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

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WebDev
WebDev

Hi,

I'm 44 years old and just had the first of two eyes implanted with the new (I'm in the U.S.) Symfony Toric lens, which I've researched extensively and was very eager and excited to get.

Now four days since having the surgery, I'm mostly satisfied: colors are much brighter and more vibrant (and more pinkish, bluish, interestingly), my distance vision is now restored and fine, and I can see pretty well at intermediate distances, i.e. objects are clearly defined all the way in to about 23 inches away, perhaps even 21 inches away in bright light (yes, I notice some degradation in low light, more than I'd expected).

The real issue for me is my near vision, which is much worse than I was expecting. I do know that the Symfony isn't all-around perfect, that e.g. I might expect only 20/32 or so (mean uncorrected near achieved in the U.S. clinical trials). And I know that's just an average, but even the distributions left me hopeful, with 81% of trials patients achieving 20/40 or better (that's monofocally; 96% were better than 20/40 bifocally). Meanwhile, I'm struggling to make out these words as I type, pretty much anything inside of 23 inches is blurry, and in good light I can only make out the 20/80 line (if I really exert myself, I can barely make out, mostly by guessing, some of the 20/60 letters, but mostly they're entirely unrecognizable). I feel as if I could have gotten results like this simply by going with monofocals, and I'm beginning to fear this is as good as it'll get, which is depressing.

Some background facts: Pre-op, I was mildly myopic (-1.75) in this eye and mildly astigmatic (about 0.94 cylinder). Also, at 44 I'd already gotten used to presbyopia, and typically would wear +1.25 readers for near. The specific lens implanted was the ZXT150 +16.5 (1.5 D cylinder). I doubt lens alignment is off, as my distance and intermediate vision feels non-astigmatic. My other eye (right) is scheduled for another Symfony lens 10 days from now.

So, I wonder:

1) Have others had similar experiences, i.e. poorer than expected near vision?

2) Does anyone have any idea what might have caused this?

3) Can anything be done to correct it?

4) If anything can be done, should I expect my ophthalmologist to do it (without having to pay more than the significant amount I've already paid)?

Thanks for any info and advice!

4 likes, 452 replies

452 Replies

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  • nancy528
    nancy528 WebDev

    Posted

    I just had my surgery today with a Symfony lens.  The plan is to do my other eye with a Tecnis Multi focal to get the optimum result for all points of vision.  I am hoping to get a good result to be able to read without my 1.5 readers before I decide to do my second eye.  From what I have read on this forum so far, this may not be achieved.

    my husband has the Tecnis Multi focal in his dominant eye and a mono lens set for distance in his other eye,  he can read pretty much anything without any readers with some exceptions, low light, small color print, etc.  he is very happy with his choice of lens.  I am hoping I have made the right decision for myself.  In hindsight, I am thinking I should have gone with the Tecnis Multi focal first and see how I can read close up.  My distance is excellent in both eyes.  Too late now!   So nothing to do but wait and see what happens,   I may have to get the second eye done sooner than I wanted in order to lose the readers.

    • m50257
      m50257 nancy528

      Posted

      Nancy, your plan is exactly what I have had done.   I am 10 weeks out with the Symfony lens and three weeks post op with the Tecnis Multi-focal.

      ​I have some astigmatism in the eye with the Multi-focal which is going to be corrected as soon as the healing is complete, but I can already read with it in good light even though it is a little blurry.  My distance vision seems not to be as good as I had hoped with the Multi-focal.

      ​The eye with the Symfony lens is fabulous for long distance and pretty good for intermediate vision and s-l-ow-l-y I am almost able to read with it in good light.   I think there is more time needed for these lens to settle in than anyone expects.  I would wait until you get your vision as good as it can be with the first lens before doing the second.  

      ​I do think you have made an excellent decision based on the input I have had from my doctor regarding these lenses.

      Best,.

