Technis Symfony Multifocal Lens

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I am scheduled for my first cataract surgery next week.  I have cataracts in both eyes.  I am considering the Tecnis Symfony Multifocal lens in each eye to correct for both far & near distances. There is a considerable cost out of pocket for this.  Just wondering has anyone had any experience with these lenses?  Am rather scared and anxious but if I didn't have to rely on reading glasses that would be awesome!

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  • Posted

    I thought it was the best option for my needs, and 2 years postop of having Symfony IOLs implanted in both eyes I have on average at least 20/15 vision at distance (that line was easy, and they didn't have a line below it to check), 20/20 plus a bit on the line below at 80cm, and 20/25 at best near. At 40cm it was at least 20/30, they didn't have a 20/25 line and I read some on the 20/20 line so likely its 20/25. That said, results vary, studies only show average results. It depends on each persons natural depth of focus, and the quality of their visual system and the surgery what results they get. A small % of people do need readers at times, and a tiny % have problems with night vision artifacts like halos, since unfortunately every model of IOL so far gives some people problems.  If you have micro-monovision where you set one eye to focus slightly nearer in (which I didn't do) that increases your odds of not needing readers, without much reduction distance vision or depth perception the way full monovision can. 

    I will note though that you say to "correct for both far & near distances", that the Symfony's main strengths are distance and intermediate and a good chance of decent near. So it depends on what you consider "near" and what your visual needs are if its the right fit for you. There are multifocal IOLs, bifocals or trifocals (available outside the US, the FDA hasn't yet approved one in the US) that provide better really close near, at the expense of not as good intermediate (though the trifocals come close) and a higher risk of night vision artifacts and reduced contrast sensitivity (e.g. they may not do as well in dim light) . One study I saw a year or two ago indicated that of the premium IOLs available, that the Symfony had the best visual acuity results from 46cm outwards, but that some did better nearer in.

    The Symfony is actually considered an "extended depth of focus" lens rather than a multifocal. Some people confuse it with multifocals since it is also a premium lens used to try to get a larger range of vision, but it uses different optical technology to do so which leads to a lower risk of problematic side effects.

    In my case I almost went with a trifocal, (I traveled outside the US for surgery), but I preferred having better intermediate and distance, that really close near wasn't as important for merely occasionaly use since I could always use readers if needed or a magnifer app on a smarpthone, etc. It seemed the better near from the multifocals might be tempting, but it wasn't going to be used as often as the other ranges of distance.  

    For a good overview (if you can skim over any technical jargon) there is a good summary of the studies, but since this site sends links to a moderator, to find it  google: 

    "High rates of spectacle independence, patient satisfaction seen with Symfony IOL".

    The vast majority of people have good experiences with it, moreso than with other premium lenses though as with any product its the minority who have issues that are more likely to post (which is part of why I try to post to keep things in perspective). There is a minuscule chance of wanting a lens exchange, so it is important to be prepared for that, but I figured its worth the risk since the benefit of having better vision the rest of my life was worth it.

     

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    • Posted

      Thank so much for your input!  It was extremely informative & helpful.  You are right, it is an Extended Depth of Focus IOL.  I was confused betwen the two. I did google & research the overview you suggested, which was also very helpful.  I really appreciate you taking the time to post on this.  My first surgery is next Tuesday and I feel much better about it after reading your experience and that of others. I am only 58 and want the best vision available to me.   I will let you know how it goes.  God Bless!!!

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    • Posted

        I was even younger when I had my surgery, 52, after having gotten a problematic cataract in one eye at age 49. I figured I may potentially  live with the results potentially for a few decades, so I figured it was worth some risk. I figured most likely I'd have great results, and the miniscule risk of a lens exchange was worth taking. I postponed surgery 2.5 years since one eye remained correctible to 20/20 in hopes the US would approve a better lens, and then gave up and went to Europe to get the Symfony before it was finally approved here. I'd been highly nearsighted all my life, unable to see anything without contacts or glasses, so the potential for not needing correction the rest of my life was worth some effort. 

      I'd liken the Symfony to being like early presbyopia, where you just start to notice needing to hold small print out at a different distance, but most things being easy to see without needing to think about it.

       

       If you have a high prescription now, I would caution you to be prepared for the possibilty of needing a laser enhancement since there is more of a risk of the lens power being off. Also if you have astigmatism, that can take some adjustment postop as well. 

      Many doctors   confuse the Symfony with a multifocal, since their focus is on medicine rather than optics and with the diffractive rings it looks like a multifocal.  To most people the difference really doesn't matter since all they care about is the results, and the distinction is mostly important in that the sorts of results you get are different than with multifocals.

