near vision poor after getting Symfony...seeking others' experience

The odds are that the surgery left you farsighted, hyperopic, due to the lens power being off. That can happen with any IOL, and if you'd gotten a monofocal your vision at all distances would be worse and you'd be even more upset.  There is also the possibility you have residual astigmatism, which would reduce visual quality a bit at any distance including near.

 

People shouldn't "need" something as large as a 2.75 diopter correction to read with the Symfony if its on target rather than leaving you farsighted (even if might make things crisper so there is no harm). 

If you are left hyperopic they can correct that with contacts/glasses, or more permanently with laser correction.

I'm wondering if there might also be some other eye issue reducing your visual quality (which would have made things even worse with another lens). What is your prescription, your refraction? What is your "best corrected" vision at distance, to know if there is some other eye issue going on?

 

Halos can be cause or made worse by dry eye (which is sometimes a temporary side effect after surgery, and people are sometimes unaware of it since the nerves are cut that tell the brain the eye is dry and need to heal), and  residual   astigmatism ( though I'd seen some claims hyperopia might as well).

My Eye Doc initially said all of the things you mention above...then, all the Symfony patients were having the same problem.   He was originally going to schedule me for laser correction but now thinks it won't work.  Symfony oversold the near sightedness.  

If he was going to schedule you for laser correction, that suggests you were left farsighted. If he claims it "won't work" I'd suggest you ask him to explain *why*, the odds are its something else wrong with your vision unrelated to the IOL choice, or a problem with your eye preventing laser enhancement (which they should have been able to spot before cataract surgery to warn you).

You might consider a 2nd opinion (I'm almost wondering if this doc accidentally gave you the wrong IOL, gave you a monofocal, and that is why laser enhancement won't work).

 I'd suggest posting your refraction, your prescription for correction, so people can tell see if that is the issue. It'd also be useful if you posted your "best corrected" distance vision, i.e. what your 20/XX visual acuity is when they correct your vision. 

The Symfony's operation is based on physics, it provides a larger range of focus than a monofocal, as many surgeons and studies have confirmed with patients and on optical benches outisde of patients. It isn't like a mechanical item that can break or something. Its true that people's result vary in terms of the level of near vision even when corrected for good distance vision, but that is mostly due to their eye's natural depth of focus. If your eye has less depth of focus with the Symfony than average,   the odds are extremely high that you'd have far more to complain about in terrms of near vision with a monofocal.

 

I had the same experience unfortunately. I see double . Only did one eye. Cancelled the second surgery for the other eye. No one would take responsibility . I went to several docs. They all just said they don't know why.

i read reciently that the FDA is doing a clinical trials on a protein that is inserted in the eye that dissolves cataracts. 

Mabe I'll try that instead of IOL's. 

 

Laser did not work for me in this case at all. Very frustrating. 3 years later still see double. Had lense replaced too for astigmatism. Now I wear three different pair of glasses and a pair with prisms. Ask about glasses for reading with prisms. 

keep us posted.

Strongly suggest you follow softwaredev advice to seek a 2nd opinion from a high volume surgeon, this will help eliminate any bias in determining the source of whatever is causing your issue.  

re: "high volume surgeon"

Yup, with rare issues it makes sense to deal with those who are likely to have run into them before. There are varied  eye   issues that can lead to double vision. If you've been to "several docs" I have to wonder if you need to figure out a better strategy for finding the highest quality doctor you can, I don't know how you'd found all those docs. They should at least be able to enumerate the potential causes and explain why they can't decide between them.  Perhaps one could do that for you to post.

Re: "see double"

The most likely explanations have nothing to do with the IOL choice (for those who hadn't looked above, it sounds like this person started out with a different IOL). The most likely factor is residual astigmatism, and its not clear why laser won't correct that, if it didn't the first time then they can try a retreatment.  

 

Dennis,

?I had my left  eye done 5/3/17 with the Tecnis lens and can already see better than I can with the Symfony.   When I reported same to the surgeon he found that  I had developed more astigmatism than I had in my right eye before the Symfony implant.  I asked for and received a glasses prescription and went to Lenscrafters and bought some glasses so I can see what on earth I'm doing until everything heals up.  For me, this has been more of a journey than I had anticipated.   I have no idea whether the initial measurement was incorrect or if my eye has changed shape since the Symfony was implanted.  The glasses have helped immensely with the halos around the TV.  

