Symfony lens halos

Hi soks,

I am 61. At this point I can't say I would have chosen them if covered by insurance. If things improve, I may change that opinion.

Thanks!

Daniel - I would encourage you to reach out to Night Hawk as he had just a week ago had a Technis monofocal toric implanted.  His vision has been improving a bit each day and looks very good for distance he’ll wind up at 20/20. He is considering a mini monovision with a symfony in his other eye to give him more mid and near vision which he won’t get with the Technis toric monofocal.

My posts are above - I have 2 Symfony regular lenses and see well at all distances.  Been over 2 months and I do not need glasses.

I wore glasses since my teen years but had no trouble reading but was not keen on losing near vision after cataract surgery.  I work full time with spreadsheets and computer so that played a lot into my decision.  Night vision getting better and I would not trade the few hours a week I drive at night for having great daytime vision- better than I have had in years.  

Yes, I got a Tecnics monofocal toric IOL (3D cornea cylinder) in my right eye 10 days ago.

This morning I achieved the best vision yet in that eye, easily 20/20 and often able to read the next lower line 20/15 too! Thats getting very close to matching my unoperated on left eye's best corrected vision - its excellent gets 20/15 and sometimes even the next smaller line 20/12.  I will be very pleased if my right eye settles around this spot where it is today, reminds me of what that eye could do years ago with a good contact lens.

I have had some small floaters in both eyes for several years, but now they are all pretty transparent little blobs so don't block my vision and I hardly ever notice them. In the right eye they just sometimes can cause a little cloudy view for a few seconds if a ghostly one moves in the middle, so not a big issue.

I do like that with the tecnis monofocal toric IOL I don't have any significant halos, or other night vision artifacts - at least no different than my other unoperated on eye with eyeglasses for best corrected vision.  I noticed last night the full moon appeared quite a bit brighter in the right eye with the IOL than the left eye, so the left eye could see more details on the moon's surface since the right eye it was too bright!  I suspect that extra light sensitivity will reduce in the coming weeks/months.

So better results today.  Amazing how it’s been improving day by day.  I too noticed the very bright full moon 2 days ago.  Could see the craters - which I haven’t been able to do without glasses for years.  It’s a whole new world!

With the latest best vision in my right eye today with the toric IOL, I again today tested near and intermediate vision with various OTC reading glasses I have around with that eye.

With +1.0D glasses added, thats fine for computer screen viewing at 24"+ but for smartphone use I have to extend my arm to maximum for clearest vision so its not really comfortable and its not as clear closer than that - I guess useable for shorter periods, kind of the bare minimum.

With +1.5D glasses smartphone use is excellent at a more comfortable viewing distance maybe 16" or so.  I would guess +1.25D would work as well with maybe 20" viewing distance.

So I would want to target my left eye for about +1.25D (window +1.0 to +1.5) to achieve decent computer and smartphone viewing. With a monofocal toric in the left eye set for that much nearsightedness, it might be OK but reduced distance vision accuity in that eye. 

A Symfony toric IOL should be able to provide that much range especially if it were targeted for -0.25D or -0.50D while still should get decent distance vision too which is my ideal goal to have both good distance depth perception (both eyes together) plus decent intermediate computer and smartphone vision with at least one eye without glasses. A monofocal toric IOL in the left eye could achieve the latter but not the former, but would offer improved night vision and probably no artifacts like no halos and circles around lights indoors and outdoors that the Symfony might do, though less so with only one eye.  While driving if a particular nasty situation occured temporarily with the Symfony eye, could always close it for a minute using the monofocal eye until a bad light artifact from a car had passed by.

Those are the tradeoffs for me to consider for the future, probably for the next few months or longer I will have to just get new sets of eyeglasses to get the best vision from both eyes together, though its looking like the right eye will just have a clear eyeglass lens with very little or no correction needed...

Thank you Sue for the referral to Night Hawk as well as your own experience, both help in getting me to focus on what is my objective.  I have heard that two Symfony's will work better together than just one symfony and a different lens in the other, have you heard that?

Yes two Symfony IOLs should allow both eyes to work together better at all the focus ranges for distance to intermediate and some near.

Mixing a Symfony with a monofocal set for distance should give the same dual eye vision for distance, but for intermediate and near it will be using primarily the Symfony eye so would be a little less but still I think better than both eyes monofocal, except for the night vision artifacts of the Symfony. The mixed Symfony with monofocal option however may reduce the effects of the night vision artifacts compared to both eyes with Symfony. But for reading, both eyes with Symfony clearly is an advantage.

