If I got Symfony in one eye 4 months ago, and that eye needs -1 for distance, +2 for near and I see halos with it too..is the outcome bad enough to get IOL exchange to monofocal? I almost went ahead with the lens exchange surgery and then backed out last minute fearing what if the result is even worse?
My other eye does not have cataract but I need -3.5 for distance. Accommodation for near still works for near with this eye.
I am 40 years old.
Tried progressives but can’t adjust.
I understand about progessives but ive had halos circles since my surgery 2 years
ago. Unfortunately I had yag done I am not able to have my lens replaced and. Would give anything to get it replaced. Depression from not being able to drive is taking its
toll. Oh I forgot to say I’m blind in other eye so I’m screwed. So I can’t tell you what to do but they never go away whatever anyone says! I would love to ware glasses if halos and circles would go away.
Wow, how could a Symfony lens ending up like this? It's almost acting like a monofocal. This is a head scratcher for me. An IOL exchange may allow no distance correction and the issue of halos. It is a tough call, indeed. Sorry to hear this. I hope you find a good solution.
yes, the outcome is not what I expected. the question really is how risky is the lens exchange surgery itself? I've read about capsule rupture and other issues that is making me afraid of going for an exchange. anyone with experience in getting IOL exchange can chime in?
Hi Sunny - I too cannot understand the outcome of your range of vision with a Symfony Lens. Did it start better than this or has been since surgery. I have 2 Symfony lenses and have not worn glass since surgeries. The glare and starbursts were strong for about 5 or 6 weeks but they’ve calmed down considerably but do see multiple concentric circles around certain lights at night.
What target was your surgeon aiming for. What is puzzling is that you need -1 for distance which should give you excellent near vision with Symfony but you are needing +2 in that eye for reading? Makes no sense.
Perhaps you should get an exact prescription for that eye to find out what is going on.
If nothing works a lens exchange would be something to consider.
I am sorry to learn about the very bad results with your Symfony lens.
Seeing the very annoying halos or multiple circles around lights at night is unfortunately quite common with Symfony lens, but the resulting eye prescriptions for distance and near (as stated above by you) don't make much sense. Please make sure that there is not an error in that.
Also, do you have significant astigmatism in the operated eye and if so, what is the cylinderical correction?
How well can you read at distance with the operated eye with the best distance prescription?
In any case, based on my excellent experience with LASIK on both eyes (after cataract surgery), my personal choice will be LASIK (or PRK) enhancement to correct vision instead of exchanging the lens. However, that won't fix the halos. So, you are the only one who can decide if that is worth the lens exchange.
Whether you have LASIK enhancement or a lens exchange, having an excellent surgeon is a must!
unfortunately, the prescriptions are correct. it makes sense for what I can and cannot see
to be exact, I got symphony toric with 1.5 astigmatism correction which indeed is corrected because my -1 for distant is just spherical.
yes, it started that way from right after the surgery. I could barely read unless at full arm's length in bright light and I couldn't see perfect distant either. however, initial distance prescription was -0.5 spherical with +.25 cylindrical but it has now settled at -1 spherical, no cylindrical.
overall so disappointing that most of you can't even believe it.
I considered lasik to improve the distance vision but when I simulated it with a contact lens, it took away whatever little was remaining for near. so I chose not to go for it because that would mean the results of a monofocal with halos added.
so, the options I have are -
1) do nothing, get used to progressives
2) do nothing, wear single vision glasses and use only right eye to read.
3) get lens exchange to monofocal and get lasik on right eye and wear glasses only to read
4) get lens exchanged to monofocal and live with monovision - distant with left, near with right
5) anything else?
From what I have read you can get a lens exchange up to about 6 months. It might be worth looking into and considering what is best for you. It is such a personal decision and not a one solution Best or fits all. But given it is only 4 weeks you definitely have time to consider these options.
