Is it possible to have mini-monovision with Symfony lenses? I believe that Shanon Wong who has a youtube video may have opted for closer range Symfony. But one of the doctors I consulted with said that it exponentially degrades distance vision and said the wont do over -0.25D.
Depending on the vision which you are trying to achieve with mini-monovision, combining a Symfony lens with a monofocal lens may be a better option any way.
Hi Soks - yes it is entirely possible to target one Symfony Lens closer and many would likely benefit from experiencing closer reading distance with that arrangement.
Symfony can also be combined in that set up with a monofocal (with monofocal lens in dominant eye targeted for best distance.). This may likely reduce the night vision effects of Symfony too - definitely something to consider anyways.
How close? Is -0.5D doable? The doctor I saw said they shoot for -0.25D anyway because they don't want to overshoot the distance vision.
In that combination what correction for distance would be left with Symfony? -0.5, -0.75...?
If your plan is to go with 2 Symfony lenses (or even for a monofocal lens) the surgeon usually implants the lens in your dominant eye when both eyes need cataract surgery anyways. And they target -0.25 so you don’t end up farsighted. Most surgeons wait till healing takes place before operating on 2nd eye (minimum 2 weeks) - vision can change in 6 weeks following surgery.
If that eye ends up plano you could aim for more than -0.50. Even -0.75 to 1.0.
That would ensure you good near vision.
There may just be a difference in terminology being used by your surgeon when it comes to monovision. Monovision or mini monovision has generally been used with monofocal lenses but any combination of premium IOLs can be used for monovision cataract surgery. When accommodating or multifocal IOLs are used, the term "modified monovision" often is used, since these lenses offer an expanded range of vision by nature of their design in addition to a prescribed monovision effect.
I have good near vision and both eyes are plano (confirmed by my optometrist,). Can read very well even small fine print (in good lighting) - anything 11 inches away. I wasn’t expecting that but am happy it turned out that way. There are variables unforeseen that play into that like your cornea and eye health. How near or farsighted one is prior to surgery. Reason why surgeons cannot guarantee perfect vision or glasses free.
That being said no reason why you should not aim for something and then hope for the best.
Guess you must be getting closer to a decision?
I did read and post about a new Extended Depth of Focus lens by Zeiss. Called at LARA. I imagine Europe will be using it soon. Will be interesting to see the patient outcomes on that. Word is they allow a bit more range of focus than Symfony and fewer halos. But one would need to see what patients have to say before those claims are confirmed.
Good luck to you Soks.
Thanks for letting me know about LARA. It is a beautiful outcome for you that you can see well from 11 inches. I would pay extra for that outcome.
I am getting near to getting my left eye operated on. My right eye is now starting to show a tail for green stop lights.
I asked for 0.5D mini-mono vision with Symfony and two surgeons said that that would increase glares, halos. One of them said that it is not worth it going beyond -0.25D with Symfony.
He did talk about looking at where this eye ends up but this is my non-dominant eye so the preferred correction is best left on the non-dominant eye.
Due to my migraines and desire to have eyes balanced both eyes were targeted for plano.
So given how well I see at 11 inches it is entirely possible that others will too.
You could also go with suggestion if a201 will a monofocal lens targeted for distance and then have a Symfony tRgeted for -0.50 in the other eye. Likely would minimize the halos.
Good luck Soks.
May be you already know the answer to my earlier question, but before you decide on the combination of lenses or the amount of mini-monovision for your eyes, you must decide and share your priorities on the type of vision you will be happy with (far vision, intermediate distance vision, being able to read without glasses and with glasses, not seeing multiple circles around lights at night etc). There is no right or wrong answer which applies to everyone. Every combination will have its pros and cons. So, it is better to be clear on your priorities and then ask about / figure out the best choice specific to you.
I didn't see a question in your earlier post. My preference is for Symfony so I can at least have intermediate and far. At 42 I have not lost a lot of my accomodation yet. While I don't like it, I don't care too much about night artifacts as I am not much of a night person and consider night highway driving to be unsafe anyway. If they are indoors too then it could be a problem. My original post was about the feasibility of mini-monovision with an EDoF like Symfony as I got conflicting feedback from the surgeon I consulted with.
If you are suggesting mon-vision and Symfony then my question was how much correction would you keep for Symfony to make it near biased.
Based on what your desired vision is, I don't think that you need 2 Symfony lenses with mini-monovision. You can probably achieve that without the mini-monovision.
If you don't mind using minimonovision, then my suggested order of preference will be:
1, A monofocal lens set for -0.25D in the dominant eye and another monofocal lens set for -1.0D in the other eye. This will provide good vision from far distance down to about 26 inches, but you will need to wear glasses for reading. You will have the least amount of night vision issues. This is also the most economical option.
2. A monofocal lens set for -0.25D in the dominant eye and a Symfony lens set for -1.0D in the other eye. This will provide good vision from far distance down to about 16 inches. So, you will not need to wear glasses for most reading. You will also have less amount of night vision issues and less cost than having 2 Symfony lenses.
Hope that this helps.
I just did an internet search on that new Zeiss at LARA EDOF IOL and found a graph comparing it with Symfony and pictures of the lens too.
Appears very similar to Symfony with the concentric circles visible on the lens, so might have similar night effects around certain lights.
The focus range looks impressive, appears to go out to nearly -2.0D compared to Symfony range to about -1.5D.
However I didn't see any mention of a toric version with Zeiss, so for those with significant astigmatism to need a toric IOL, the Symfony Toric may still be the only option along with the toric version of the Crystalens (Trulign) for an extended focus toric IOL.
For the #2 approach you suggested the surgeon says the Symfony with -1D will cause lot of glare.
If you are concerned with #2 approach because of the surgeon saying that "Symfony with -1D will cause lot of glare.", you should go with approach 1.
However, my personal opinion is that the glare with Symfony with -1D will not be that much higher than a monofocal lens with -1D, which is used all the time in the mini-monovision combination. Essentially, the dominant eye with good distance vision takes over and so, one does not see the glare as one will see if both the eyes are set for -1.0D.
When Symfony was on trials was there both a regular and Toric version announced? Shame there wouldn’t be one with at LARA. I too noticed the rings in the lens - not sure how
night vision would be better than Symfony - unless rings further apart? In any case will be interesting how that lens does when patients start reporting their experiences.
I also found the subjective ranking of the different lenses in night driving conditions interesting.
The Zeiss site states: "In pre-clinical tests using the "virtual implantation" setup, 48 subjects compared four different IOLs in a typical night traffic situation in a random blinded manner: one monofocal IOL, two EDoF IOLs (ZEISS AT LARA and J&J TECNIS Symfony), and one trifocal IOL."
The rankings for night driving conditions(1 being the best and 4 being the worst) were about 1.1 for monofocal, 2.5 for AT LARA, 3.0 for Symfony, and 3.4 for the trifocal lens.
Still double the rating of a monofocal. I also don’t know how you’d rate findings. Very subjective. It’s not as though the same person could try different lenses and then rank them. If they had a viewer for you to have a look at the halo effects each lens causes - that would help.
In this case, everyone did try ALL the four lenses using the "virtual implantation" setup, even though it is hard ti know how representative that is of the real world conditions.
After looking at the night vision with all 4 lenses in simulated conditions, everyone rated them 1 through 4 (1 being the best). The posted scores are the average of the ratings by all 48 people.
That "virtual implementation" sounds interesting - they should provide that technology for patients to try out the view with different IOLs prior to choosing!
Couldn’t agree more. Or if too pricey at least provide photos of the type of glare/halo you would expect.