Tecnis Synergy

Hi AJ_Canada,

Sorry, but I accidentally enabled <Reply> for your post, when asking the question to @tim20514. But, as this forum does not allow the deletion of posts, I take the opportunity to comment that I chose Synergy for my other right eye, in part, after reading your posts. I was very excited to see from 12", a condition that Symfony in my other eye didn't give me. I didn't worry about the negative aspects related to dysphotopsias, as I already knew them from Symfony and I tolerate them well. weeks after the surgery , the only thing I don't understand is this variation in the quality of vision, at a very sharp moment and at another a little blurry. I read in one of your posts that you had dry eyes, which gave you blurred vision in the morning, and I have the same, but the lubricating eye drops didn't work for me.

AJ_Canada, I'm sorry, the question was for tim20514, I hit the wrong <Reply>.

Hi tim20514,

This post is from 2 months ago, I would love to know how you are now!? I implanted a Synergy LIO on 3/30/2022 (almost 3 weeks) and I am experiencing something similar. Every morning I wake up with blurred vision for all distances that improve throughout the day. Even so, there are rare moments of extreme sharpness at all distances, but most of the time I don't find the sight wonderful. My comparison reference is with my other eye, which has Symfony lens since 06/12/2021. But even at times when the vision seems to be clear, my Symfony eye still has the best distance vision. Have you also suffered, or still suffer from this variation in the quality of vision?!

Hi Val,

Your experience regarding waking up with blurry vision that clears as the day progresses is almost certainly dry eye. I had this issue for at least 6 months and it still crops up when I am in a very dry environment (e.g. Winnipeg in winter). My guess is that when the surgeon cuts into the cornea, it damages the nerves that determine the tears needed to lubricate the eye. I suppose everyone has some form of dry eye after eye surgery, but the degree is dependent on individual sensitivity and environment. Have no idea if it ever clears up completely, but in my case it is certainly much less of an issue now (14 months later) than it was after surgery.

Regarding your far vision, I have no way to compare against another IOL since both of my eyes have Synergy implants. That said, my distance vision is - to me - pretty good but then it wasn't great before surgery. It will never be "perfect" simply because the physics behind how these lenses work makes that impossible. There will always be some form of visual interaction between the different areas of focused light on your retina. How well your brain ultimately downplays this interaction only time will tell. I still see every one of the dysphotopsias I wrote about before, but I generally ignore them. My brain has not "magically" eliminated them and it probably never will. But you get used to them and they become less intrusive. In general, "neural adaptation" should really be read as "well, you'll ultimately get used to it".

@AJ_Canada,

Off topic, but I am curious about catarct surgery in Manitoba. I have not lived there for 50 years or so, but I have a brother there that is ready to get cataract surgery. I presume Manitoba Health covers the cost of a basic monofocal, and if you want a premium lens you pay the differential? Is the basic covered lens an aspherical one, or spherical, and you have to pay extra for the aspherical? The extra cost for a toric if you know it?

Tx, Ron

Can't say what it would cost in Manitoba as my surgery was performed in Ontario. That said, I understand there are some very good eye surgeons in Winnipeg.

Ok, I had assumed from your Winnipeg comment that you lived there. He is currently lined up with a surgeon in Brandon, Dr. Rocha. So hopefully he is good. Seems like he is in a private clinic like we have here in Edmonton where they do both Lasik and cataract surgery. Months long waiting list though....

Hi AJ_Canada,

Now I'm almost 3 months away from the second surgery and everything has stabilized a lot. Like you, other members here have cited dry eye. I tried using lubricating eye drops, but I didn't get any better. What was evident to me from this 3 month experience is that for some reason, with strong natural light, the image quality in my Synergy eye is worse compared to my Symfony eye. As the day ends and natural light diminishes, at dusk and at night, the image quality (sharpness) in the Synergy eye equals, or even surpasses that of the Synfony eye. As an example, from my bedroom window I can see several buildings and, in the morning, playing the game of covering one eye and the other, everything I see in the distance with the Symfony eye has more details. Now, at dusk and especially at night, the thing is reversed, in the Synergy eye the images are slightly sharper, the contrast looks better. I'm not a voyeur, but at night, I can see with extreme clarity of detail, through a distant open window. This also happens in my work environment. During the day, while there is natural light coming in through the windows, the image quality is not very good, but when it gets dark and artificial indoor light prevails, the image quality improves a lot, at all distances. Strange is that this seems to be the opposite of what happens with most. Maybe it has to do with the size of my pupils and how much they fail to contemplate the lens rings...