I know some surgeons provide a lasik package along with premium lens. Would you know if your surgeon included that with your pricing for premium lens?
It is really unfortunate you did not get a better range of vision. This still puzzles me.
You said you got a symphony toric lens. If your toric lens shifted even just a few degrees, it can throw your vision off at all ranges (near, mid-range, and distance) which would explain everything. The doctor should be able to adjust it back into the right position if that is the problem and if it is done soon after surgery. If that's the case, then it should also be easily corrected (or tested) with glasses or a toric contact lens. As others have said, it's very important to make sure you have a great doctor. If your doctor has no solutions, then perhaps it's time for a second opinion.
Sunny - I would like to point out that I too was nearsighted in both eyes about -3.5 which I think is similar to your situation before surgery. My right eye could only be corrected to 20/50 before surgery due to the cataract. We did a mono focal toric in the right eye and the toric lens had shifted just a little bit. In spite of it, I was 20/30 after surgery in my right eye and I needed +2 for near (for my right eye). The prospect of bifocals did not thrill me at all (glasses for both near and distance).
My left eye had a very slight cataract but because my right eye was now adjusted to distance, it was like I was in full mono vision mode so I decided to do my left eye and went with a mono focal for that as well. We decided to bring the left eye 1/2 diopter in from distance to get a slightly better range of vision (mini mono vision). It worked out great. My left eye was seeing almost 20/20 a week after surgery and I could easily read my phone and anything else within an arm's length. Because my right and left eye were adjusted relatively close (mini mono vision), they work together and over time my right eye has continued to get even better. At my last visit 6 months post op I was seeing 20/20 distance and better than 20/30 near with mono focals. With that said, I agree that you're kind of in a spot because your eyes might see a lot better AFTER you get the second eye done. But, with no cataract (or maybe a very minor one) I can see your concern as I felt very concerned before I got my second eye done. I waited three weeks and the full mono vision was driving me crazy. You could consider doing a mono focal in your second eye and have them set it to distance but bring it in slightly about 1/2 to 1 diopter. This might give you an all around better range of vision. I had a VERY minor cataract in my left eye and after the first surgery on my right eye, I tried testing my left eye with a few different "test" soft contact lens to see if I could tolerate mono vision. No Good - it was a faulty test because even as minor as the cataract was in my left eye, for whatever reason, the IOL provided much better and more clear vision than the test contacts did. In other words, I see better up close after surgery with a +1/2 IOL than I did with a +2 test contact before surgery. I don't know if that was partially due to the cataract in spite of how minor it was. I'm glad I went with distance but biased slightly towards near in my second / left eye.
Others have suggested a laser correction and I've mentioned if your toric contact did shift, then you might be able to get it corrected surgically or with a laser. After that, you might want to research a mono focal for the second eye set to distance but shifted in slightly. If you set the eyes within one diopter, you should not notice the mini mono vision and it shouldn't bother your depth perception much either. I think even before surgery, one's eyes can easily be 1/2 diopter or more different. Good luck to you.
Thanks all for the feedback. I am also puzzled (read grossly disappointed) by the results of symfony. Had it not been for the concentric circle halos I'd have questioned my doctor - "Did you really put symfony or did you put a monofocal by mistake?"
Sue - it's been 4 months not 4 weeks since surgery. So I am not hopeful of things getting better on their own.
Mike - thanks for sharing your story. my doctor has checked for rotation and says it hasn't rotated. also, the fact that my prescription is straight -1.00 spherical, doesn't make me thing astigmatism or rotation is the issue here.
As for getting the second eye done, I don't think I want to as there is no cataract or presbyopia (just myopia -3.5) and nothing beats the natural lens for accommodation.
So what does your doctor suggest and do they have an explanation for the poor range of vision? Maybe the symphony lens is defective. I'm not sure if that's possible but there has to be some reason as to why your vision is the way it is. If they have no solutions then you might want to consider a second opinion.