Agree with Night Hawk.  There are pros and cons to both set ups.  Yes 2 Symfony lenses work well together but a monofocal targeted for distance with a Symfony targeted -5D would provide good vision all distances but less night vision halos since the concentric circles only start at about 30 yards.

Daniel I should mention that although my Symfony lenses were targeted both for 0D my 2nd surgery ended up -50D and provides me with the ability to see nearer at 10 inches out - I can read very tiny print.  Although not my original plan I am actually happy with this set up.

I plan to get a refraction eye test at an optometrist later this month, to find out exactly where my right eye ended up as well as get the latest Rx for my other eye.

The doctor recommended that for one month after surgery so I hope I can do that just before Thanksgiving in order to order new eyeglasses online in time for the big Black Friday sale discounts available each year!

Have you gotten a refractive eye test yet to find out exactly where your Symfony eyes ended up?

How do they do that test?  Didn’t know that did that.  Is that done at optometrist?

Yes I am looking forward to Black Friday sales too.  Hoping to get some good hotel deals for upcoming vacation.

Thank you Night-Hawk for the comeback, very helpful, and glad your getting a good result.  

Thanks again Sue, I will discuss these options with my doc, 

Yes its just a simple eye test at an optometrist where they have you look thru different lenses and ask you if one is better or worse until they find the best prescription for eyeglasses for each eye.

You would find out for each eye if you have some residual astigmatism as well as the power like -0.5D.

It would be good to know and record it to have a baseline for future eye exams in the coming years to track if your eyes change much, even though you don't need eyeglasses now.

Last time a couple years ago I just went to the cheapest optometrist I could find, that was locally at an optometrist at a Walmart or Costco store. Only about $50 or less for the refractive eye exam compared to triple that price at other eye doctors.  I have an opthalmologist I go to for full medical eye exams, but she didn't do the refractive test since she didn't prescribe eyeglasses or contacts. So a lower cost one is fine just to get an eyeglasses prescription, then I can order glasses far cheaper online with the Rx information plus with coupon codes or at sales time, even bigger discounts!

Ok thanks.  My private insurance covers that exam every 2 years but I was there in Jan and when I was informed I had cataracts.  Might be worth as you say a baseline for future eye exams.

There is obviously more than one good way, but based on my experience, there is zero issue introduced by mixing a Symfony lens with a monofocal lens. I have a monofocal lens in my left eye set for reading and a Symfony lens set for distance in my right eye. With the 2 eyes working together, I have 20/25 or 20/20 vision at all distances between 16 inches to far distance. Thus, there is no need for me to wear glasses for any activity. There has never been any issue with depth perception.

Thus, my only issue has been with the night vision due to the multiple circles around lights at night. As I have mentioned before on this forum, if I had the choice of starting from scratch, the only change I will make for myself is to have the monofocal lens set for distance and the Symfony lens set for intermediate distance. That should still give a good daytime vision at all distances with a reduced chance of having the night vision issue of seeing multiple concentric circles around lights.

Thanks for the comeback. I do hours of reading in the morning, if I went with a Tecnis toric monofocol set for distance in my dominate eye and a Symfony adjusted for near vision, would that put strain on my eyes more so than two Symfony's? I like the approach of one Symfony just to minimize the exposure to concentric circles, but at age 77 my chief goal is reading and avoiding night driving where I can.

Just to be clear, if you get a monofocal lens set for distance in your dominant eye, you should get the Symfony lens (if you use that combination) set for the best focus at intermediate distance (and not the best near vision stated in your post above). That will correspond to having a prescription of -1.0D for the eye with the Symfony lens. You will be working with a mini-monovision, but that is easy to adjust to (some people find adjusting to a bigger difference of 2D or higher between the two eyes a little harder to adjust to). You should be able to read most of the print fine with that combination. Actually, your near vision will be slightly better than having both of the Symfony lenses set for distance, as many people get. The near vision will be only slightly worse  than having one Symfony lens set for distance and the other one for the intermediate distance. But, with the 2 Symfony lenses, you will have a higher chance of having the night vision issues due to seeing the concentric circles around lights at night.

If the near distance is of prime importance to you, you may even consider having the monofocal lens set to end up with about -0.5D and the Symfony lens set for about -1.5D. With that you may end up with about 20/25 vision for distance (instead of 20/20), but should be able to read even fine print (all these numbers are estimates based on not having other vision issues). The chances of seeing the multiple circles around lights will be small with this combination.

Appreciate your taking the time to answer, very helpful.  

