I am 40 years old, and I found out last year that my worsening vision is due to cataracts. Everything is completely blurred with my left eye, but my right eye is still pretty good. I know soon enough I will have to have surgery. I have never needed glasses and would prefer to not need reading glasses if that option was available, even at an added expense. What types and/or brands of lenses do you recommend? Also, does anybody have any recommendations for eye surgeons in the Baltimore, Maryland area? Thanks!
I am scheduled to have Cataract surgery on my right eye on August 13 and my left eye on August 30. My doctor has given me two options. If I want to be able to see at all distances without glasses, he will use a Symfony Multifocal lens in my right eye and a Symfony Multifocal Toric Lens in my left eye to address the astigmatism. These are both premium lens and cost $3300.00 per eye. Second option is to correct distance only with a regular monofical lens in my right eye that is Covered by my insurance, and a regular Toric monofocal lens for my left eye. The cost for the regular Toric lens is $2200.00. I would have to wear glasses for reading and possibly intermediate distance with the second option. I have a week to decide. I have read a lot about both options and am leaning in the direction of the Symfony Lenses.
So sorry to learn you have cataracts at 40. Must be a difficult decision especially since you likely don’t need reading glasses now. Do you wear glasses or contact lenses currently? If you’d care to share your current prescription there are a number of people here that will offer suggestions.
Is your worsening eye still able to correct to 20/20 or 20/30 with glasses or contacts? I am from Canada and when my best corrected vision even with glasses was worse than 20/40 our healthcare system paid for the surgery.
I had both eyes done last summer due to cataracts at 53. Once you have cataract surgery your eye(s) lose all accommodation so if you don’t need cataract surgery yet I personally would wait and read all you can as most of us have not found our surgeons very good at providing much information. You’ll find this especially true in the USA where a lot of them will push for premium lenses at quite an expense. There is no guarantee you’ll be glasses free with them but likely you’ll be more glasses independent. They do come with a trade off/compromise of your night vision. There are more halos around light sources to contend with. Some prefer the regular monofocal lenses where one eye is targeted for distance (usually your dominant eye) and the other for intermediate and monofocal lenses tend to have less night vision issues.
As you have one eye that doesn’t need surgery you may want to consider having a monofocal lens in the eye that needs surgery targeted for best corrected distance. Your good eye will be able to read and you’d likely not need glasses (if you don’t wear them now) or wear a contact lens in that eye.
I had to have both eyes done and did chose Symfony EDOF (extended depth of focus) lenses and don’t wear glasses but do see concentric circles around light sources at night (traffic lights, car brakes, LED porch lights). If I did a lot of driving at night these would not be lenses i’d choose.
There are pros and cons to each lens (no perfect ones yet on the market) so it’s good you are looking into your options prior to surgery.
Wish you all the best.
I was exactly in your situation last year. 40 years old, cataract in the left eye and no cataract in the right eye. The only difference was that I have worn glasses for distance since 14 years old. Based on my doctor’s advice (sales pitch), I got Symfony toric. A decision I regret every day since the day of the surgery till today.
My advice - postpone getting the surgery as long as possible. Even with Symfony your near vision would not nearly be as good as it must be now, even with cataract. Symfony works best when done in both eyes- at least that’s what I have been told, but that’s not what you’d be doing. With one good eye and one Symfony you’d always be comparing left to right and feel frustrated. Symfony comes with glares and halos that make night vision miserable.
Monofocal lens will lead you to needing glasses also. But that is the best bet given how clear the vision can be without side effects. I would advice getting a monofocal set to near a little bit so you end up at needing about -1.00 to -1.25 and wear glasses for distance. Given your without glasses perfect right eye, you will mostly just do fine at all distances with that.
Johns Hopkins would be a good place to go in Maryland.
I am somewhat insane situation as you. Diagnosed a year ago. I am 42. Left eye is completely blurred far and near.
My left eye is short-sighted at -2.0 and right eye is currently implanted with Symphony EDOF IOL set to -0.5 (good for intermediate distance but not good for near distance shorter than 40cm to 50cm, depending on contract and lighting condition), which was the result of discussion of me and my doctor on August, 2017, almost one year now.
Now, I don't need glasses for daytime since my left eye takes care of near objects and right eye takes care of intermediate objects (from 50cm upwards). Yes, in the beginning there seems to be a slight coordination problem between left eye and right eye. But now, I don't seem to feel it.
As Sue.An said "...here are more halos around light sources to contend with" in Symphony EDOF lens, especially at night, which is ABSOLUTELY correct and I am getting used to it now. I drive often, mostly on daytime, so I wear glasses or contact lenses to correct my short-sighted left eye, no correction for my IOL right eye.
