Tecnis Synergy

Update: One other thing I should mention about "primary" halos. I actually see them during the day around bright pinpoints of light at all distances. For example, sunlight bouncing off waves in the water. The halos are small but bright, and so it almost looks as though these bright points of light are out-of-focus. In practice, they actually are in focus but the halo makes it look like they aren't. Sort of like a "glistening" effect. Only happens with bright, small pinpoints and I don't find them all that annoying.

Very interesting - thanks for sharing. I have had Symfony IOLs 3.5 years now. Thankfully I see no halos or glare during the day outside or inside or in a lighted room at night. I do have glare and see concentric circles at night around certain light sources which have never gone away.

Sue.An2: Question regarding the halos. Do you recall whether you saw halos when you first had the IOLs implanted and that they slowly faded away, OR that you didn't have halos from the very beginning? Also, same question regarding ghosting around letters. I believe the Symfony and Synergy are similar in many ways so this may give us a clue regarding healing.

Thanks!

AJ, you may be interested in a subject that another contributor here spoke about a short while ago. There is a therapy used to help with the "lazy eye" issue called Brock String. If you have not heard of it, you may want to google the phrases below to find a couple of useful sites.

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What is a Brock String?

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How the Brock String is Used In Vision Therapy

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My wife has the issue and is on the waiting list for cataract surgery. I have done a bit of research on it. It seems there are different flavours of it. The one she has appears to be when the brain simply tunes out the image from one eye. Another is when one eye does not follow the other eye. I suspect the therapy is more effective in the latter.

If my memory serves me right I recall posting that I did see any concentric circles those early weeks however had a lot more glare. ie street lights were very fuzzy. In fact driving at night was troublesome. I would plan my routes where there were overhead streetlights as driving in pitch dark was a bit scary. Oncoming cars and there headlights would be blinding. I even drove with my car's interior dome light on as it helped somewhat. But after initial weeks I started seeing huge concentric circles around car brake lights when brakes were applied and in red traffic lights. As I got closer to the lights the concentric circles got smaller and by the time i am stopped at a light they disappear. The glare diminished though and lights are a little fuzzy but not nearly like it was in those early weeks. That gradually improved I would say in about 4 to 6 months. Interesting too I would get a flicker when a light source was to my left. Right side never experienced it. This went on for a couple of months and then went away. I think during healing process the IOL gets shrink wrapped (for lack of a better description) and it was the light catching edge of IOL.

So I guess that is what you mean by halos is the glare or fuzziness around lights? I think if yes you will see improvements in time. The very distinct concentric circles are huge - they reach done to the road from red traffic lights when I am at a fair distance from them and get gradually smaller as I approach closer. The inner rings are more vibrant than outer rings - outer rings are quite faint. As horrible as that description sounds they aren't as bothersome as the glare was. Today I drive at night without even thinking of the route. I suppose I would not want yo make my living driving at night but for my lifestyle it is OK.

Someone here on forums when I first posted had a monofocal implanted first for best corrected distance in dominant eye and then had to find another surgeon who was ok with mix and match to implant a Symfony at .50 diopter nearer. He said it worked out extremely well as the monofocal for distance took over and mitigated all the concentric circles of Symfony. And Symfony gave him the best intermediate and near vision.

Hope this helps a bit.

AJ_Canada

Should say I too am Canadian. Nice to see a few of us here.

Forgot yo address the ghosting. I see a little of that too in high contrast situations ie TV and iphone with black background with white lettering. The white looks like it has a slight shadow under it.

Hi Sue,

Thanks for the reply. I call the "fuzziness" around medium to bright lights, "glare", while the distinct single circles around bright lights, "halos". My halos are distinct and fairly bright, subjectively 25% to half as bright as the light source. They are also relatively close - typically about equally distant from the light source as the light source is wide. As such, wider lights have wider halos while point source have tight halos. This is different from the concentric rings I see which correspond perfectly to the diffraction rings (echellettes) in the IOL. When I see a bright red light, for example, there will be 15 concentric rings around the light at a pretty good distance. As I get closer, the rings get smaller and brighter as you describe. My sense is - and also based on your experience - that glare and halos will tend to diminish over time while the concentric rings of the echelettes tend to remain. Perhaps our brains don't really know how to adjust to this effect as it is particularly foreign to our visual norms.