Hi,.sorry for the delayed response. I have seen the optometrist at the clinic 3x now. Previously I was slightly long sighted..with the Synergy I am now slightly short sighted. They have made a set if glasses for me to show me how things would be after a small laser correction..and it appears it would fine tune things for me. I will wait 6 weeks more to ensure I am happy, then go for the laser correction if they can confirm it will be the same as with the glasses. Hope this helps. Eyedrops and keeping hydrated also improve the overall vision by the way.

Just to confirm that my reading and close vision is brilliant, the glasses they made up are only correcting (and showing the result of any future laser correction) my distance vision without disturbing the reading vision.

The doctor who performed the surgery said he had reached the 0.00D target (Synergy). In the evaluation he put +0.25D and it was worse than 0.00D, then he put +0.50D and it was better than +0.25D, so he said it was 0.00D. I thought it was strange, so I had a second evaluation with another ophthalmologist. In his assessment, he said it is at +0.50D. I bought a +0.50D lens on my own and did several tests mainly at a distance. I came to the conclusion that with +0.50D it gets worse. Uncorrected is better, but not as sharp as my other Symfony eye. Maybe the target is somewhere between 0.00D and +0.50D, but I couldn't figure out where. As the refraction is small and positive, there is no laser retouch option for me. As for near vision, as Symfony starts from 22" not helping Synergy much, even so, I can use my cell phone from 13", but it's only brilliant from 16". Wish him good luck, and hope you can correct your vision with the laser.

On August 22nd, I have final tests and double check on my distance vision, then a consultant review and plan a date for laser fine tuning...will post again after this.

Consultant has said we should wait to January before any final decision on my distance vision...as the alteration would be between 0.25 and 0.5 diopter per eye..but neither I nor he want to risk the excellent near vision I have and he cant guarantee it wont degrade slightly with any laser work. The glasses they made up for driving, distance etc work fine for me, so I have a decision to make near the end of the year.

That is an interesting reaction. Well, at least you know you've got both light and dark covered, lol, even if in weird kind of way. Maybe you'll get used to it over more time? I've had dry eyes (wearing gas permeable lenses) for a very long time (no surgery so far), and an optometrist years ago suggested that I buy a bottle of sensitive eyes saline solution (as in for soft contact lenses) and "wet" my eyes with that -- which I've been doing since. He said that the usual types of eye lubrication drops cause a form of addiction and your eyes don't respond after a while -- it can even make it worse. I don't know if my eyes are less dry on a long term basis, per se, but the saline solution as a rinse does really help. I'll rinse my eyes with it before and during lens wearing (have to remove the lens first to be safe though). I tilt my head, pull up my eyelid, and squirt it into the corners of my eyes and let it flush across the eye, then blink it around. I also use it regularly to flush my eyes out on a daily basis, especially in dry air circumstances (such as where I live now), or if I feel something in my eye. I can definitely feel a difference in the moisture level in my eyes after doing this, though it doesn't necessarily last a long time. But, there's also no long term side effects from using it as much or as long as you want (I've been doing this for over twenty year now). I don't know if it might help you? I just buy a big bottle of Bauch & Lomb Sensitive Eyes Saline at Walmart -- it seems to do the best job. Maybe worth a try?

this is known problem with synergy. i visited 4 surgeons and they wont offer synergy due to vision quality.

Thanks for your comment! It's been a long time since this post of mine and I follow life without problems. In fact, nothing has changed, I still have better distance vision with Symfony (I lack details and sharpness with Synergy), however, Synergy gives me better close-up vision. Fortunately, I never had any eye problems other than presbyopia followed by cataracts. I never had dry eyes before the surgery and I am convinced that I still do not have this problem. I even tried some eye drops that were indicated to me, but without any effect. I believe it all comes down to the limitations of my own biometrics and the limitation of each lens. I've stopped worrying about the results of the surgeries, I just go on with what I have, and it's not so bad!

I wish all the best for you!

Thank you. Good to know that you've achieved a balance with your own surgery.