      Unfortunately some doctors  have writeups on the net that spread that confusion. Even some more savvy folks have contributed to the issue.  One of the inventors of a trifocal IOL who as knowledegable about optics also confused the issue when he did an optical bench study comparing it with the Symfony where some results using single colored light seemed to make the Symfony look like a bifocal, but others responded and clarified the issues and problems with his experiments (like that he didn't use white light which is what we use in the real world). 

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  • Posted

    Sorry about the late response to your post.

    Just so that you know, I have good day vision with the Symfony lens, but have had night vision issue of seeing multiple concentric circles around lights with Symfony lens. I have discussed this issue in my post, "Has Any One Else Noticed this Unusual Vision Issue with Symfony Lens" on this forum. Many other people seem to have had this issue. Rather than repeating that discussion here, you may want to read the comments there.

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  • Posted

    There are several of us on this site that have had the Symphony Lens put in. I had my last tweaking of sort yesterday to correct a little blur in my left eye. This blur was not caused by the lens, but rather from the capsule that is usually left in that was holding the cataract. In my case this capsule turned cloudy instead of staying clear, causing the vision in my left eye to register 20/30. My surgeon removed this film yesterday and the blur is gone.

    I am very happy with my Tecnis Symphony Lenses.

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    • Posted

      Hi, I am new to the site.  I have had Tecnis Symphony lens in both eyes in May.  For some reason I will need a YAG procedure very soon (within 3 months) for both eyes. Have others had this so soon?   I am very happy with the lens, I have amazing intermediate and pretty good far vision.  My near vision is not great, but fine with glasses.  

      The biggest problem for me is night vision with blur around headlights and extreme starbursts from oncoming car headlights.  Fore those who have had the YAG do these symptoms improve?  I really hope so, because I really can't do night driving with that present.  

      Also, do you know if having the YAG procedure precludes getting a lens change out later.

      Thanks for any feedback!

       

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    • Posted

      I have heard that the YAG procedure makes it very difficult to replace the IOL in the future.

      I am considering going with one eye with a toric monofocal for good distance and the other eye possibly with a toric Symfony set for intermediate distance since that might allow the monofocal eye to get great night vision viewing and block any night vision artifacts from the Symfony eye.

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    • Posted

      There are so many reasons for having starbursts around lights, such as some degree of astigmatism, the design of the Symfony lens etc, which can cause starbursts, that I would not assume that those are due to Posterior Capsule Opaqueness (PCO), which the YAG procedure is meant to be used for. Unless you confirm that a film in the posterior capsule is actually affecting your day time vision also, I would not have the surgeon use a YAG laser to make a hole in the posterior capsule to get rid of the film so soon after the cataract surgery. This will completely take away the option of getting the lens replaced, if you  need to have it done.

      The basic message is that unless the film is so bad that it is also affecting  your day time vision, don't have the YAG  laser procedure done to get rid of it. Like a lot of procedures, there are pros and cons, so taking a risk to correct a minor problem is not worth it. (just for myself, I have had a film in my left eye for the last 18 years. Yhe YAG laser has been suggested, but never pushed, over the years because every doctor knows the limit of the improvement it can potentially make and the ever-present negaive things which can happen.)

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  • Posted

    A few weeks from your surgery, how do you like your Symfony lens?
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    • Posted

      It is now week 3 for the first lens and week 2 for the second eye.  My near vision is really good but I do have the film over both lenses that the doctor will do a Laser Yag on, both eyes.  My distance vision isn't good yet because of the film.  That Laser Yag is scheduled for August 2017 to clear this up.  So for now I would compare my distance vision to that with my contact lenses before cataract surgery.  It is acceptable to me for the summer months so I am not complaining.  I would definitely do the Symfony lens again because in the end I think it will be worth it. 

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    • Posted

      It is definately worth it. I had both eyes done in February. My left eye had the film, and my surgeon removed it via YAG. On the next visit he decided to schedule me for a correction of the astigmatism that wasn't totally corrected at the time of cataract removal. This they did with the Laser, local anesthesia etc. So remeasuring and sculpting of my cornea took about two hours. That was two weeks ago. I am presently headed to another check up as I type this. (Husband is driving 😉wink. Thinking I now have better than 20/20 vision. It all took longer than I had ever planned on, but I am glad my surgeon is a patient person and wants the job done right.

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    • Posted

      Yes I agree, I thought this whole thing with me would be done.  But it will be worth it in the end I think!  Let me know how your check up goes.  It would be AWESOME if your vision was better than 20/20!  Good Luck and God Bless!!!

       

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