Symfony IOL refraction target suggestions?
Posted , 8 users are following.
Hello. At a young age of 25, I had catarct surgery with a monofocal lens set to distance in my right eye a month ago. My left eye is normal and untouched. Because the surgery happened abruptly with no prior information, I was devastaed with the loss of near and intermediate vision. Because I am a developer and intermediate vision is paramount, I have talked to another surgeon about getting the monofocal lens replaced with the Symfony, which he said was possible.
But I'm struggling to decide upon the refractive target I should ask for. My wish is that I would be able to see clearly from about 55cm (21.5 inch) onwards. I won't mind blurriness for anything nearer, but I want to see 'quite comfortably' at this range and onwards, even without the aid of my other untouched eye. I am struggling to decide between targeting for 0D, -0.5D, or maybe -0.25D...
Could anyone share their experience on target refraction for the symfony and their results? I know people's experiences vary alot, but I would be grateful for any suggestions or advice.
Thank you in advance
NOTES:
- Before the monofocal lens implant, my vision for the eye had been -5.00D (myopic) with astigmatism, which was corrected by incision. But I suspect astigmatism was not removed completely as things are still a bit blurry.
0 likes, 15 replies
Sue.An yulie93
Posted
Yulie93 - so sorry you’ve been as to experience this at such a young age. As some have posted with good intermediate and near to that range (20 inches) with a monofocal lens it’s disappointing you aren’t to have better vision. Is your distance vision crisp?
I have 2 Symfony lenses targeted for plano and see distance 20/20 (20/15 in right eye) all the way near to 11 inches. My surgeries were July 10 and August 21 respectively. I like my daytime vision very much and work with spreadsheets and computers and have yet to wear glasses at all. I sa my optometrist
2 weeks ago and she said I may want to get readers for any extended reading I do. For reading I do need good lighting. In restaurants with dim lighting for ambiance menu reading was hard (used my iPhone flashlight - lol).
I do see concentric circles around certain light sources st night (ie cars when they brake applied - don’t see the circles when brakes lights are on but not applied ) on certain porch lights etc. First 6 weeks or so glare and starbursts were terrible at night and made driving very difficult. These have since subsided a lot and although I still see the concentric circles driving is no longer problematic.
To your question about targeting Symfony. Others have posted they do not have as good a near vision as I do so maybe targeting .50 is a good option to consider.
One thing I would caution you will is do a lot of research on a surgeon as an exchange requires a surgeon with more skill. Most of them are explanting multifocal lenses for a monofocal lens. So make sure you understand what you are going to have as night vision as your compromise to seeing all distances.
I recommend you read through Dr Por Yong Ming’s blog as he has been implanting Symfony lenses in Singapore for 2 years now. He discribes to a tee what I have experienced with Symfony and expectations. He also has a Q&A and answers people’s questions. It is great to ask questions of a doctor (this forum is all patients as far as I know). I would feel terrible if you based your decision on one of us.
But please find a good surgeon and ask lots of questions.
Best of luck to you Yulie - feel free to ask me any questions if you need to.
Sue.An yulie93
Posted
Given you are 25 and other eye doesn’t have a cataracts is likely the contrast between what you see through an artificial lens is likely greater. Many of us here joke about not seeing this well since our 20’s is just joking. Fact is at 53 I probably don’t really remember or could possible compare vision I had then from contrast to colours. With one eye done I was amazed at Colorado differences (other eye had a cataract and everything had a yellow tinge).
I really feel for your situation and wish you the best.
yulie93 Sue.An
Posted
Sue.An - - Thank you for your detailed response. It's strange that my monofocal lens won't even give me crisp distance vision let alone any intermediate or near. Personally I suspect that my pyschological devastation has been keeping me from getting best results, since I cried a lot for a whole week after surgery - that certainly can't have been good for the healing eye. Really, patients should have full rights not only to the choice of lenses but also to prior knowledge of what they're getting into.
Anyway, your experience has been really helpful. Some posters including yourself have reported 20/15 vision at distance when achieving plano with the Symfony. So I think I will be going for -0.5D, slightly myopic, since there's a fair chance that distance vision will still be around 20/25 or more. Also, I think shooting for -0.5D and ending up plano is better than shooting for plano and ending up hyperopic (+0.5). I'm expecting halos/starbursts to be manageable since my other untouched eye will suppress them.
Thanks again heaps for your kind and helpful words. All posts like yours are exremely valuable to me at this stage of decision-making. Thank you
robert20416 yulie93
Posted
The Symfony lens, if put in correctly, should give you good intermediate vision set anywhere between -0.5D to plano, even slightly hyperopic. The intermediate vision is hard to miss, as long as nothing strange happening like your monofocal implant. I just had a monofocal implant set to -1.0D. It gives me great intermediate vision with little or no artifacts of any kind. That may be something to consider as well.
