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

Posted , 66 users are following.

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

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  • Posted

    I had cataract removal in my right eye with Symfoni multi focal lens implant on 7/24/17. By my first post op checkup, my far distance was very good. But my close up sight was not good. I can read with glasses on but not even then with small print. The thing that has upset me most is when I had to drive 3 nights ago, the street lights and oncoming traffic lights all have halos around them. I really didn't think I was going to make the 77 mile trip home. I left word with the optometrist to call me back about this for 3 days now and he still hasn't called back. I wasn't fore warned about this and until I read this forum that this is normal with this type lens, I was ready to have it removed. When I saw him that first week postop, he stated that there is a haze that has developed and that is probably why I can't see close up And that he could probably use a little laser on it and clear it up. So when is healing considered to be completed after surgery. 

    I really wanted this surgery so I could see to play the piano again. Guess I am just disappointed that it could possibly be months before this could happen, if then.

    Please reply because optometrist wont even call me back.  Thank you.

    • Posted

      Sorry about your frustration.  Do you have both eyes implanted with Symfony or just one.  You should have good near vision to 18 inches.  My Symfony lens gives me good vision from 16 inches but even at 18 you should be able to see sheet music.   

      How far away is the opthamologist office?  Perhaps you need to show up if he is not returning your callls.  If you have PCO think twice about having a laser to clear it if you are thinking you'd like the lens replaced with a monofocal lens. Best of luck Rose.

    • Posted

      What is PCO? I only had right eye done. I haven't been able to see out of my left eye except light and a little form since I was a child with amblyopia.

    • Posted

      PCO is posterior capsule opacification.  Your natural lens is about 4mm thick whereas the artificial one implanted is a fraction of that.  Sometimes the capsule becomes cloudy - what surgeons call secondary cataract.  This can be cleared by a TAG procedure (laser)
    • Posted

      Sorry meant YAG procedure by laser.  Google it and it will explain.  This can occur a few weeks after surgery for cataracts or yeRs or never.
    • Posted

      I had 2 Symfony lenses put in all most 2 years ago .The results were not bad but I had a distant probem and had to ware glasses to correct the problem.

      I went to a specialist and both doctors said they could correct the problem.

      They said if they tweak the lenses I would be able to see as well as wearing my glasses.

      I thought this was great but then I found they wanted to charge me $5,200.00

      I had already paid $1,200 / lens and felt this was their error or miss calculation and felt they should bare the cost.They said they would work something out and now I have waited many months I feel after many calls they are playing games. 

    • Posted

      You must have very good near vision with that arrangement?  Was surgeon aiming for 0D?  It isn't an exact scienc getting the power spot on.  There is always a possibility of error either side of + or - .25.  

      If target of 0D achieved with Symfony most find they will need readers for fine print.  If you were left slightest near sighted are you able to read well and need glasses for sharper distance?

      That sounds like a lot of money to tweak (thinking you are meaning lasik not lens exchange).  Some surgeons with multifocals discuss prior to surgery a package at a fair price ti include lasik treatment in case needed as the whole aim of multifocal (EDOF) lenses are to eliminate glasses.

      If they won't offer a better price you could shop around to see if you can get better pricing.  If not perhaps contact lenses would be preferable to glasses?

    • Posted

      You may have to tweak only one eye and not both of them ( if the only problem is the less-than-desired distance vision) to have good vision at all distances

      What is the current prescription for each eye? And which one is your dominant eye?

    • Posted

      Had Symfony lens place a month ago.  The glare at night on LED lights is blinding.  Would definitely not do it if had to do over again.  Horrendous halos that blind you.
    • Posted

      I've had them in both eyes for over a year now.   The Doc said the night halos and starbursts would go away.  It came from wrinkles he said.   Well, I still have them and they are not as bad as the first week but the irony was, I made the decision to get the cataract surgery because my night vision was bad.   Little did I know it would get worse.   

    • Posted

      I continue to be amazed by the doctors who continue to tell the patients that "night halos and starbursts would go away.". Unless the Symfony design changes as the time passes, which it does not, the night halos or multiple circles around lights at night (caused by the diffraction circles in the lens) are going to be there. I have not seen any change in my seeing them in over a year. Yes, as I have mentioned before, all of us learn to live with those just as we do with all the other unpleasant things in life, but that does not mean that those are not there any more.

    • Posted

      My Doc (and the entire eye clinic) had been told by the Symfony sales team that the lenses were the best thing since sliced bread with correction of astigmatism,  low percentage of halos, and close vision correction.   He told me everyone was excited.  I was one of the first to get these lenses and when hype turned to reality, my Doc now claims he was oversold.  So I, too was oversold.   
    • Posted

      Just curious Dennis 87675 if you have to wear glasses for close vision/reading.  I too have 2 Symfony lenses and see 20/20 (for right eye better at 20/15) for distance but can also read well at 11 inches and beyond.  My optometrist checked my vision about 4 weeks ago and confirmed plano both eyes.  Astigmatism was .50 in one eye and .25 in the other.  I am wondering if there are more visual artifacts/disturbances when the patient’s visual outcome is further off from target.  The glare and starbursts have settled a lot since my surgeries just over 4 months ago.  Headlights - especially those blue/white ones give me trouble but there have been a number of newspaper articles about those new lights.  Turns out people without IOLs or cataracts find them hard to see around too.  I would not consider the glare and starbursts an issue anymore like I did in the beginning.  The concentric circles I do see and although I wish they weren’t there I have learned to adapt.  I much prefer having all round great vision.  Maybe having to wear glasses for distance since childhood and now not needing any for me personally is terrific.  