 

Daniel, I am 74 and had Symfony lens implanted in December of 2016.    The allure of not having to wear glasses was like the cherry on top of the ice cream sundae!    My surgeon was also very experienced but that didn't change the outcome of all the glare and distracting halos and circles!   My advice to you is to tell you surgeon to remove your cataracts and fit you with a new pair of glasses!   That is exactly what I WISH that I had done.   All the verbal "headaches" that go along with the Symfony Lens just aren't worth it!   Frankly, I paid big money for these so called "wonder" lens but what I wouldn't give to have just a good old pair of glasses once again!   Good luck to you.....I just wish someone had warned me before I made the jump!

 

I would not recommend the Symfony lens.  For me, I would put a monofocal distance lens in both eyes and wear progressive glasses for close up and intermediate.

Hi, so you do not have the Symfony lens, just the Tecnic's brand of monofocal toric lens. Is that correct? I'm looking at all avenues and appreciate having found this site. I had retinal surgery and developed a fast growing posterior cataract in that eye. Now looking at cataract surgery in a few weeks and have so many unanswered questions as time has gone on since first speaking to the cataract surgeon. I'm near-sighted, still have one eye that is without a cataract, I've worn progressive glasses for years and love them and don't mind continuing to wear glasses but hate the idea of losing my near vision in my bad eye (dr wants to use a mono focal lens set for some level of distance then finish vision correction with a new glasses prescription). This is why I was interested in the Symfony lens and happy for any information and experiences I can get. Thanks!

Hi, so you think a monofocal distance lens is a better option than the Symfony lens. What would you do if it was only one eye being done because there is no cataract in the other eye? That's my situation. I've worn progressive glasses for years and am happy to continue to do that but want to ensure I'm getting the best lens for me with only one eye needing a cataract removed. I worry about not having any near sight in that eye any longer. 

Hi at201, you sound so well informed. I'm wondering what your take would be on my situation. I had a vitrectomy recently due to a hole in the retina. I developed a posterior cataract within a month of that surgery while bubble was still in my eye so I've had to wait months until I could have cataract surgery (can't do it while the bubble is still there). I am near-sighted, still have near vision but find glasses make it sharper than without now that I'm older, the other eye has no need for cataract surgery at this time and won't for a long while. I wear progressive glasses and don't mind continuing to wear glasses. My big concern is losing near vision in my bad eye after cataract surgery plus I need to know both my eyes are going to be able to work together once this is done. My cataract surgeon "never" puts in a monofocal lens for near vision. Result would be "Coke bottle thick lens" to correct the rest of my vision in that eye. She does not recommend multi-focal lens and she wants to put in a lens with some level of distance correction and then once I heal, a new progressive lens prescription for my glasses. Any thoughts on this? Again I worry about losing my near vision...how do I see things up close when glasses would be in the way (i.e. make up, silly things like plucking eyebrows). Thanks!

I've found a good small/lighted 5x or 7x magnifying mirror (the type that has a suction cup on the back you can put on your bathroom mirror) can help a lot if you have only have distance vision for working at the mirror closeup without glasses.

My right eye was corrected for distance vision with a toric monofocal IOL, but if I did it over I would now have targeted for intermediate vision instead since I spend more time on the computer at 2-3feet or so and that focus also works at the mirror and good enough around the house for TV watching, in the kitchen, etc.  Might have to wear distance correcting eyeglasses for best vision while driving with that option, but in the day usually need sunglasses anyway.

I have the Symfony lens in both eyes and it has given me huge star burst and halos. It has not been a good choice for me and I would not recommend Symfony.

Sorry to learn about the vision issues you have had.

You are wise to consider your options upfront rather than after the cataract surgery.

I think that irrespective of whether you choose a monofocal lens or a Symfony lens for your bad eye, one of the most important things is to not have more than 1D difference between the prescription of the 2 eyes. It is hard for the brain to adjust to bigger prescription differences between the 2 eyes when using glasses due to the differences in the image sizes seen by the 2 eyes (it is not a problem if one wears contact lenses). Unfortunately, not many doctors pay much attention to that.

Practically speaking, this means that your target distance for best focus (for the bad eye) should depend on what your prescription is (and the best corrected vision with glasses is) for the good eye. If you can share that information, then I may be able to make a more definite suggestion for the bad eye.

I have the same wish as night vision glares/halos continue since 2017.  However, do get some relief by using night vision Polaroid glasses which  reduces glare.  Halos and flares still there but not as bright. Improves estimating distance of oncoming cars which was difficult due to oncoming cars headlight brightness.

Hi cheryl20210, how long have you had those Symfony lenses? I know a woman who has one in one of her eyes (done 2 years ago) and loves it. She's having the 2nd eye done next month. Seems more people hate them than love them.

