Trying to decide on multifocal or monovision IOLs

Posted , 15 users are following.

I had pretty much decided to get the Symfony multifocal. My husband likes his.  I have had monovision contacts for almost 20 years and had no trouble adjusting. But it just seems to me if both eyes are working together it’s got to be better.  Then the doctor told me in my case it’s a toss-up or maybe 51% in favor of monovision. 

What is making me re-think this is that my dad had macular degeneration

The tech sent me this email-

A family history of ARMD is something we like to take into account.  Having family history increases your risk of developing macular degenration (though doesn't guarantee it).  In folks that have macular degenration we typically advise against getting the multifocal as the quality will likely be limited.  In people who have no sign of macular degenration at the moment (such as yourself), we are certainly ok with people pursuing the multifocal.  However, if you wanted to pursue the most conservative approach, pursuing monovision would over the multifocal would likely be a better option if you were to develop macular degenration later in life.

Do I am really having trouble deciding. 

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  • Posted

    I went thru the same thing just recently and I picked mini-monovision monofocal over Symfony. I'm quite happy with my results, mostly based on cost and the desire to be safe from possible complications. I do have to wear glasses which I don't mind.

    Good luck whatever you choose.

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  • Posted

    Getting a Symfony lens and having monovision are not two exclusive options.

    I have a Symfony lens set for the best focus for far distance and a monofocal lens set for best focus at about 17 inches. My day vision is good at all distances from about 15 inches to far away. However, I wish that I had better night vision due to the annoying multiple concentric circles which I see around lights at night.

    If you would rather not wear glasses at all, I would suggest getting a monofocal lens set for far distance in the dominant eye and a Symfony lens set for the best focus at about 40 inches (corresponding to about -1.0D). That combination should give reasonably good vision down to about 16-18 inches and with hopefully less night vision issues than my combination.

    If you don't mind using glasses for reading and would rather not take any chances on seeing the multiple circles around lights at night, then getting 2 monofocal lenses with slight monovision (one plano and the other at -1.0D) will also be a very good choice.

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  • Posted

    Hello Susan, you might want to consider getting a second opinion, perhaps from a retinal specialist, to help you decide. What your ophthalmologist told you is somewhat surprising to me, as I'm faced with the same problem...my mother had AMD, though she developed it in her early sixties, and I'm now 66 with no sign of it.  I consulted a retinal specialist and two ophthalmologists, and mentioned that my mother had AMD, yet none of them said anything about me not choosing Symfony lenses because of it.  (The only reason I'd gone to the retinal doc for a consult actually had do with my having had a retinal tear in one eye many decades ago, and I was--and still am--worried about having cataract surgery because it raises your risk of future retinal tears/detachments a bit for everybody, and I'm already at higher risk for another tear due to already having had one.)   Like you, I had just about decided on a Symfony lens too, but your comment makes me wonder if that really would be best.  Honestly, I always thought my mother's heavy smoking was what had probably caused her AMD, as no one else in the family had/has it that I know of. and smoking can be one of the causes.  

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    • Posted

      My dad was a smoker too. The doctor didn’t say he wouldn’t do a multifocal lens, just that in people who already have ARMD he wouldn’t and if I were to develop it later on, i’d Be better off with monovision than multifocal.
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  • Posted

    Hi  Susan 44499

    I can relate to your indecision - it isn’t an easy choice.  I have 2 Symfony lenses and am happy with them.  I seem to recall reading something about what your opthamologist said concernig macular degeneration and multifocal IOLs.   But technically the Symfony isn’t a multifocal although most people refer to them as that.  But they are in a class by themselves as EDOF (extended depth of focus).   You might want to check with the Opthamologist to see if that changes anything.

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    • Posted

      I guess I am calling it the wrong thing then but the doctor said he’d use the Symfony if he doesn’t do monovision. 
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  • Posted

    I went through that same decision process.  I'm going to start with a mono-focal set for distance in my cataract affected left eye, and then think about what I want in my other eye as it gets cataract over time.  At the moment, I'm okay for near vision in my right eye.   I just think mono-focals are a more conservative option.  That isn't to say that people don't have great results with the Symfony though too.  I guess it's just a matter of preference. 

    G

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  • Posted

    I was considering multifocal toric symfony lenses but after seeing all the posts of people seeing halos and or concentric rings, I decided to postpone my surgery as I can still see 20 20 with my glasses with a bit of difficulty in dark situations. Dr said I could wait. So, I may just go with clear lenses with no vision correction and continue to wear glasses. Good luck with whatever you choose.
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    • Posted

      Hi Edgru2 - my thoughts mimic yours.  This isn’t the procedure to do just to be glasses free.  Lens aren’t perfect neither is hitting an exact target so although one can be less dependant on glasses no surgeon can fulfill the promise that you are glasses free.  If that’s what they are telling patients - be wary of that surgeon.  Red flag (or miniumum yellow cautious flag) they are in it for the

      money.

      Although we aren’t a big sampling of patients - I have noted that those of us who came to the forums looking for info about Symfony lenses and went ahead with it are happy with them.  To my knowledge all the negative posts (not discounting their pain and I satisfaction) but they went looking once they had an issue with them.

      For me they are great and I am pleased with the result- they do have a compromise of set multiple concentric circles around certain light sources but I was aware  of that prior to surgery.

      I believe most people are satisfied with cataract surgery results (regardless of lens type) and don’t think to post anything.

      Just my 2 cents.

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    • Posted

      I was surprised my doctor wasn’t pushing the Symfony , since he stands to make a bigger profit with those. 

      I would rather wear glasses for night driving than have to pull out a pair of readers 20 or 30 times a day.  Readers for fine print in dim light would be acceptable.

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    • Posted

      Hi Susan - I asked around if possible for opinions on night halos.  The few I spoke to in person here said thevglarr and starbursts were worse in the beginning (5 or 6 weeks).  I did opt for Symfony lenses and found that true in my case.  I do see concentric circles around certain lights which I don’t think diminish in time but these are lighter and less bothersome than glare and starbursts.  I am pleased with Symfony lenses - great all round vision during the day.  No halos inside - just outside when lights are about 50 yards away and as you get nearer the halos (multiple concentric rings) disappear.  
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  • Posted

    Hi

    my dr is contimplating swithching out my symfony toric for monofocal his reasoning is he never had a case where symfony lens had problems especially clarity in intermediate vision which is very fuzzy by me and feels cloudy even when i put on 1.5+ to read. Does any one out there had this problem with symfony toric in intermediate that u need gladses for intermediate also does the vision appear cloudy like a wrapper was left on the iol.

    thx orshulim

    ps he claims does 50 catarcts aweek total all diff kinds

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