Symfony Lens: Cataract surgery done on right eye- 37 years old- starbusts,haloetc

My left is dominant based on the test we did before the first cataract surgery. I have follow up next week on right eye and left eye is scheduled on Nov6th. But they already did ascan for both the eyes so not sure if they will redo it. I was told some computer algorithm calculates the prescription. 

I work mostly on computer so not sure if monofocal on left will cause any issue, i am trying to avoid glasses/contact.

My main concern is glare/starbust, rigth now I mainly see it if I close my left eye, but with both eyes I don't see much glar/halos etc.  I guess I don't know what will happen once I get my left eye done.

Will yag help my right eye since I have 5% second cataract, does Alphagen eye drop helps. I still see some glar during day specially at car daylights.

Based on the information that your left eye is dominant, I will suggest going with a monofocal lens for your left eye set for distance. That will minimize seeing the concentric circles at night because the dominant left eye will not see such circles (monofocal lens does not have multiple circles in the lens design as the Symfony lens does).

If you get the Symfony lens in the left eye also, your night vision issue will probably not get much better.

However, you should be aware that while the monofocal lens in the left eye is better for your night vision, your near vision will then be about the same with both eyes as you have right now with just the right eye. Thus, it is possible that you may need reading glasses for reading very fine print. But that is a trade-off which you  are in the best position to make depending on your life-style.

Hi 201

I had cataract surgery about 4 years ago, they put the Stronger lens in my naturally weaker eye (I always wore glasses) and that eye was done first. 

Then in my dominant eye they put the Weaker lens, it really did my head in for years and I think I am only starting to get the eyes working together and starting to feel normal again.  I wanted my prescription to be under-scribed as I had always been short-sighted. 

Get it wrong and it is really hard to adjust.  Any thoughts.

What is the prescription for each of the 2 eyes? Also, what is the best corrected vision for each eye? That may help me understand your situation better before I offer any suggestion.

I am always impressed by people that have that kind  of detail.  However, I do have prescriptions for after the surgery which reads:

2014  -  Right - Sph -1.00  Cyl -0.50  Axis 85    Left:   Sph -1.00 Cyl - 0.50  Axis 95  

2015   -  Right - Sph -0.75  Cyl -0.50  Axis 95   Left:   Sph -1.00 Cyl - 0.75  Axis 80

Although I do not ever get the glasses, as I don't really feel I need them.

Vision unaided  6/7.5 and 6/9.5

I have  Bilateral Pseudophakic, exophoric and endpoint nystagmus, evidence of levator aponeurosis dehiscence.  Could you please explain these..

I had great difficulty with my left eye after operation and the pupil now seems to be permanently smaller size than my right, it makes my eyes look different from each other.  Is there anything I can do about that.

Thank you for information it will be greatly appreciated

        

                                However, I have never got glasses since the cataract operation although I go every year for an examination.

OOps the prescription says add +2.5 for reading.  However I use +1 cheap reading glasses which I am comfortable with.  Is this okay?  Thank you Carol

Do you still see glar/starbust around headlights or direct lights? I wonder if it will go away since it's only being 7 days to surgery.   I am not bothered much by rings since I only see it around brakelights or traffic lights. 

Do you use any pupil constriction drops like alphagen? I wonder if that will help eventually if needed. I do see starbust go away on the bottom of the light if  squint.

The prescriptions for your 2 eyes is quite close to each other. So, differences in the IOL power between the dominant eye and the non-dominant eye should not be a contributing factor to your difficulty in making the 2 eyes work together.

The "+2.5D" for reading in your prescription is just the difference between the distance prescription and the reading prescription. Just going by your 2015 prescription, +1.25 or +1.5 reading glass may work out slightly better than +1.0 reading glass for you.

It does seem that you should try wearing prescription glasses for distance, specially if you are driving. You may be surprised by how much better you will be able to see.

I am sorry that I am not very familiar with the other eye issues, which you mention. Please make sure that you have a good ophthalmologist, who can provide you good answers.

 

Based on my experience, the concentric circles or rings will not go away with time, although I am sure that you will learn to live with them.

The glare and specially the starbursts are more a function of the imperfections in your vision. Your vision will be changing some more over the next few weeks. The changes can be for the better or for the worse. Thus, the glare and the starbursts will change accordingly.

The constriction drops will essentially reduce the effects of the astigmatism and other imperfections in your eyes. Thus, the glare or the starbursts will probably be better, but there will not be any effect on the rings (which are caused by the light dispersion from the circles in the lens itself). However, the constriction drops will decrease your ability to see in low light.

Hi Sam - as mentioned I had Symfony lenses implanted in July and August.  I am not an expert.  Just my experience the glare and starbursts from car headlights did diminish for me at about 6 weeks.  I found first few times out driving at night difficult but living in Canada it is dark pretty much just after 6pm so driving in the dark a lot now and finding it easier.  The concentric circles are there but not as bothersome  to driving as that glare.  Some of the worst are from the newer LED headlights which bother my husband too and he doesn’t have cataracts.