    • nancy528
      nancy528 m50257

      Posted

      So good to hear from you and your experience!  I am trying to remain positive and hopeful I will be able to read my iPad from12-18" with my Symfony.    I have noticed some improvements in my eye today.  Still have lots of light flashes and waves though.  Did you experience this during the day?  I will be giving this a couple of months or so before I do the other eye for sure.  My husband had a Multi focal lens and also did not feel he had enough distance with it so he did a mono lens for distance in the second eye. He is happy with his choice.

      thank you for posting to my thread and i hope we can continue to share our progress going forward.

       

    • m50257
      m50257 nancy528

      Posted

      Nancy, I don't have a lot of light flashes and waves at this point, but I do have a couple of little "floaters" that make me a little crazy.  I'm going to find out what can be done about the next time I see the Dr. in a few weeks.  One thing I find is that if I get up in the middle of the night and look at the light from anything there is a circle arouond it from the Symfony lens.I don't like this at all.   I've noticed the Multi-focal lens bothers me less than the Symfony driving at night but I'm hoping I'll get used to it though I don't drive that much at night...especially at this time of year.  

      ?I have a friend who had two Symfony lens implanted in January and she is still finding her vision is improving and can now read with both of them so that's why I am trying to be more patient than I might be.   I just want my vision to be perfect!   Or as close as I can get.

    • nancy528
      nancy528 m50257

      Posted

      Definitely get those floaters checked soon.  I would call your doctor about that and not wait until next appointment. My literature said to call about that symptom as it is not normal.  My eye is still dialated so I am hoping the flashes stop when it goes back to normal.  I too just want the best near vision I can get and hope I made the right decision to achieve that! Patience is not my best virtue so it will be a long painful wait!
    • Amf555
      Amf555 m50257

      Posted

      Did your vision ever clear up? I just had the symfony multi focal lens inserted and after 3 days, near distance is still a little blurry and at long distance its a bit cloudy. I'm wondering how long will it take to clear up and if yours cleared up.

    • bruce56873
      bruce56873 Amf555

      Posted

      Hello, i was wondering the same thing about m50257, hope she replies.  I thought I was getting a Symfony but found out later they put in a multi focal in left eye 5/10/17.  Long story short, two months later vision still not sharp near, mid, or far and not improving.  Susposedly 20/25 but I am a good guesser at charts lol.  It is a struggle to read with that eye alone so I read with right eye using my old glasses that still have the right side perscription lens left in.  Surgeon wrote me a perscription for new glasses last week  +, he wants to wait 6 months and then see if YAG needs to be done to correct vision.  I am in no hurry for surgery on 2nd eye till left eye first surgery eye resolved.  I plan on insisting for Symfony lens this time. Let me know on your progress with Symfony.  Thanks.

       

  • nancy528
    nancy528 WebDev

    Posted

    Hi there, I just had. Symfony ZXR00 implanted 4 days ago.   I was using 1.25 readers for my near vision and had excellent distance vision in both eyes.  My goal in under going this procedure was to rid my self of the need to use readers to see everything close up.  I had no cataracts in either eye.  Purely an elective decision.  

    As you experienced post of, I too have no improvement in my near vision.  I know it is early on in my healing, but I am not too optimistic about it getting better since my mid and long range vision is very good now in that eye.  I will ask my doctor at my next visit this week if an adjustment was made for less near vision correction since he is recommending a Multi focal lens in my other eye for best results.  

    I am curious where you are now in your journey and what you did in your second eye.  Did your near vision improve prior to having your second eye done?

    thanks,

    nancy

     

    • m50257
      m50257 nancy528

      Posted

      Yes, my near vision is still improving very very slowly and I am not using any glasses as I write this note.  However, the improvlement is incredibly slow so at four days out, I'm amazed that you are seeing so well.  I am two months out with the Symfony.   

      I had a Technis multi-focal for my second surgery but I need some astigmatic correction done and this Dr. does not do it until a few months out to make certain the lens is firmly in place.  

      Overall, my impression is that these lenses are not quite as good as they are said to be.    I had no idea I was going to need any more procedures.

      Just be patient though....it sounds as though your outcome is goine to be fabulous.

