my surgeon thinks I should have surgery earlier rather than later to minimise traumato the capsule and has suggested having a TECNIS Symfony Extended Range of vision intraocular lens, has anyone had experience of this with this eye condition (Fuchs’s endothelial dystrophy) ?
Hi
How old are you? Are both eyes affected? If there is a risk of damage to the capsule then the phacoemusification should be done at 0 speed if they use phacoemulsification.
I am leaning towards Symfony myself. Only thing holding me back are the night time issues with Symfony (Concentric circles around lights and low contrast vision in dim light). I am 41 and losing lens accommodation is a bit unsettling.
From what I read online there is no treatment and there was this precaution :
If you have been diagnosed with Fuchs' corneal dystrophy, be sure to discuss this with your eye doctor if you are considering LASIK or other refractive surgery or if you have cataracts and need cataract surgery. These eye surgeries can worsen the condition, and corneal dystrophy often is considered a contraindication for elective refractive surgery
If you look up this condition on Medscape there is a lot of good info there. This site doesn’t allow for posting of links. But you may want to read up on it before going ahead with cataract surgery. Have you seen more than one specialist?
Sorry to learn that you have an eye condition (Fuchs’s endothelial dystrophy) which is requiring you to have a cataract surgery at a young age. Unfortunately, I don't know much about this eye condition to offer you any tips on dealing with it.
However, while Symfony lens is a good lens, please make sure that you are aware of the pros as well as the cons of this lens (I have had a Symfony lens for the last 1 year). You will find posts by many people talking about these pros and cons. The bottom line is that the Symfony lens is overall a good choice for achieving good day time vision in the far-to-intermediate distance range (but not near) or the intermediate-to-near distance range (but not far), which will be a better range than that provided by a monofocal lens. However, the night vision can be expected to be worse than that of a monofocal lens, because the designed-in diffraction circles in the Symfony lens also cause the multiple circles around lights at night at 50-200 yards distance, which can be very distracting and annoying. The night glare because of lights can happen with any lens because the sharpness (or lack thereof) of focus can be a significant factor in that.
I am 59, and both eyes are affected one more so than the other but at the moment can drive etc. , I am confused as an NHS patient cataract surgery was a no no but then as a private patient it changed, the reason being a younger eye would be less prone to damage but previously the same surgeon told me surgery could speed up the dystrophy. I do no know of any surgeons in the Liverpool Manchester area who could give me a second opinion.
I am not sure why my earlier message is being held up to be moderated, but the gist of that was that I am sorry that you have a terrible eye condition and that I am not much familiar with this condition and thus can't give you any helpful hints to deal with it.
Based on my personal experience with the Symfony lens (as well as on posts by other Symfonu users), my main advice is that you should make sure that you know not only the advantages of the Symfony Extended Vision lens over a monofocal lens, but also its relative disadvantages before you make an informed choice. The Symfony lens provides about 1D more range than a monofocal lens so that it is, for example, also good for intermediate distance when the best focus is set for far distance. However, it may not be good enough to read at 16 inches or so. The main disadvantage of the Symfony lens is the higher night vision issues (such as seeing multiple circles around lights, glare etc). This subject has been discussed a lot on this forum and I won't repeat all that here.
If I understand your comment the NHS won’t do cataract surgery due to your eye condition but a private clinic would?
Private clinics will do almost anything as the total cost is absorbed by the patient. NHS the costs of cataract surgery is absorbed by the gov’t and there is little to no expense passed on to the patient. NHS will only do monofocal lenses for cataract surgery.
Given the added complications due to your eye condition if I were in your shoes I would seek out a cornea specialist. I am not very familiar with your eye condition but from the little I could find online it seems lasik, PRK, CLE as well as cataract surgery could potential make the condition worse.
Katiewarrington,
I am sure that you don't need any more scary thoughts. But, based on a article on John Hopkins web site, you may also want to consult a retina specialist before making a decision regarding your cataract surgery. To quote some of the words from the article:
"Some people with cataracts also have Fuchs Endothelial Corneal Dystrophy (FECD). If a Fuchs patient undergoes cataract surgery, the fragile endothelial cells of the cornea may be damaged. (The endothelial cells are those cells at the very back of the cornea. The endothelial cells deteriorate in patients with FECD.) The loss of too many of these cells can lead to edema (swelling) of the cornea. This edema can then sometimes lead to painful corneal bullae (blisters), deterioration of vision, and eventually, the need for a corneal transplant.
In summary, in a patient with FECD, a cataract surgery may hasten the need for a corneal transplant. Because of this risk, the corneas of FECD patients are examined carefully before cataract surgery. Sometimes, the eye doctor will decide that the patient should have both cataract surgery and a corneal transplant at the same time. By doing this, two separate surgeries are combined into one procedure, and recovery time is greatly reduced."
Hi Nina234
I actually didn't think it was possible to have monofocals set for distance AND to be able to see close up as well. I thought if you set for distance then you'd have to have to wear glasses for close up. Bit confused now!
I will hopefully have the op on both eyes sometime around April/May next year and was thinking of setting for close up as I don't want to have to wear glasses for reading (currently I just take off my glasses for reading as I'm short sighted -5 ish in both eyes). I was going to do a mini-monovision with one set to about -1 and the other set to about -1.75 or thereabouts.
Could I conceivably have my eyes set for distance and still be able to see close up like you can?
Hi Nina
Glad for your results. May I ask how old you are?
My eyes were -5.0 and -4.5. So the answer is no. Likely nina was a -1.0 or something allowing a distance fix that still allows for some closer up vision. Be aware that if you correct your -5.0 for distance with say a 14-15 strength replacement lens, then your near vision will not be able to see under about 7-8 feet. You will need readers or maybe better progressives.
Note that replacement lenses are plano at 20. It is rough est but for each 1 corrective lens on glasses you would need -1 from the 20. IE 20-5 is 15 +/-1 strength replacement lense
Please could you point me in the general direction of the studies you found. I have an appointment this Friday with my surgeon (check up for the crosslinking) and I'd like to discuss this option with him.
Hi CaroZim
I think Nina posted that on her thread entitled : Abbott Study Comparing Symfony IOL with Monofocal IOL
Are you returning to Dr Por Yong Ming?
Thanks Sue.An - I'll find that post.
Yes, I will go back to Dr Por. He's a cataract and cornea specialist which is what I need given that I have a mild case of keratoconus and am planning to have lens replacement surgery.
He's also a really nice man and I feel very comfortable with him. He's not money focused like some surgeons out there. He's recommended that I have monofocals not multifocals even though he'd probably make more money putting multifocals in my eyes.
I still read his blogs and find it wonderful that a doctor would take the time to respond to people’s questions online. Here we are all just patients sharing our info - which is good but nothing like having an expert in the field.
If you reach out to Nina she will tell you that she also gets very good intermediate vision and can read without glasses. Studies she found indicate that her results are the norm with monofocals. Also least amount of halos too.
Wish you all the best CaroZim.
I can't find that study - it's not the Abbott study you mentioned (that's basically saying the Symphony lens is better than a monofocal!). Hopefully she can let me have the study she was referring to.