better, now that my right eye seems to be improving and hopefully will now stabilize close to 20/20 or better after several weeks.

To me now its a tradeoff between better range of focus vision vs some night vision issues with the Symfony IOL.  Since I'm now only driving at night maybe once or twice a week, and reading some others results especially improvement with mixing a Symfony with a monofocal for distance in the other eye, I'm definitely considering that tradeoff may be worth it for me.  For others who need the best night vision and drive at night more often, the choice may be different - monofocals would offer the best for that, but probably with more need for the use of various eyeglasses at times.

Until my left eye qualifies for cataract surgery (or I decide to spend extra out of pocket, probably about $2000 extra without insurance) I'll probably just stick with eyeglasses like I have used the past 4 years and not bother with a new contact lens for the left eye based on my tests.  After the right eye is stable in a month or so, I'll got to an optometrist for a new refraction eyetest and then order new set of eyeglasses, a progressive pair, a computer vision pair, and a close up reading pair, plus maybe a distance only with sunshade pair for driving.

The target for my right eye was 0D to -0.25D and it appears to be spot on with that right now.

Intermediate vision is about what I expected with that target, similar to how my eyes were with contacts a few years ago set for best distance vision.  I needed about +1.00D for computer glasses (2feet+) and +2.00D for reading glasses and its similar to that with the right eye now too.

For smartphone use at my usual viewing distance about 18-20" I find I need to use +1.50D glasses with my right eye as of now.  With the phone farther near maximum I can stretch out my arm (not really good for long term comfortable viewing) I could get by with +1.25D or so.  Hence my thought that the Symfony IOL in one eye could achieve that much focus range for good smartphone and computer viewing, in addition to still getting good distance vision in that eye.  Might target a little nearsighted like -0.50D in that eye to get the best chance of the nearer vision if my right eye ends up at 20/20 or better that seems more like now as of my vision today.

Outside this afternoon today the sun came out and my vision was excellent in the sunlight! The right eye looked almost identical view to objects in the distance, nice and clear.

Also I noticed the biggest difference in color between my eyes was the tile roofs on my house and all the houses in my area.  Its supposed to be red tile roofs and now in my right eye with the IOL they actually look reddish!  In my left eye with the old yellowish-green natural lens, the roofs look more orange-green...

It’s great the progress you’ve seen - better day by day.  Looks like it will be right on target or pretty close.  That opens the door for a variety of options for the other eye.

Yes I remember just how amazing it was to see colours.  Even the pavement looked grey vs more brownish.  Bathroom fixtures were gleaming white.  I had 6 weeks between surgeries and found myself closing one eye then the other comparing colours  as well as sharpness in vision.

Its too bad they don't make a contact lens that uses the same optics as the Symfony IOL to duplicate the extended focus effect - would provide the same vision before someone had a cataract as well as a way to test it out first!

My right eye has a little too much astigmatism for the highest cylinder Symfony Toric IOL available in the USA. So the monofocal toric IOL was the only way to achieve the best distance vision possible in that eye.  But my left eye has less astigmatism so a Symfony toric could work in that eye.

So having a Symfony in both eyes wouldn't probably have achieved the same quality of vision in any case, so mixing them is my only real alternative vs mini-monovision which I don't believe would do as well for me for my daily activities.

The monofocal toric in my right eye though somewhat blurry at 18-24" by itself is still probably good enough to add to a Symfony's clear focus at that distance in the other eye to do a little better than the Symfony eye alone I suspect.  Thats what I notice currently with my progressive and computer eyeglasses with the right lens removed, one eye vs both eyes.