My right eye came first and was a little off at first but now is 20/20 after 3 months.

The doc increased the strength on the second eye and now I'm 20/20 in both with a very slight left eye astigmatism.   Both eyes need 2.75 diopter for reading.

I go to a eye doctor center with about 25 doctors.   They had the Symfony problem with everone.  Lots of unhappy patients and doctors.

The vast majority of people are happy with the Symfony, there is something really weird going on if you are making claims that everyone has trouble. There would be lots of articles being written about it.. rather than lots of articles with surgeons talking about good results, and saying they'd choose it for their own surgery. I'm starting to wonder if you are trolling, or perhaps need to go to another clinic to get a 2nd opinion and perhpas discover this doctor center has been misleading you, perhaps they gave you a monofocal or something by accident.

  There are large numbers of people getting the lens, which is why a minuscule fraction of them having trouble accounts for the problems posted online. If they were all having trouble, there would be far more. 

A claim that you "need 2.75 diopter for reading" (as opposed to say "needing" 0.75D readers but like anyone with vision corrected for distance, , able to use 2.75D readers) sugggests that there is something wrong with your eyes as I already posted, or that you have eyes that are well below average in terms of the eye's natural depth of focus and that you'd have much more issues with monofocals. 

 

re: "that  I had developed more astigmatism than I had in my right eye before the Symfony implant. "

That would have happened then with the Tecnis monofocal  if you'd gotten that rather than the Symfony, but you'd likely have more complaints due to even worse vision and a lower range of focus.

Sometimes before surgery people have astigmatism in the lens in the opposite direction of the astigmatism in the cornea, and the two balance out to provide less astigmatism overall.  When the natural lens is removed, that gets rid of the lenticular astigmatism and so there is more corneal astigamtism left over. Usually surgeons measure the corneal astigmatism and prepare to treat that. The problem is sometimes there is astigmatism they miss.

Unfortunately some doctors only measure anterior corneal astigmatism, since they used to think  posterior corneal astigmatism   was negligible, but they often had surprising amounts of astigmatism left over. A few years ago some surgeons discovered it  isn't negligible in some people and accounted for some of the suprise astigmatism results they had. Unfortunately they are still working on upgrading approaches to measuring that so many surgeons don't have the equipment to do so (and there is still question I gather about the accuracy of some equipment that claims to measure it) so  there are still astigmatic suprises. 

Also although its usually minor, surgery itself causes "surgicaly induced astigmatism". An incision causes the eye to reshape, which can either increase astigmatism, or counter existing astigmatism. That is true of the incisions they use for to take out the old lens and insert the IOL.  I don't know if for some reason it was more than expected in your case.  It used to be more of a  concern when surgeons used large incisions for surgery that caused large amounts of astigmatism, but modern surgery involves "micro-incisions" since the lenses fold up to insert them through smaller incisions so its usually minor. It could be it was more in your case for some reason, if perhaps something happened where they needed to enlarge the incision perhaps as part of removing the old lens or getting the IOL properly inserted.

Its possible there was human error somewhere along the way, that does happen also, a mistake in calculations or copying some number.

I don't recall if you had a toric lens, those can rotate after surgery, or not be placed at the right orientation in surgery, and that changes the astigmatism.

 

I belive i left you a reply in another thread, but since my head is spinning after reading this long thread, can you sum up all your wisdom from the last 8 months from everyone you have helped with the synfony vs tecnis multifocal.  Such as did the synfony really help with degree of hallows?  Can the synfony be paired with a tecnis multiifocal in other eye to get a better range or is it better to use two different models of tecnis multi focal.  Is there really a difference with the synfony with light degradation.  Would love to know if any studies are out using large number of postops at 6 months to see satisfaction of patients multifocal vs synfony on near, intermediate and far vision and hallows.

Hi m50257:  Appreciate your comment re. the Tecnis lens you used on 5/3/17.  Please be specific re. WHICH lens you used on this date, because the Symfony is also a tecnis lens also.  Thank you.