Symfony or not? Can someone help!

Thanks Dennis. I just read your recent post about your Symfony experience. Also thanks for sharing the Symfony results will everyone. You are right about saying that the doctor should know the best. My thought is similar to yours. I want to remove the more dense cataract from my right eye and have an IOL which will provide good near vision. Having mono vision all along I am used to this. Since I can wait to do the left eye in the future when I will have a chance to go with either Symfony or another one available at that time which may add to my near vision. I am wondering if I should go with mono focal for near vision for my right eye or go with something that gives me two zones. Like near and a little distance vision as well. Thank you again for your response. 

Mind my asking where u had the surgery please . 

Dr Tal Raviv at Mount Sinai NYC.

is it usual to see circles of light at night following surgery?

 

I have always seen the annoying  multiple circles around lights at night since the day of my surgery almost 2 years back with no change in their intensity. These are due to the diffraction circles (to provide the extended depth) on the lens itself, which can be seen by the surgeon when looking into your eye.

Since everyone does not complain about it, I assume that different people's eyes may not dilate as much as other's eyes at night or have a lower contrast perception which can make a difference about one's ability to see the circles. For me, it is an annoyance and I can live with it, but really wish that I did not see these multiple circles.

Thanks. I asked my surgeon to do 'min mono vision' and he said I would need readers for fine prints. So I told him that it is fine but I want to be able to read my cell phone comfortably. He said some people hold their cell phone close and some people like to hold it far and read. I told him that far is better. I am not sure if I should measure at home and tell him in inches rather than far and near. You mentioned to set the best vision at 20 - 26 inches range. So does that cover cell phone and computer both? These are the two things I look at all day long. 

Smartphone reading 20" is doable if your arm is long enough.  I've tested with my monofocal eye set for distance focus and I need at least +1.25D reading glasses for smartphone reading at that distance. A Symfony IOL should be able to get you that if the power ends up near plano, if you target slightly nearsighted like -0.25D or -0.50D you could get better near vision with still good distance.

Different people feel most comfortable using cell one and computer at slightly different distances. I use both of those at about 18 - 20 inches. You can probably check what distance you typically use those at. Of course, one always makes slight adjustment to that distance, if needed, depending on one's vision.

As I indicated before, the prescription in your left eye should influence your choice for the right eye. For example, assuming that you have negligible cylindrical correction (for astigmatism),  if the spherical prescription in your left eye is  -0.75D, then my suggestion will be to aim for -2.0D for the right eye (corresponding to the best focus at 20 inches). Similarly, if the left eye is at -1.0D, aim for -2.25D (18 inches) and if the left eye is at -0.5 D, aim for -1.75D (23 inches) for the right eye.

If you can share your current left eye prescription, then I may be able to make you a more specific suggestion.

Yes a Symfony Lens would provide computer and iPhone distance.   I haven’t needed glasses since surgeries.   I don’t have to extend my arm st all to read text messages - arm comfortably bent.  My preference is to have both eyes read.  I wouldn’t want to put that all on one eye but that’s just my personal preference.  Others may find the monovision to their liking.

I find one eye for reading the smartphone works fine for me, thats how I'm doing it with glasses - my left eye has a progressive lens for distance and near focus and my right eye has a nearly clear lens since the IOL is set for distance focus

I do have a pair of eyeglasses now with progressive lens for both eyes, but I find the one with only the left lens progressive works best most of the time since progressive lens reduces the clear focus width.  With one eye non-progressive that gives me a clearer wide focus view overall and for reading its not usually 3D so one eye is ususually enough though with two eyes you can focus on smaller print easier.

So with my eyeglasses pair with left eye a progressive lens and the right eye almost a clear lens, I'm hoping to approximate what I might get with a Symfony IOL in the left eye in the future to to with my monofocal toric in my right eye.  Not precisely since the Symfony gives about a 1.5D focus range, and my progressive lens gives 2.25D range, but good enough for smartphone and computer reading anyway.

I find most days are spent in that near or intermediate range (at least for my work - perhaps that will change in retirement).  Hopefully by the time you need that 2nd surgery there will be a better EDOF lens that provides a greater range of focus than Symfony.