Sue.An yulie93
Posted
I went back to your original post. You mentioned there the surgeon told you while operating that you had a cataract that he was going to fix. So can understand how devastated you must have felt. I am not a specialist but have a hard time with understanding how that surgeon could even come up with a lens on the spot without benefit of pre tests and measurements that is usually associated with cataract surgery. Perhaps no surprise to those hearing your experience that you are unable to have crisp vision at any distance. I assure you that isn’t the norm with a monofocal lens.
Whatever you do see another expert for a 2nd opinion. I would not trust the surgeon who did this and if you live in USA you may have grounds to sue him.
You’ll want to find out from someone else why it is you cannot see at least one distance well and get their opinion on what to do next.
Best of luck to you - let us know how you make out as I am sure you are not the first or last to have a surgeon do this. Patients have the right to know more about the surgery and lenses. Often that is not the case. Even in my own situation I was given some info but it wasn’t till a trip to optometrist for my daughter (and prior to my surgery) that I started to research online more. Our family all see same optometrist and when she casually asked me about my visit with opthamologist (one she referred me to) and learned I was considering multifocal lenses that she strongly advised me against that. In the end I went with Symfony anyways but I am glad she said something or I would not have looked into it more.
robert20416 yulie93
Posted
Well, as soon as I posted the above reply, I realized I'm suggesting replacing a monofocal with another monofocal. Sorry, never mind.
Sue.An robert20416
Posted
robert20416 Sue.An
Posted
Oh, really? I didn't know that his cataract surgery was done in such an impromptu manner. THAT IS NOT RIGHT!
Sue.An robert20416
Posted
I am no doctor but knowing the pre-tests I had done, scans and eye measurements how can a surgeon opt to do a lens exchange without knowing power needed etc? Unless he substituted power of implantable lens and chose same for IOL? Maybe he didn’t even have a large selection of lenses there. In any case this is most likely reason for Yulie93 seeing poorly at all distances.
Yulie93 have you seen another surgeon/expert? I think that should be your first step. Find out why the monofocal isn’t giving you any usually vision. Don’t jump into a lens exchange without knowing what is wrong.
at201 yulie93
Posted
Just noticed this as I am traveling and don't have a good access to internet.
Just a few comments and suggestions because of the limited information at this stage:
1. Don't seriously consider a lens replacement, specially with a Symfony lens (minimal advantages for your specific case and some potential disadvantages)
2. Need to know your exact distance prescription for the right eye and your best corrected vision for that eye. Is the right eye your dominant eye or the nondominant eye? Something is not making sense. If your right eye is plano and your left eye is normal, you should still have good vision at the usual range of distances!
3. Depending on what was actually achieved for the right eye, a LASIK (or PRK) enhancement for that eye to achieve the target will provide a much more predictable result than a lens replacement
FYI, I have a Symfony lens in my right eye for about an year (good distance and intermediate vision, but undesirable night vision effects of seeing multiple circles around lights) and a monofocal lens set for reading in my left eye for 19 years (with a gap of 18 years between the 2 cataract surgeries). I had successful LASIK enhancement in both of those eyes. Don't need glasses for any distance,
Sue.An at201
Posted
Merry Christmas to all!
yulie93 at201
Posted
Hello, hope everyone enjoyed a merry christmas. Thank you for all your replies.
@at201,
My uncorrected vision in the eye with monofocal IOL is 20/25 to 20/30 at distance. It is the dominant eye.
It is true that theoretically my unoperated eye should be able to cover all distances, but having to use only one eye to see at certain distances came to me as such a shock especially when my vision definitely wasn't affected by cataracts at all before the surgery. I decided on lens replacement with the Symfony because I figured it would at least give me adequate computer vision. It's really difficult reading the computer screen with one eye, especially for long periods, with the other eye a complete fog.
My operated eye is the dominant eye, and I don't know why it's not giving me the crisp 20/20 vision it's supposed to. My doctor says its because of posterior capsule opacification but I highly doubt that's the case. For one thing, the reading glasses he prescribed is helping me with distance vision, strangely. But when I point this out he simply says it's impossible! -- he simply rules out my firsthand experience. All in all, I have lost all confidence in him and am definitely going to another surgeon to seek advice.
But are there any particular reasons you suggest that lens replacement with the Symfony is not a good idea in my case? I'm booked in with another surgeon tomorrow, and any other information/advice beforehand would be helpful for me. Thank you
Sue.An yulie93
Posted
diane48177 yulie93
Posted
I'm curious how you are making out Yulie. Did you have a lens exchange or are you just living with the result of your first surgery?
Night-Hawk yulie93
Posted
If reading glasses indeed improve your distance vision, that would probably indicate you were left farsighted. There is always the possibility of the results being off after cataract surgery, its not exact due to the possible errors in calculating the proper lens power, the steps (0.5D0 between available powers on the lens, and the unpredictable nature of the healing of each individual's eyes. Of course the ideal result is 20/20 but thats never guaranteed unfortunately - I ended up around 20/25 to 20/30 for distance vision due to about 1D of residual astigmatism, though the power ended up close but about 0.25 to 0.50D from the target, which is expected just from the lens power steps.