Right now I'm legally blind in my left eye due to my cataract so have no corrective vision in that eye. My glasses don't work for that eye any longer. I checked for my last eye records but they did not post those to my patient portal so all I have is an older prescription from several years ago and it hadn't really changed in my right eye (good one). These numbers are for my right eye only:

Distance -2.00 (sphere) +1.75 (cylinder) 015 (AXIS)

Reading Add +2.50

I've no idea what any of this means and so many of these posts have numbers that make zero sense to me because I never paid attention to that. Thanks for any suggestions but I think that might be hard given my circumstances right now.

I should add that I'll try to get my latest prescription info in the morning and get that to you. Can I ask what it is you do that enables you to understand all of this so well?

 

Badsoden:  -2.00 sphere means you are nearsighted / +1.75 cylinder is the amount of astigmatism and the add of +2.50 is the prescription for reading (presbyopia).    With that amount of astigmatism you may want to consider a toric lens.

Will look forward to learning about your latest prescription for the right eye. Are you using glasses for the right eye with the same prescription right now? And how well can you see with that eye right now?

If the prescription has not changed much from the one you mentioned above from a few years back, I would try to get the IOL for the left eye set for the best focus at about 40 inches (corresponding to ending up with a prescription of -1.0D). That will probably give you the best chance for the two eyes to work together. But, let us not make any decision on that until you know what your latest prescription.

To answer your other question, I am a retired engineer and have just picked up the eye-related material as I have needed for my wife and myself.

Thanks at201...my retinal surgeon went to school for mechanical engineering then got into eyes. We liked that since my husband is a retired ME as well. And now you. Your brains just get how things work and what things mean, collecting all that info. It boggles my brain so I share all info with my husband and he goes into all my appointments. My sounding board. He's explained to me how this Symfony lens works like a camera lens. It is hard to know what to do about this Symfony lens, so many negative reactions yet I know someone who loves the one she has had in one eye for 2 years and will be getting her other eye done soon. Someone else on this site loves hers as well. Wishing there was a trial period without surgery. My glasses prescription has been fairly constant over the past 2 eye exams so the right eye is about at the numbers above I believe. My glasses right now are probably close to the above and my right eye can see fine out of those.

Because if my vitrectomy my astigmatism may be gone. A lot of layering was done on the retina to remove scar tissue so shape of eye may have changed. Dr will look at that during my appt for IOL measures.

I am sure your doctor has the current measurements.  I was going by your post and explaining what numbers meant.  Would be good for you if astigmatism was corrected.

The majority of the posters on this forum who dislike Symfony (or other lenses) come on after surgery and want advice/help with current dissatisfaction with outcome.  I have now find outside of forums others who are happy with Symfony.  All of us see the concentric circles - as mentioned it’s part of their design (much like a camera) and something one should know about prior to surgery and understand that compromise.  If vision isn’t great the worse that compromise is and I am thinking there are other issues than the lens as they do provide very good vision aside from the circles.

I came looking for help prior to my surgeries and chose Symfony despite the negative reviews here.  Am happy with the outcome and perhaps knowing from here and my surgeon that there was a compromise to make helped me transition.

Badsoden,

That is indeed quite a coincidence that your surgeon, your husband as well as I have ME background.

Thinking about your situation some more, assuming that your right eye's prescription has not changed much, you do have another option besides trying to get the IOL for the left eye set for the best focus at about 40 inches (corresponding to ending up with a prescription of -1.0D).

In this, you can go ahead with getting the left eye targeted for about -0.25D, as you surgeon has suggested. If that is achieved, that should provide you reasonably good vision at intermediate as well as far distances without glasses. However, you will have to be careful about the glasses prescriptions which you get from the doctor's office. For example, you will probably find that your eyes will have a hard time working out together if you use your current prescription of -2.00 (sphere) +1.75 (cylinder) 015 (AXIS) for the right eye (this assumes that you won't be needing much of a correction in your left eye any more). Your eyes will work a lot better together if you get a milder prescription of -1.00 (sphere) +1.75 (cylinder) 015 (AXIS) for the right eye together with an Add of +1.5 (not 2.5) for both eyes. This is called blended vision and may be the best solution in your case. You will also probably just need bifocals instead of progressive glasses. Of course, you may have to convince the doctor each time that that is the way you want the prescription because that is not the way they usually do it.