Thanks for your response to my question. Yesterday, I went to my optometrist to get my prescription. Here are the details: OD: Sphere: -2.50 Cylinder: -0.75 Axis: 172 Add: +2.75  and  OS: Sphere: -1.0 Cylinder: -0.75 Axis: 017 Add: +2.75. Now both eye seem to have the same number for reading. My optometrist said once I get a mono focal lens I am stuck with that number. He said if it was him he would get a distance in the right eye which has cataract that is more dense. However, he also said I can continue to use prescription glasses for up to two more years. I am not able to decide what I should do. I have 3 more weeks to work on this and decide what is the best option for me. 

I think that there is no single choice, which is best for everyone. A lot depends on what one's needs and desires and what one is used to.

From what I understand regarding your situation, it is important for you will like to be able to work comfortably on the computer for long time without needing glasses and you don't mind wearing glasses for distance.

Your current eye prescription actually makes it easy to achieve your goal without a significant need to adapt to a new way of day-to-day living.

You should not have any problem, if you get a monofocal lens for your right eye, which  set for the best reading at about 18  to 20 inches (-2.0 D to -2.25 D). Your astigmatism is small enough that you should be able to work comfortably on the computer or see the cell phone clearly without any glasses. You may not need any glasses for reading, except for reading fine print. Your two eyes will be working a little closer than they are working right now. You will still need glasses to see well at distance, but you are used to that. You will have some glare at night due to a small cataract in your left eye, but the glare from the right eye will be a lot less.

Thus, you should see improvements in many areas, without taking a chance of introducing new issues.

As I said before, following this plan, when in a few years, you need to have a cataract surgery done in your left dominant eye, you will still have all the options for your left eye. At that time, you can decide between the monofocal lens, a Symfony lens or something better than Symfony (in terms of reduced night vision issues) such as ZEISS AT LARA to pick the best choice at that time.

Thank you, again at201! I appreciate the time to review my prescription details and respond. Ok, so first I am now convinced that I am going with a mini monovision with a mono focal lens set for near vision in my right eye (going first). I am still a bit confused whether 18 - 20 inches is good range (-2.0 D to -2.25D). I am not sure if this mean I can hold my cell phone 13 - 16 inches away from my face and read without glasses. I am setting up one more appointment with my surgeon before the surgery date of October 12th and discuss. I also want to know if there are different kinds of mono monoclonal IOLs to consider. Like an upgrade (AcrySoft?). Or just let the surgeon decide which one is best for me.Once I get my right eye done I will perhaps know how soon my left eye will need to have a lens implant. However, Symfony in my right eye is no more on my mind any more. I have read a lot of different stories about Symfony causing glare and rings etc. That scares me. Am I on the right track? Thank you. 

It sounds like you really decided on a plan that will work well for you. I just wanted to say that I, too,  was concerned about some of the comments I read about issues with the Symfony Lens. However, the idea of not having to wear glasses was so appealing to me that I decided to go with the Symfony Lens. I had my first surgery on August 13 and second surgery on September 13 and am extremely happy with the Symfony Lens. My vision is very clear at all distances. The night time issues are not bothersome to me. Good luck with your upcoming surgery.

Great to read this. May I ask your age group? Rough idea. thanks

It is hard for me to believe, but I turned 70 this year. I am very active, go to gym, walk, etc. i’m meeting my son in Kona, Hawaii next month. He earned a slot in the Ironman World Championship.

Hi at201. Now that I have got my right eye surgery done I wanted to mention here that your assessment of my situation and prediction on my outcome was accurate. It's only 4 days since my near eye surgery and I am working at my computer without glasses. I can also comfortably use my cellphone and see my car dashboard. I have negative dysphotopsia which I am told may resolve with time. The only reason I need glasses now is to watch TV and of course for driving. So, now I have to decide between all my other choices for the left (dominant) eye. Get cataract surgery done on my left eye for distance or don't do left eye surgery and use a progressive lens in my glasses and no correction for right eye. Will this keep mono vision going without problems? Also, the idea of waiting for a new lens is great. That way if something better than Symfony comes along I will be completely free from needing glasses. I am not sure mix and match works for everyone.

ANU1942

I just wanted to say that I am completely free of glasses with the SYMFONY lens. I think it is because my doctor is an expert in selecting the correct strength of lenses that I needed.

You're lucky if you have no adverse effects with night driving as I do with the symfony lenses.