Again Ihave no expertise in this area - but my guess is if you are seeing well in the day now it isn’t likely due to lens power being off.  Your eyes are still healing - hopefully I’m a few weeks you’ll see a difference.

You may want to wait a while to see how it plays out before going ahead with 2nd surgery to make a change to kens selection.

I tried one thing at night where I am flashing iPhone flashlight from the side of my eye and all the starburst etc goes away and the car light is perfectly clear. Why is that , is it something with my pupil ?

When you shine a flashlight to your eyes it should cause the pupil size to shrink, so that would tend to reduce the night vision artifacts at the expense of some light sensitivity.

This is what I see or almost-

Car headlights - http://cataractsurgeryinformation.com/wp-content/uploads/2012/12/22.jpg - More like the street light with starbust.

Some time street lights looks like - http://www.lasikcomplications.com/halos.htm

Any of this vision issue goes away as eye heals?

Hi Sam - I do believe some of it has to do with the pupil.  My surgeon commented on that saying that younger patients’ pupils do dialate more.

I have driven with inside dome light on which sometimes helped too.

Yes the links of how streetlights and car headlights appear is pretty accurate for me too.

Do you have a good camera for nighttime pics?   I have a neighbor I walk regularly with evenings (this time of year it’s well after sundown).  She doesn’t wear glasses except for driving (slight prescription for distance at -1.25) and she sees same image as I do for streetlights and car headlights - finds those new bright LED car headlights as blinding as I do.  I have taken pictures with my camera too of car headlights and streetlights and the image is what we both see.  Now the concentric circles are different and part of Symfony Lens design- I have taken photos of cars breaking and although I see them the photograph does not depict those.

Sometimes I think the glare we see is quite normal.  But the concentric circles are not.

I often feel like Katniss in The Hunger Games playing the game True or Not True with Peta.   

For a few weeks after surgery the streetlights and glare from car headlights were very strong / larger.  But not so much now and I think what I see is normal.

I just had a session with my psych counselor, and she said that she see's Halos and Glares at nighttime too; so much that she doesn't drive at nighttime. She does not have cataracts but is a contact lens wearer and She's fairly young as well. im thinking that it really does vary as people can see some light time flare around bright lights-  that makes it hard to see regardless of cataracts or IOL lens. Speaking aside from the concentric circles of the Symfony lens of course. 

Really do think that is the case Miguel.  I also wore sunglasses winter through summer - curse of blue eyes.  Cataracts made the glare worse.  I know I see better at night with Symfony than when I had cataracts.

Must be hard on you as you’ve many years to live with this.  I wonder if a new lens/technology comes out of you can do an exchange down the road.   If that was your thinking be careful about getting a YAG procedure for PCO

I had my 10 day postop today, Dr said lens is centered find, he did not check anything, eyes were also not dilated. I asked him about starturst, halos etc, he said that happens with this lens. He said for left eye you can do monofocal if you like:

Few Question:

1) What about crystalens? I heard it has less halo etc, since its monofocal but Accomadting lens.?

2) If I go with Technis Monofocal, will it still allow me to see Intermediate or about arms lenght vision for laptops, computer etc? Any range information on which ranges I can see with Monofocal

3) My Dr rushes a lot, literally 2-5 minutes, even in PostOp he just checked eye in 2 seconds  and done, should he be also checking for any refractive errors, etc?

In answer to your questions:

1. The Crystalens has the potential of providing lens accommodation, but it is limited. It also depends a lot on how good the eye muscles are. More importantly, it seems to cause a higher percentage of people to have PCO. Its diameter of 5 mm is rather small and tends to cause edge reflection from lights. We did not know all this when my wife had one installed couple of years back. Of course, as normally seems to happen, the Surgeon never mentioned any of those facts to us.  Based on her experience, I did not consider Crystalens at all (Symfony lens became available in USA only after my wife's cataract surgery)

2. If you get Technis Monofocal with the best focus set for intermediate distance (-1.5D), you will have no problem with reading computers, lap top etc. However, you need to have your prescription checked for the right eye before you make any decision for the left eye because that will determine the best desired focus distance for the left eye. You can have the 2 eyes complement each other by using mini-monovision. (I use a monofocal set for reading distance and a Symfony lens set for distance and have good day time vision at all distances).

3. Your doctor may be in a hurry, but then he should still have had one of his assistants check your refractive error. The vision is going to change a little, but that is no reason for you not to know where you currently are.

I have monofocals set for distance in both eyes and have no problems whatsoever seeing intermediate distances without glasses. My brother has the same thing and also has no problems, same as numerous other people I have read about online who also have no problems seeing at distances of 2 to 6 feet without glasses with monofocals set for distance.

Oh and I found 3 studies done by Abbott themselves that said 95% of people with monofocals set for distance can see fine at intermediate distances without glasses, so it's not just a few people who have that outcome, it's 9 out of 10 people.