At any rate, I'm reasonably confident that my experience will be similar to yours with the Synergy IOLs. For those reading this, my guess is that the Symfony and Synergy lenses will produce similar artifacts (dysphotopsias) assuming identical implantations. Perhaps my artifacts will be a bit less, or maybe a bit more, but basically the same. That said, my near and medium vision are both very good even at a few weeks and so those thinking about Synergy will (I think) need to consider whether they will be ok with the artifacts people are experiencing with the Symfony lenses.

Thanks for this, RonAKA. I will definitely check into Brock String. I have more the former issue than the latter, but every little bit helps.

Yes those comments would line up with my experience as well.

It would be nice to 'try' these on to know in advance whether tolerable or not and a fair trade off for glasses free. I would imagine if daytime vision was poor the trade off would not seem worth it at all.

it is difficult to correct after age 17. the brain shuts down the other eye because the vision quality from that eye is too bad to be usable and gets used to doing that. there are magic glasses if she wear them she will only see the eye that the brain is using. if we use it we see both our eyes.

brock string is string with 3 adjustable balls. you keep them at different distances and focusing on the ball makes you see an X instead of the straight string.

thanks for sharing. the temporal arc that u see is probably negative dysphotopsia. may or may not go away. good that it is not bothering you.

how would you rate the quality of vision for near and far? beyond the visual acuity.

In bright light, my near and far vision in my right eye is very good. Equivalent to my glasses prior to my cataract. My left eye is tougher to gauge as it is still adapting to the correction. That said, it is certainly much better than when it was left uncorrected.

In low light, near vision contrast is not quite as good as what I remember prior to the cataract. For example, a little tougher to read my laptop keyboard in low light but doable (in fact, doing that now). Reading the labels on my remote at low light levels is a bit of a struggle.

how much light are you describing as low light?

also do u see the arc in both eyes?

It's tough to convey light levels as every situation is different (wattage, type of bulb, room size, room colour, etc.). But this might help. In sunlight, my near and far vision in my right eye is excellent (20/20 or 20/15) and there is no point between that appears fuzzy or out of focus. I can read small print on drug bottles. In a brightly lit room (e.g. kitchen), my far vision is still excellent but my near vision degrades slightly. I can read newsprint but may need a little help on smaller print. In mid level light (e.g. den), far sight is still very good. I can also read newsprint, but it may take a second or two to adjust. In low light (e.g. lights lowered to watch TV), I am probably 20/25 far and 20/35 near. A bit tough to read newsprint, but possible if I concentrate.

I only see the arc in my left eye. It's annoying, similar to seeing the edge of a contact lens. But it isn't a shadow - more like a blur.

thanks for the detailed reply. i wonder if panoptix behaves similarly for near vision in lower light conditions.

wish you the very best for your healing.

On paper Synergy looks better to me, but we all know how that goes. My only suggestion would be to find an Opthmalogist that does both lens and has lots of experience and get their opinion. In the US this is difficult to do, but Dr. Chang might be an option to try. I have emailed him before and he did respond, though not that helpful on the question I asked.

You can also try and contact doctors in Canada that have done both.

I know that can be a pain in the butt as I did it when I had my first cataract surgery.

But I finally got a top clinical trial Opthmalogist that actual called me back who had lots of experience with implanting just about every IOL and he ran down in details what his patient's experience had been with the different IOLs and I can tell you it was a defining reason I choice the IOL that I had implanted in one eye.

Don't know if the Panoptix IOL is better in any particular way from the Synergy, but the fact that both use similar technologies to perform similar functions suggests that the dysphotopsias will be similar. The important thing to consider is that you are going to have haloes, starbursts and glare with either one. It's simply the physics of the optical systems involved. Perhaps more important is how a specific brain will adapt. In my case, for example, I don't really mind the starbursts but I would really like the halos to reduce. I would trade larger starbursts for smaller haloes but it doesn't work that way. Will just need to wait and see how I neurally adapt over time.

i think the pan optix effects will be lesser. i say that because of the edof used by synergy to cover broader intermediate range.

Hi AJ Canada,

@AJ_Canada

Would you be willing to write up your experience this many months on ( 4 months?)

Thank you,