My doctor has no explanation other than 'technology has limitations'. He has offered lasik for distance correction or lens replacement to monofocal.
If it were me I would seek out another expert. No harm done and it would give you an expert opinion on the options you suggested. We are all patients with no medical degree. There is also a blog of a Singapore doctor who answers questions. He does a lot of Symfony implants and answers questions on line freely. His name is Dr Por Yong Ming. Google his name with Symfony as we can’t include links here. Perhaps he could offer suggestions.
1. Am glad that you don't have any astigmatism needing cylindrical correction.
2. My guess is that: you had a prescription of +2.0 for reading (at 16 inches reading distance) when your distance prescription was -0.5 spherical with +.25 cylindrical, but is now only +1.25 or +1.50 when the distance prescription has changed to +1.0. There should be only +2.25D or +2.50D difference (and not 3.0D difference) between the prescriptions for distance or reading. It is not a big thing in view of the other vision issues you are having, but it still may be better to make sure that there is no error as you consider your choices.
3. If you decide to use glasses (and do nothing else), please do not try to get the distance prescription in both eyes. With a difference of 2.5 D in the 2 eyes, the difference in the image sizes seen by the 2 eyes will be too large for your brain to handle (that problem should not happen with contact lenses or without any glasses).
4. If I were in your shoes and only wanted to use glasses, my first choice will be to get glasses with -1.0D for the operated eye and -1.75 D for the unoperated eye (based on the prescriptions which you have quoted). You will have a slight amount of monovision or (minimonovision), which you should be able to handle. With that, you will be able to see well at distance as well as intermediate distances. For reading purposes, I would then just add +1.25 D to each eye. With that you will have good intermediate and near vision. Please note that a vast majority of optometrists never suggest monovision or blended vision, but they will go along with that if you ask for it.
Hey!
Just wondered if you could share a little more about your situation with having LASIK after RLE surgery? I am almost 6 months post op with the Carl Zeiss trifocal toric lenses. Overall the results are fantastic, my last eye test (2 months after surgery) should that I had a residual prescription of +1.00 with -1.00 astigmatism but also with an ADD 2.00 on the prescription? I feel like my vision is very good but I know then when I have an eye test, it can still be corrected to better, I think I'm at 20/25 for distance, I can read my phone etc with no problem at all but I actually find that pictures and videos always need to be made slightly bigger or zoomed in.
I was wondering if you think LASIK can give and ALL ROUND improvement, or whether it's just used to adjusting the range, for example compromising the distance to get better near vision?
LASIK is included in my package so even though I am getting by just fine now, if there is improvement to be had then I would definitely like to take advantage of that!
Thanks!
I think that if your stated prescription is correct (+1.0D spherical, -1.0D cylindrical) you should find the LASIK enhancement beneficial not only for distance vision, but also for the near vision.
With LASIK enhancement, your astigmatism should be reduced to less than 0.25 D, which will be beneficial at all distances.
Right now, your eye is farsighted (+1.0D). Being farsighted does not help vision at any distance! Reducing that to the 0D to -0.25D range (that is plano or very slightly myopic) should provide better-than-current vision at all distances.
Hmm..interesting take. I will talk to my optometrist on this thought. Thank you!
Yes. Hopefully, the optometrist will look favorably at the blended vision approach.
You may want to try this approach with slight variation in actual numbers to see what you feel most comfortable with.
For example, in addition to the one in my post above:
My new first choice: -1.0D (operated eye), -2.0D (unoperated eye); Add +1.0 (both) for reading
or
-0.75D (operated eye), -2.0D (unoperated eye), Add +1.0 (both)
Thanks so much for the response! I have my 6 month follow up with my surgeon next Monday so if there is improvement to be had then I am definitely going to push for that!
Can I ask, how was your vision after your implant surgery, was the LASIK something that you felt was essential due to the initial surgery being unsatisfactory or was the LASIK more of a 'bonus' improvement?