Symfony toric lens cataract surgery September 2017

First off, I would like to thank profusely everyone who has commented about their cataract surgery experience, especially softwaredev.  I've learned a great deal, but I'm still anxious about my two Symfony toric cataract surgeries scheduled for 6 (right) & 13 (left/dominant) September 2017.

I'm 67 and have an active lifestyle: skiing, cycling, hiking, and climbing.  I have stigmatisms, am quite myopic, and have worn glasses for more than 60 years.  Glasses corrected my vision to 20/20, near & far, until last year. I gave up on hard and soft contact lenses about 20 years ago.

The plan is micro-monovision with a goal for 20/20 both eyes throughout the range of vision (as I understand it.)  During the consultation, the surgeon said that he would probably use the ZXT 150 lens, but that he was going to analyze my measurements a bit more before making a decision.

I had asked about "reverse" micro-monovision because I use my right-eye exclusively for an optical scope sometimes, but the surgeon said that "reverse" was problematic and not as predictable as the normal micro-monovision.

I would be grateful to hear from anyone who has experienced or knows about "reverse" micro-monovision.

The surgeon said that I would have better depth perception with this approach than if a monofocal toric lens were placed in my left eye and the Symfony toric lens in my right eye.

Halos, starbursts, and glare are not too important to me as I rarely drive on busy public roads at night.

The surgeon's informational packet has a couple of booklets extolling the wonders of laser cataract surgery, but he told me that there would be no difference in the outcome between laser and blade surgery.  The professional literature seems to be mixed on this question, but my feeling is to go with blade because that's what the surgeon first suggested;  he was #1 in his undergraduate class at Harvard (physics, concentration in optics), graduated from Duke Medical School with highest honors, and has had an extremely successful practice for 20 years.

The surgeon said that he would do the surgeries with laser if I wanted, so I would be interested to know if anyone on "Patient" has had cataract surgery and would recommend it over blade for specific reasons.

The surgeon will not do a LRI with me and he does not believe that I shall require a lasik enhancement post-op for excellent vision.

The surgeon's literature states:

"The ORA laser scan is used as need.  The ORA takes intraoperative wavefront aberrometry readings."

The Symfony literature states:

"1. Automated examinations may not give reliable results.  These may include: auto refractors using infra-red light, wavefront sensors, photo reactors, and the Duochrome test. Manifest refraction with maximum plus technique is recommended."

Is the ORA problematic in view of Abbot's advice about measurement?

About 7% of Symfony patients (per Abbot) have some problem related to the surgery;  I shall try to mitigate any complication by taking the anti-inflammatory drops exactly as directed and generally using common sense:  no heavy lifting, hard exercise, eye-rubbing, fast movement for a fortnight.  The surgeon will administer an anti-biotic shot during the surgeries.

My German Shepherd, Vait, goes everywhere with me;  although he won't be in the operating theatre, the surgeon said that it would be fine if he accompanied me on this trip. (I had been a bit worried about infection.)I would be grateful for any other tips anyone might have for good recovery.

The day after surgery apparently I should be able to drive;  that will entail Denver freeways and then about 150 miles of mountain driving.  Again, it would be helpful to hear from people who have had challenging driving directly after cataract surgery.

I live on a ranch and for about five weeks after the surgeries I plan to deal with paperwork rather than the dirty, dusty work of the ranch in the hope that my eyes will be completely healed when I do return to what makes the ranch actually run.

The cataract in my right eye is getting really bad.  Hence I am inclined to get this done now.

My left eye has a small cataract, but that eye is still correctable to 20/20 with glasses.  The surgeon's advice is to do the left eye as well now, albeit new cataract lenses are in development.  Given his high success rate I'll take his advice. Each iteration may well be better, but the Symfony usually has excellent results and its doubtful that any toric lens will ever be perfect. Sometimes it's better not to let the perfect be the enemy of the good. 

Has Symfony (Abbot) published any data on studies of cataract patients with astigmatism >1 d?

In sum, I would really appreciate any advice for the procedure and recovery which anyone may have.

Thanks very much for your consideration!

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