    • nancy528
      nancy528 m50257

      Posted

      Hello

      Are you the same person that was WebDev?   

      Thanks for your information about your procedures.  Do you know why your doctor recommended the Multi focal for second eye and not another Symfony?  I think mine said the near vision would be sharper with just the two points of vision vs. the extended vision lens.   So I Guess I will  wait a few months before I do anything else and see how it goes.  

      I am surprised you do,not have better near vision with your Multi focal lens now.  My husband could see very well near and far right away with his.  He opted for a mono for distance in the other eye and is very happy with his decision.   Symfony was not available when he had his surgery.

      just crazy how everyone is different!   Hope you get to your goal soon!

    • SymfonyinOneEye
      SymfonyinOneEye nancy528

      Posted

      Hello  Nancy...I am interested in your surgeon's recommendation of a multi-focal in the other eye.  My surgeon will not do it.  I drove some distance to consult with two other outstanding opthalmologists, one of whom is conducting a research for Tecnis in micro-monovision using two Symphone lenses set for different focusses.  However, both he and the other surgeon, who is on the faculty of a major opthalmic academic program at a SC university AND also has an active surgical practice.  Both recommended the ZLBOO, also a Tecnis product, a multi-focal.  This was because I firmly expressed my desire to be able to read without using reading glasses every time I want to read a label or my phone.  She PhD professor also consulted with multiple surgeons at an international meeting and said that they were unanimous in their recommendation of the ZLBOO for my 2nd eye. HOWEVER,  I have noticed a definite dimunition of my balance since I have had only one eye corrected and, In effect, now have monovision with my Symfony eye seeing distance and the unoperated eye reading but fuzzy at distance. So much so...that I have consulted with a neurologist and a couple of physical therapists, most of whom felt strongly that both eyes should be set to work together for optimal balance.  Do you know anything about the balance issue for lenses are mixed and matched? Any help from anyone on this forum will be appreciated..  Thank you, Annette

       

    • Sue.An
      Sue.An SymfonyinOneEye

      Posted

      Hi Annette - you mention your Symfony eye sees well for distance.  What target was achieved (plano)?  What is your current prescription of other eye?   Are you having cataract surgery to balance the eyes or due to cataract in that eye as well?   Have you been able to test with contact lenses to see if your eyes will tolerate mini monovision?  Depending on your current prescription in unoperated eye (and if Symfony is at 0D) you may have too big of a difference between your eyes. If you have 0D vision with Symfony eye try a contact lens if you can at .50 diopter closer.  Most eyes should be able to tolerate that.

      I had a 6 week wait between surgeries (both have Symfony lenses) but had to wear my old glasses during those 6 weeks with one lens popped out.  I could not tolerate the difference otherwise.    

    • at201
      at201 SymfonyinOneEye

      Posted

      I agree with your surgeon that you should not use a multifocal lens in the second eye.

      If you are happy with the distance vision with the Symfony lens but need to be able to read well at near distances, you should either have a monofocal lens set for near distance in the second eye (if you have been used to monovision or can try it with a contact lens) or a Symfony lens set for intermediate distance (which should provide you near capability) in the second eye (this also uses mini-monovision, which is easy to adjust to).

      I have a Symfony lens in the right eye for far distance and a monofocal lens set for near distance. That combination provides me good day vision at all useful distances. The only issue, I have, is the night vision issue of seeing multiple circles around lights at night due to the Symfony lens.

       

  • Inez40956
    Inez40956 WebDev

    Posted

    The big promise of Symfony lenses didn't materialize for me.  I'm 20/80 in one eye and 20/50 in the other.  Halos are a major detriment even during the day.  I am at a loss as to what to do.

    • m50257
      m50257 Inez40956

      Posted

      You don't say how long ago you had the surgery.   If it was recent, your eyes will improve slowly but steadily for the next six or seven weeks.

      ?So just be a litte patient and then double check to see if your eyes have formed any scar tissue or whether you have developed any astigmatism, both of which developments could cause your vision to be not as good as it could be.    Either/both of these conditions can most likely be helped through laser surgery.  Good luck.

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