Round 2 With Symfony IOL - my personal journey

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Hi everyone- yesterday morning I had my 2nd cataract surgery.  Chose same IOL as first eye Technis Symfony extended depth of focus lens.

After surgery all  was very blurry and light refracted off every light source in weird angles.  Basically after taking the Ativan prior to surgery I spent rest of day and all night asleep till post op visit this morning with my surgeon. What a difference a day made.  I could see very well today.  My 1st eye operated on 6 weeks ago tested 20/20 (post op I read 30/30 but missed 2 letters).  I could read line under that one but wasn't asked to test for that.  Newly operated eye missed 3 letters in 20/20 line but once it settles I'm sure it will improve.

Two eyes reading together did well. (wasn't tested for that after first op as my surgeon says Symfony does that better together).  I could read all the way down reading chart except last line.  I can read at 13 inches away which surgeon found to be excellent. He will see me in 6 weeks once both eyes are settled.

As for night vision haven't yet been outside after dark with both Symfony eyes.  I did have a discussion with my surgeon.  He says it is normal with overhead street lights night driving would be better than dark highways.  He mentioned younger patients eyes dialate more than older ones which would make glare from headlights bigger.  This could improve as I age.  Also he doesn't believe the concentric circles disappear- it may be as I get used to seeing them I will tune them out over time.  Although he didn't say prior to my surgery he said this is the lens he would choose for himself.  I asked about the newer lenses in the pipeline (LAL - light adjustable lens) and he said they aren't proving to be the breakthrough yet.

Sitting in waiting area with same patients yesterday for surgery most had monofocal lenses.  2 ladies were asking about mine as I wasn't wearing glasses and texting on my iPhone.  I said I could see gone without glasses.  Both said even with their arm outstretched they could not read their iPhone or iPad.  At 2 feet outwards things were clear.  They didn't know their lens type though.  Perhaps not all

Monofocals are created equal.

Anyways so far so good one day after surgery I am happy with the results.  Unbelievable to walk around and be able to read everything see vibrant colours.  Hopefully get on with life again!

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  • Posted

    Congratulations on your successful second eye surgery. Am very happy for you.
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    • Posted

      Thanks.  Was so happy this morning to see everything so clearly.  Took a day.  Blurring could have been caused by pupil being dialated or Ativan who knows.   was especially surprised how near I can read.  With one eye done it was 16-18 inches .  Now closer at 13 with both eyes.

      Will test out night vision later.  I knew it would be the compromise.  If the near vision didn't work out would be rather disappointed after making the night time compromise.

      Do you think the glare from headlights is worse on young patients due to how much pupil dialates?

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  • Posted

    Hi Sue.AN,

    my story is almost identical to yours.  I'm 2 weeks out from my 2nd surgery and never reach for my glasses.  I too had Symfony in both eyes.  No night driving yet, but i anticipate the concentric circles; on dark cloudy days i can barely see them.  I'm overjoyed with my results.  If anyone is in Little Rock, Arkansas i highly recommend McFarland for cataract surgery.

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    • Posted

      Thanks for sharing your experience.  Despite some negative reviews I think ours is the norm for outcome.  I hav driven a couple of times at night locally and been a passenger on a longer drive on dark highway.  Locally I mad out fine -  see the concentric circles.  Those are not as annoying as glare from headlights from oncoming cars.  
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    • Posted

      I drive tonight- first time with both eyes done with Symfony.  With overhead streetlights I found the drive ok.  Just looked to side of road when faced with oncoming car's headlights.  Concentric circles aren't bright - can see through those.  Real test will be on a darkened highway without overhead lighting.  I knew that was going to be the compromise- my surgeon did say this decision was going to necessitate my giving up something.

      Overall really happy with near vision I got.  Can see from 14 inches out.

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  • Posted

    Drove my car tonight first time with both eyes implanted with Symfony.  I was able to manage the drive ok.  With overhead street lighting I had no problem.  Yes there is glare and halos.  The concentric circles are not actually as troublesome as the glare from headlights of oncoming g cars.  I also found the size of the glare and halos around lights smaller now that I have 2 Symfony lenses.  

    Drive to see my daughter's soccer game - first game this summer that I could see the players well.  Floodlights didn't bother me at all - glare from those I didn't think were any different than with my natural eye.  

    The real test will be darkened highways. Without the overhead streetlights this might prove more bothersome. 

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    • Posted

      Thanks for the feedback Sue. I have to be able to drive at night on a road that isn't perfectly lit up on all parts of it with some people who literally drive 100+ mph (illegally of course, but nothing is done to stop them) weaving in and out of cars. So if I even have a small chance of night driving issues, I'm sticking with an aspheric monofocal lens since my intermediate vision is perfect in my first eye as I have said before.

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    • Posted

      Also have to worry about driving in heavy rain at night where I live even though I try to avoid doing that.
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    • Posted

      Oh and my eye tested at 20/15 for distance yesterday, wow!
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    • Posted

      That is great!

      Since you have confirmed that your distance vision is very good and that intermediate vision is also good, you should definitely consider aiming for -1.0 D or -1.25 D for the second eye. That will provide you much better near and intermediate visions.

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    • Posted

      My suggestion is fo stay with the same monofocal lens for the second eye.
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    • Posted

      Thanks for the info at201 - I'll definitely update again as I go along.

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    • Posted

      Wow - did your eye improve after a week or two from 20/25 to 20/15?

      Has your intermediate vision down to 20" or so stayed about the same or has it gotten a little worse as your eye got better for distance over the past week or so?