As sunny68454 said: "...With one good eye and one Symfony you’d always be comparing left to right and feel frustrated. Symfony comes with glares and halos that make night vision miserable....", which is somewhat I had gone through but I didn't feel too troublesome after a few weeks.
Because my right eye was completely blurred near and far before cataract, I did a research by reading a couple of cataract clinics papers and talked to my doctor about what I desired and we had reached an agreement on what kind of surgery and what kind of IOL to use. Yes, the IOL will never be as good as natural eyes but with cataract I had no choice but to choose what I thought was the best for me. I am satisified with my decision and am grateful for the help of my doctor.
I concur sunny68454's suggestion that Monofocal lens might be the potential best choice for you. Please, find a good doctor who is willing to talk to you about the pros and cons of the surgery and IOLs. No IOLs will be as good as natural eyes so a good doctor is very important to help you getting the best surgery/IOL option available. Good luck and wish everything goes well with you.
Do you by any chance know what your axial length is of your right eye.
I am asking because even after leaving you -0.5 refraction it still is only 40 to 50 cm and not closer.
I am going to follow similar strategy and wonder if better near vision is a function of axial length.
Susan83795
I am 51yo in Maryland, and had long time stable nearsightedness until a recent cataract issue that seem to come out of nowhere with in the past year. I was all set to have a bunch of evaluations from 3 different surgeons, when I developed a detached retina in my non-cataract eye requiring emergency surgery just 3 weeks ago. That is a major curveball in my cataract surgery process, but I also am in Maryland and looking for the best option. For me, I wanted to have the Symfony lens as an option, and 3 different surgeons I spoke to don’t use it.
In Maryland, Wilmer first found the cataract after others missed it, so that is one place I will consult with. The other is the group who saved my vision from the detached retina, and that is Katzen Eye group. Was thoroughly impressed with how professional the surgi center was.
I am also debating whether to go with the Symfony lens and the risk of nighttime halos, or mini monovision which seems to have successful outcomes for certainpatients. I am still hoping to get a chance to try it out through contact lenses, but as I said, my recent eye surgery threw a bit of wrench into things.
Will share what I find out here, and please do the same. If you want to DM me for other surgeon names please do.
Thanks for all of the responses! It sounds like there is no perfect lens. I hadn't thought about getting different lenses in each eye. That sounds like a good idea. Right now my right eye seems really good. Sometimes I have trouble reading small print, but shining my phone's flashlight on it always works. My left eye alone is completely blurred now. I can see colors and shapes, but I can't tell what everyday objects in front of me are or read the large headlines on a newspaper no matter how close it is. I have glasses that are very weak that I don't bother to wear. With both eyes, I see well enough to get along, but over the last few weeks I am starting to see an annoying cloudiness on the left side of the visual field, and sometimes I have trouble with driving.
I am in no rush to get surgery, but soon enough I figure I will be there. Would getting a monofocal lens now and a multifocal lens in the future be a good idea? It may be years down the road and there may even be better lenses developed by then. I will go ahead and make an appointment this week to speak with a cataract doctor. I went to Omni Eye Specialists last year, and I will check and see if they offer a variety of multifocal lenses. I have heard good things about Wilmer, although I am not a fan of Hopkins in general because it is so big and people can get lost in the "cracks." If I don't like what I hear at Omni, I will call there next.
Given you need only one eye done - I think your thoughts of getting a monofocal lens targeted for distance is a sound way to proceed. There could be better lenses (EDOF or multifocal lenses) that will be better in the future that could be good combined with a monofocal lens. Today’s multifocal or EDOF lenses work best when combined so if you only need one eye done you may not get the full benefit of one (or so the surgeons say).
Do you know if the eye that needs surgery is your dominant eye?
Good luck Susan.
Your idea of starting with a monofocal lens for one eye and considering years down the road when the other eye needs cataract surgery a multifocal or EDOF lens (hopefully with more advanced ones available then) is a good one.
Thats what I chose to do, since I also only had one eye with a cataract that made vision in that eye (my right eye) worse than 20/40 at best correction. My left eye has only a very early stage cataract that hasn't affected its vision since it can still correct to 20/15, and probably won't get bad enough for surgery for many years. I do have significant astigmatism (about 3D in my right, 2D in my left) so I went with a Tecnis toric monofocal IOL for my right eye. The result is usually never perfect, so I ended up uncorrected in my right eye at about 20/25 to 20/30 because still have a little 1D residual astigmatism in that eye 9months after the surgery. But it can correct to 20/20 with glasses. Still 20/25-20/30 uncorrected is better than I've ever had uncorrected before - a big improvement! I would definitely consider a Symfony toric IOL for my other eye when it needs surgery years from now or hopefully a newer better lens if available then. Alternatively I could go with another toric monofocal IOL in that eye but set for slightly nearsighted to get clear intermediate (computer monitor 2-3feet) vision.