Hi, thanks for all of that! I've printed it out so I'll have it at hand. I reached out to my old ophthalmologist over the weekend and he called me today and went over his thoughts on my issue. He said no to any type of IOL other than a monofocal one set for some level of distance. Because my retina is such a mess now the others would not work well for me. He told me that based on my prescription which is the one I have in my current glasses, I have not been nearsighted in my left eye especially for some time. But I could still see up close with that eye prior to my retinal hole I told him. He said that happens in some people but nope I am not nearsighted any longer. He agreed with what my current doctor wants to do and I think what you have said above will be the way my doctor will go. I'll maybe compare notes with what you've suggested vs what she says once she does all the computerized diagnostics when I go for my IOL measurement. I do thank you so much for the thought you've put into my situation and your suggestions. As for my glasses, I know the prescription will change for those and I need new ones anyway. I expect once the IOL is inserted they will pop out my old lens and I'll walk around with weird one lens frames on my face until my eye heals enough and they can measure my vision for a new and improved prescription. I felt such relief after my phone call from my old doctor. He was my doctor for years and this new doctor is just that, new to me. Doesn't know me, makes me feel as though I'm asking too many questions or not hearing what she is saying, but actually she doesn't hear me. I have to ask her to stop and listen to what I'm saying because she just rattles off information and doesn't stop to listen to me. Something she needs to learn. She's young yet. I know she is very capable though. I actually thought about going north to my old doctor to let him do this procedure but I want to keep it local, close to what is home now, and keep it all within the same eye care center at this teaching hospital. Again, thanks so much for your input.

Popping out a lens in my glasses between surgeries (span of 6 weeks) worked for me.  Wasn’t ideal but I was able to manage.

I've heard it works and why wouldn't it...this lens on that side of my glasses does me no good any longer. I'm anxious to get on with all of this...been 1/2 blind for nearly 5 long months.

Very frustrating isn’t it.  I lived with that thinking I just needed stronger glasses.  Knew something was off with my vision summer 2016.  Waited till new insurance plan year Jan 2017 to see my optometrist.  She could have knocked me over with a feather when she told me I had cataracts and she couldn’t correct my vision anymore with glasses.  Had to wait another 7 months for first surgery.  

It doesn’t always work when you poke one lens out on glasses.  Due to difference there is between the eyes and how brain adjusts to blend 2 different size images.

If you are lucky, popping out the lens on the left side of the glasses may work, However, there is a good chance that it will not because of the power of the glasses for your right eye, because there may be too much of a difference in the image sizes for the brain to handle.

Actually, if your left eye does end up close to plano after the surgery, you may find that you can do most of the things from 26 inches and beyond fine without any glasses (even though you will  want to eventually get better prescription glasses later with the suggestion I made in one of my earlier posts). You may then also be able to do the reading fine print by using standard or inexpensive +1.5 (or so) reading glasses from a drug store.

I switched to a new eye doctor as well when my older long time eye doctor retired.  The new younger eye doctor was very condescending and like yours wouldn't listen to me much. So this year I switched to a different eye doctor and he is much much better personality and is much more flexible too!  So have to try out different doctors to find the right ones.

I had cataract surgery 8 months ago on only my right eye with a toric monofocal IOL.  My other eye (left) is similar to the prescription you posted for your non-cataract eye, in my case its 2.00D cylinder astigmatism.  I was able to work fine with my old eyeglasses with the right lens popped out, so the Rx difference wasn't too great to do that so I suspect it should be OK for you as well if your posted Rx for your non-cataract eye is close to what you posted.

Also good to know Sue.An. I'll be happy once this cataract is gone...I wish I had had the opportunity to see what I could see after the gas bubble in my eye left but this cataract came along about 6 weeks post surgery then the bubble didn't leave for nearly 6 weeks after that. So tiring but patience is the key to all of these types of things. Maybe they can give me some sort of temporary lens for my glasses that will help me manage til the eye heals. We'll see what she tells me.

I'm hoping popping out the lens will work so that will be what I try first unless the doctor suggests something else to get me thru the initial healing time. 

It will work, as you will have a monofocal lens on your left eye (cataract). If it was a Symfony lens, it would be harder to adjust; besides premium lenses work best in pair.

Oops, they work best in pairs. Credit to at201, laser PRK enhancements after post-cataract surgery are possible even with monolens. So there is no fear of losing one's near vision.

Where laser or PRK not recommended for some reasons, credit to SoftwareDeveloper, a corneal inlay surgery is possible in the US after cataract surgery to improve near vision.

 

LOL jantje - think I would prefer they measure twice & cut once.  The least amount of procedures that have to be done post op the better.   Always good to know something can be done but I’d rather they get it right the first time.

I don't want any further procedures done to my poor eye...it has had more than its share of trauma. A decent monofocal IOL and a new glasses script should do the trick from what they tell me.