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    • Posted

      I'm leaning toward maybe just getting the 2nd eye set for distance also since I'm not sure I want to mess around with depth perception no matter how small the amount. I can just get a pair of bifocals with no prescription in the top part to wear when necessary (which I highly doubt would ever be while driving since I can see my dashboard perfectly, although it's digital, but I'm sure I would be able to see it fine if it wasn't digital - I can also see my built-in GPS fine and that's closer than the dashboard). Not sure yet though of course...I have a few weeks to make up my mind.

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    • Posted

      The glasses are just called "bifocal reading glasses" if anyone who happens to be reading this wants to look into them (they have no line - they're reading glasses on the bottom and clear with no prescription on top to see distance so you don't have to keep taking them off and putting them back on and they look like regular glasses).

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    • Posted

      I thought no you are smart to check more into it Nina.   Depth perception for seniors is important.  In Canada with our winters - I know thought about it.  Also I wondered about the strain in eyes over time since one would be doing the reading and other driving.  Would one end up needing  glasses for driving in the case of mini monovision?   All questions to ask your doc.  Seems that your idea of just needing glasses for reading is a good one as you already have intermediate and distance.   
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    • Posted

      Unless perhaps, one is a world class tennis player or a football receiver, the slight loss, if any, in depth perception by using mini-monovision will never be noticed. Having had monovision (of about 2.25D difference between the 2 eyes) with contact lenses and then IOL for about 30 years, I have never felt that a depth perception is an issue. And I participate in many physical activities, including hiking in the mountains.

      A mini-monovision with a difference of 1.0D between the 2 eyes will be even less susceptible to a perceived loss of depth perception.

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    • Posted

      The day after surgery I could read all the lines except when I got to 20/20 I hesitated a little and was going to guess except I could definitely read 2 of the letters on that line so I read those (I really could see all of them probably but I was tired). So they said I was 20/25 plus 2 the day after the surgery.

      I read the 20/20 line at my last appointment (1 week and 1 day after surgery) and then I was curious so I had them show me the 20/15 line and I read that too with no problem. I still see perfectly at intermediate distance with just that eye (I'm on my 15 inch lap top right now sitting down and seeing it perfectly without glasses and at a normal font size). I actually just read about someone who can even read small print perfectly with a monofocal lens, but I find that hard to believe unless I guess they're corrected to 20/30 for distance or something like that.

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    • Posted

      Yes you can end up needing glasses for driving with mini monovision especially at night. And yes, since I'm only 58, I have to think about what things will be like in 20 or more years.

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    • Posted

      Are you familiar with jaeger numbers? If so, can you read J3 sized print without glasses with mini-monovision. And I think you said I would maybe have to wear glasses to drive at night, right?
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    • Posted

      Lots to think about for sure.   You'll make the right decision for you.  I am so pleased for you.  Nice to get results better than expected.

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    • Posted

      Honestly, this was the result I did expect especially after I read 94 out of 100 people can see comfortably at intermediate distances of 2 to 5 feet without glasses after cataract surgery with a monofocal lens set for distance (sorry to say it again, but that's the results even Abbott got when trying to push their symfony and multifocal lenses vs monofocals) and I read on another study of Abbott's that the intermediate result with monofocals was even BETTER than the intermediate result with the symfony and multifocal - that document is harder to read though due to it's being overly technical.

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    • Posted

      I am glad that's the result you got.  Can't figure out why some who got monofocal lens didnt(talking about ones who had surgery same day as me by my same doctor).  We were in waiting room together and she couldn't read her iPad.  Are there differences in monofocal lenses?

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    • Posted

      This is a different less technical study (it's called The TECNIS® Multifocal IOL Patient Information Brochure) that says 85% of people with a multifocal IOL can see comfortably without glasses at intermediate distances of 2 to 5 feet and 95% of people with a monofocal IOL can see comfortably without glasses at intermediate distances of 2 to 5 feet.

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    • Posted

      This is a different less technical study (it's called The TECNIS® Multifocal IOL Patient Information Brochure) that says 85% of people with a multifocal IOL can see comfortably without glasses at intermediate distances of 2 to 5 feet and 95% of people with a monofocal IOL can see comfortably without glasses at intermediate distances of 2 to 5 feet. It's an FDA document if anyone wants to google the title. I couldn't post the link even with spaces added.

      There are aspheric monofocals and spherical monofocals but I don't think it makes a difference.

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    • Posted

      Having astigmatism or other visual issue or having a slight far-sightedness or short-sightedness can make a lot of difference for the same type of monofocal lenses. Most people will be a lot better with slight sightedness of -0.25 D (or even -0.50D) compared with a slight far-sightedness of even +0.25D.
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    • Posted

      Yes forgot that sometimes what is targeted for isn't actually achieved.  

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    • Posted

      I have monovision with the left eye set at -2.25 D and can read J1 sized print without glasses. (I do have PCO in that eye. Otherwise, I may do even better). With the second eye set at -1.00D in your case, you should be able to read J3 or better if you do only as well as an average person.

      Considering that your latest test shows that you have 20/15 eyesight in the first eye, you should not have to use glasses for driving at night irrespective of the amount of monovision with the second eye set in a range from  -0.75 D to -2.5D.

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    • Posted

      Yes. That is always the problem. I am sure that no one told the surgeon that they want to have far-sightedness. I was just trying to come up with an explanation of why different people have different capabilities with the same monofocal lenses.
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