Sorry, I don't know my axial length of my right eye. My doctor did a complete check on my right eye and then asked what distance of clear vision I desired.
Yes, you are right and that is what I said in my post that my -0.5 refraction right eye only allows me to see objects no closer than 40 to 50cm with good lighting and contrast, which is usually fine during the daytime. My doctor first suggested me to accept -2.0 refraction for my right eye just as my -2.0 left eye so that (1) there will be less coordination problem between left eye and right eye, and (2) I can see close objects (less than 50cm) clearly. But in that case, I will need spectacles for both eyes for intermediate to far objects.
I don't know much about axial length but I know that (1) IOL loses the auto focal point adjustment ability of natural eyes, and (2) IOL is about Presbyopia 3.0. So, by adjusting the refraction of IOL will allow you to target how near object to be seen clearly.
Hope this helps and wish everything goes well with you.
Sam.My having a hard time understanding why your Symfony EDOF lens doesn’t provide better near vision than 40cm (targeted for -0.5). Would you know if it is a regular Symfony Lens or a toric lens to correct astigmatism?
I have 2 Symfony regular lenses targeted for plano and can see from 11 inches to distance. The usual is to see well from 16 to 18 inches but that should provide good reading distance anyways. With targeting Symfony for -0.5 I would expect you to be able to read well with that lens. What is your exact current prescription with that eye?
Now that I think about it 40 cm is seems a good result for -0.5 refraction. The doctors project 60 cm to be the distance for plano. Which is a 2D length. So improvement of 25% to 2D is a 25% improvement to 60 which is 45 cm.
I think people with smaller axial lengths get better results than the standard.
Hi Sue.An, You can see from 11 inches to distance, does it mean that anything nearer than 11" is blur? My husband read out to me from a book placed right under his nose, at arms length and anywhere in between with no difficulty at all. His has amazing intermediate and distant vision to boot.
I once saw a pie chart detailing a good success rate of Symfony EDOF, with about <30% patients having issues with night vision. However, I can't seem to find it now.
Yes starting at 11 inches things start to blur - I can make words out at 6 or 7 inches but it is not comfortable and as things come closer to my face things become blurrier. So your husband can see to read things very close?
Soks was wondering if the ability to see closer with Symfony had anything to do with the axial length of a person’s eyes.
Hi Soks I think I replied to Jantje that it was those with longer axial lengths that people have better closer. Thanks for clarifying as it appears to be reverse.
"ability to see closer with Symfony" as in people with high degree myopia? Yes, hubby is very short sighted with astigmatism, but was implanted with normal Symfony EDOF lenses. Sorry for bothering you all with silly questions but I've stopped bugging that poor guy at home, and decide to find out myself why he came out unscathed.
@soks, If this will put your mind at ease, new technology has eliminated axial length measurement error in 95% of cases, and thereby minimizing IOL power errors. It never occurred to me to find out my axial length. All I remembered was, during the pre-cataract surgery consultation, I had to go to two different rooms to look at 2 different machines. My husband had to go to 3 different rooms, presumably 3 different machines. In fact, we had little interfacing with the eye-surgeon other than the basic pertinent Q&A and assurance of the pending surgery(ies). We left all the IOL measurements and more complex details with the genius. These people have very high IQ, you do not want to rub them up the wrong way prior a surgery just sayin'.
I am really not sure why some people are able to see closer with regular Symfony lenses vs others. Thinking there are several factors involved including skill of a surgeon. The literature regarding Symfony targeted for plano is that one should expect to read at about 16 to 18 inches. And of course reading becomes easier when both eyes are implanted with Symfony lenses.
My pre-op tests were conducted 2 separate times. I had one done at the hospital where I sat in front of 3 different machines. Once those results were sent to opthamologist I had a separate exam and consult with him. My eyes were dialated and examined and during consult I asked about IOL options. At home I searched online and came across these forums and thatbjust made my decision more confusing so I contact the opthamologist for a second consult which delayed my surgery another month. At that consult I was leaning towards Symfony sonhe had me go with an assistant from his office for another test in front of a machine in his office. I was told I could change my mind up till 2 days ahead of surgery and if I wanted Symfony I had to call the hospital to arrange payment minimum48 hours ahead of surgery which is what I did.
I don’t look back on the decision as I do enjoy the freedom from glasses which I never really had. Would be nice not to have nightbtime vision issues but one can’t have it all. Last night Saturn was visible in the night sky. For me I saw a little hali around it. My daughter and husband didn’t see that - Saturn was just a bright orange light for them both. So yes Symfony does have it’s drawbacks. I guess if one didn’t see well during the day or needed glasses anyways that trade-off would be harder to accept.
I am just speculating. I do not know for sure. For example a natural eye lens would have to flex lens for smaller distance within the eye than for larger distance. Hence my logic.