Symfony toric in 2 days

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I'm having cataract surgery in 2 days and doc says he's using a Symfony toric lens. I have full confidence in him but he also seems so busy that I'm intimidated to ask too many questions. I'm 61 and told him my goal is to be glasses free except if I need cheaters for small print I'll be satisfied. Can anyone tell by my latest prescription how significant my astigmatism is and if I truly am a good candidate for the Symfony and if my expectation is reasonable? Here's what my prescription says: rt eye sphere +3.25, cylinder -1.75, axis 164. Left eye +3.00, -2.00, 175. Thank you and I will post an update after my surgery. I'm getting the left eye done first and then the right as soon as he says it's okay to do it.

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  • Posted

    I think that your expectations are reasonable by getting Symfony toric lens in both eyes.

    1. I have a Symfony Toric lens in my right eye in combination with a monofocal lens with distances set for monovision and allowing me to not having to use glasses at any distance. But if you don't mind using glasses for reading, you don't need to go for monovision.

    2. Am overall happy with my day vision with the combination and am satisfied with my choices. However, I do have an issue with the night vision because of multiple concentric circles seen with Symfony lens, as discussed under "Has Any One Else Noticed This Unusual Vision Issue with Symfony Lens."

    3. Looking at your prescriptions,  I think that you should definitely get toric lenses.

    4. Be prepared for the fact that the lens correction is usually slightly off the target. So, firstly, the results for the left eye may determine the best choice for the right eye. Secondly, to get the best vision, you may need to have LASIK enhancement (fortunately, my surgeon included that procedure free-of-cost in the cost of the Symfony lens)

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    • Posted

      I would like to know if there is any procedure to remove the concentric circles from my vision?  I expected halos and some flashes, but never did I expect the starbursts and concentric circles.  

      ?Thanks

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    • Posted

      Unfortunately, there is no procedure for removing the concentric circles (except replacing Symfony with a different lens, which is a drastic step which I don't suggest). The circles are due to the reflections at the diffraction circles design of the Symfony lens itself.

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  • Posted

    The odds are that if that you'll wind up with good results, and extremely high if you  don't mind laser correction to fine tune the results. Your spherical equivalent correction is rather low which suggests the odds are good they can accurately determine the lens power. 

      Unfortunately your astigmatism is large enough that usually they correct it with a toric lens (though some surgeons use incisions or laser). A toric lens needs to be inserted in the correct orientation to correct the astigmatism (unlike a spherical lens which doesn't impact things if it rotates, at least with symmetric lenses, which the Symfony and most IOLs are). That increases the risk that the correction won't be exact since the lens might not be positioned exactly, or might rotate slightly after surgery.

    Although most people have good results with a toric lens,  unfortunately there is a decent  minority that need  correction afterwards to fine tune the astigmatism correction even with a toric lens. Since they moderate links on this site, you can google this to find an article on the topic of correcting astigmatism which says that before they do something to correct the astigmatism left after surgery,( like laser correction), that a decent % have some residual astigmatism:

    "> Visser 31 considered 22 publications to 2012 that published toric IOL outcomes. The pooled estimate of the 22 studies was quite disappointing with only 43 per cent of eyes =6/9 uncorrected and 71 per cent =0.50 D of astigmatism."

    That refers to toric lenses of any kind, not the Symfony in particular. 

    Once the refraction is corrected (or if you are lucky and it doesn't need to be), different studies report a range of perhaps 80-90% who are glasses free, with the others needing low powered readers. The average visual acuity at near (I'm guesing measured at 40 cm)  is 20/30 for those who get the lenses set to distance, using a slight bit of micro-monovision (setting one eye slightly in nearer) of -0.5 brings that almost to 20/25, -0.75 slightly better than 20/25, and -1 brings it almost to 20/20 at near. Those are only average results though, unfortunately everyone varies depending on their eye anatomy, which is why some need low powered readers. 

    My vision a best near has been 20/25, recently it was tested at 40cm to be at least 20/30 (though they didn't have a 20/25 line so it might have been that since I read a bit off the 20/20 line). 

    You can find a link to what print size you can read with particular visual acuities by googling:

    "visual acuity" "font size"

     

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    • Posted

      Quick update. Had surgery 2 hours ago. Went well, don't remember much. Zero pain. Eye is extremely irritated. I feel like I have a large grain of sand in eye. It is constantly tearing and causing my nose to run. I don't notice any difference at all in vision which is discouraging, but going to try and sleep for a while and see what happens. I'm looking out one side of my glasses to write this and it's not easy.

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    • Posted

      In terms of the irritation, I'd suggest just resting your eye (as they usually do putting a bandage over it) and not trying to use it that first day, and being sure to start the drops as soon as they told you to (especially lubricating drops if needed). 

      When you posted that your eye would have still been dilated and still recovering from lots of meds and the trauma of the surgery, there is no reason to be discouraged yet in terms of vision since its too soon to tell much of use. If its good that'd be a good sign, otherwise it doesn't mean anything discouraging that early.

      While some people have good vision later that day after their eye has settled down, or more likely the next day,   for some people it can take a few days to settle down. A large % of people don't even know how their vision is since there is a bandage over the eye until the next day's postop visit, thats how it worked with me. It used to be standard practice, but I've heard some don't do that any more so I don't know if in your area its typical not to have a bandage the first day. In my case distance was good right away, but near went in and out for a couple of days, e.g. enough to require strong readers at times to see phone/computer, before settling down to be good from then on. I've heard some say instead their distance wasn't good at first. 

      Unfortunately in cases like yours your initial vision also depends on how well they corrected the astigmatism, as I noted above a decent minority unfortunately have some residual astigmatism at first which will be corrected later via either rotating the lens or laser correction. I was fortunate enough to not have astigmatism worth worrying about before surgery.

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