My Synergy IOL Experience So Far

Finally had cataract surgery on my right eye and implanted the Tecnis Toric Synergy IOL. It is my 2nd day after surgery and at this point, I don’t have an opinion, but wanted to share my experience so far to hopefully benefit others on what they might expect.

I am a 60-year-old male and had a Tecnis MF (MF) implanted in my left non-dominate eye about 5 years ago. My right eye had a bad cataract and vision from that eye was worse than 20/200 by the time I had surgery, so I basically was only seeing out of my left eye.

I think it is important to note I have not had a non-cataract lens in a long time, so I do not even remember what my pre-cataract vision was like. The only thing I can compare my Synergy vision to is my Tecnis MF vision.

One reason I chose Synergy was its amazing defocus curve and I thought it would work well with my Tecnis MF; presenting a similar image to the brain.

First, I think my anesthesiologist should be fired, as I was completely awake during surgery. I remember the entire operation and everything people said during my surgery.

According to Dr. Wong’s Optometrist, the patients that had the Synergy IOL implanted suffered from blurry vision the Day after and it took more time for their vision to stabilize. I can 100% confirm this is true at least for me.

Because of the holiday’s I will not see the doctor for a week, so I printed out a distance eye chart and Jaeger close-up chart to get a rough idea of visual acuity.

Operation Day:

Even by the end of the day, when the pupil dilation should have been reduced, my vision was very blurry. I could see the Big E, 20/200, but even that was blurry. And during the daytime, my right eye saw huge halos around indoor light sources, which were non-existent for my MF eye. As far as close-up vision was concerned forget about it, nothing but a blur from the Synergy eye.

Day 1 after surgery:

Back to the eye chart. I woke up with 20/63 vision. This was a bit scary because when I did my left eye I was seeing 20/20 distance and 20/20 close the next day. By the end of the day I was seeing 20/50, maybe some of the 20/40 but very blurry and mostly guessing at 20/40.

One issue I had, but it did get better as the day progressed was the 2 eyes did not work well together and it was a bit disorientating. Before surgery, I could not see out of my right eye so I guess my brain just present the left eye image, but now that the right eye was seeing; even though worse than the left eye; it must have been more confusing to my brain.

Day 2 after surgery (Today)

Distance Vision this morning was 20/32 so going in the right direction, but still worse than my left eye.

Hard to know if the eye is still healing and things will improve or if we missed the refractive mark. I cannot use the defocus curve to get an idea as the Synergy IOL defocus curve has no 20/32 unless I am 1 Diopter Hyperopia. That would be depressing, especially after I took several IOL Master Measurements. And there is also the astigmatism issue.

So far I am not seeing that great defocus curve. I have been looking at intermittent and close objects and in general, the Tecnis MF outperforms my Synergy eye. Though for the computer the Synergy might be a tad better. So this has been a big disappointment so far. Hmmm, as I am typing this I am trying the cover-up 1 eye at a time thing and I am noticing the Synergy is just barely outperforming the Tecnis MF for objects at computer distance. This is the first time I noticed that, so that is a good sign.

One good thing is with both eyes open I can read and see up close. I can pick up those eye drops and read the instructions in normal light with both eyes open, something I cannot do with either eye individually. I have not tried to do any serious up close reading so the jury is still out on that.

Another reason I selected Synergy was due to the studies showing its outperformance over the PanOptics and my MF in dim light. So far I have only done limited testing, but I don’t see any outperformance yet.

Now for night driving and dysphotopsias. I did drive last night. The dysphotopsias are different. From my Tecnis MF I see Halos but from my Synergy, I get more Starburst. In general the Synergy, at this point, has worse Dysphotopsias than my MF. But when both eyes work together the dysphotopsias are no worse than the Tecnis MF. Not sure what that means. Is the brain filtering it or how that works? At this point I have not done enough nighttime driving to state if night driving is better or not.

That is where I stand on Day 2; the good, the bad, and the ugly.

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