      It is too bad your docs having no experience with Symfony sold these as the greatest thing since slice bread.  Your and their expectations were unrealistic.  My own surgeon explained the pros and cons of Symfony vs monofocals and took great care in letting me know there was a compromise to make no matter which lens I chose.  I was miserable at that time and agonized over lens selection.  But I am thankful nothing was oversight.  A long time ago in an economic class of mine a professor gave this formula for happiness:  Happiness equals reality divided by your expectations.   I still find that definition to be quite accurate.  

    • Posted

      iPhone auto correct grrrrr.   Meant in last paragraph I am thankful nothing was oversold.

      Also have you been back to your optometrist to get an exact prescription of where you are since Symfony lenses?   I wasn’t going to but was encouraged on these forums to do that so that I have a baseline.   You should too.

    • Posted

      Yes...2,75 reading glasses with slight astigmatism in one eye.  I also use a lower power for computer screen reading....and can read larger text at arm's length - but not, for example, my apple watch text.

    • Posted

      It might be worth asking your surgeon/doctor about this outcome. I don’t think this is typical outcome of Symfony lenses.  And likely contributes to your seeing abnormal level of glare and starbursts.  My iPhone (not a plus size) is 11 inches away from my eyes and I don’t struggle at all to see it. I have threaded needles and screwed tiny screw of my sunglasses in after they fell apart the other day - no issues at all.  

      Perhaps your surgeon miscalculated the power you needed.  Did they take those measurements weeks or months prior to your surgery?  Did you have a strong prescription prior to cataract surgery?  I assume you had lens replacement due to cataracts.  If not that causes other issues.  I spoke to a few of my surgeon’s prior patients - one of which had Symfony others who had monofocals.  All were satisfied - none of them knew about patient forums or googled for info or posted so that tells me it’s rare for satisfied patients to comment online.  Lol one of the patients in the waiting area of the hospital had no clue their natural lens was being removed or there were options for lenses.  The only online place I could find mostly positive comments about IOLs (any type) was on my Disney forums.  It was nice getting feedback from them.  Most were very positive about procedure and lenses.

      I have difficulty with surgeons saying they were oversold or that Symfony lenses are to blame.  Maybe it is the possibility of surgeon error?  Yes these lenses have a certain amount of nighttime issues - shame on the surgeon for not fully informing patient of these.  I expect the concentric circles as part of lens design that allows for full daytime vision to never go away but these are a compromise I knew about and willing to accept.  I have absolutely no problem driving at night now 4 months post op.  However it is wonderful to see so well and not having to put on glasses - except regular plain sunglasses. But 100% surgeons  know and should fully explain this compromise to patients.  Rather than blame the lenses perhaps the surgeons should wake up and have fuller conversations with their patients.   However I live in a country where our surgeons make no extra cash whether I chose monofocal or premium lenses so there is no incentive for them not to disclose anything.  I paid the hospital $900 per lens extra .  Surgeon was paid by the government for cataract surgery.  Can the same be said for you or are you out thousands of $$$.  Then ask yourself is there any possibility greed was a part of the reason your surgeon didn’t have a full conversation about the nighttime halos with you?  

      You could have a lens exchange but you may want to see someone else for a 2nd opinion to see if lasik might enhance your vision.   I am not an expert but I do think your starbursts and glare (even on inside lights) can be traced to the power not being accurate or residual astigmatism- which can be corrected with lasik should you not want glasses to correct these.  Once the right visual acuity is achieved likely the glare and starbursts will subside.   That is why I think first 5 or 6 weeks for me night glare and starbursts were stronger (I sympathize because that was hard to drive with).  Once my eyes fully healed and swelling down glare and starbursts subsided (have very little of that now).  But my visual acuity is pretty much spot on. 

      You should not have to live with these symptoms.  I can tell you Synfony lenses DO allow for better vision than what you are experiencing.  Time to stop believing in what your surgeon is telling you and dig for some answers.

    • Posted

      Just thought you might be interested in reading a surgeon’s blog.  He has been implanting Symfony lenses now for 3 years.  His description of the this lens pretty much sums up what I have experienced.  I cannot include a link but if you google All things Eye dr Por Yong Ming on Symfony he writes about the lens and then has a Q&A following blog and answers people’s questions.  Not many surgeons take the time to respond to patient questions this way - it is well worth the read.  If you want ask your own question.  

      Best wish Dennis - I hope you are able to get a better result and some answers.

    • Posted

      Not sure why you're making all those accusations on my eye doctor.   Do you have an affiliation with the Symfony manufacturer?

    • Posted

      No affiliation whatsoever with anything in the medical field.  Just think if you are not seeing clearly (aside from the night time concentric circles) you should ask your doctor why and if not satisfied with the response seek out a second opinion.

      Don’t you find it unprofessionally for your doctor to blame the lenses?  If everyone got a poor result from these lenses and it’s been documented maybe.... but even then a good doctor will be doing something to ensure you see better than you are.  If you have not had a yag procedure you may even want to consider a lens exchange.

      If it were me I could not function that way at work and would need to do something.

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