Should I wait for Zeiss LARA in the US or get Symfony?

Eye care
1

Should I wait for Zeiss LARA in the US or get Symfony?

LARA promises 0.5D more range and lesser night time issues with the SMP.  Anyone has any ideas on this.

2

If you can wait for atLARA I personally would opt for those.   But would wait till a few patient reviews came out to see what the night time artifacts are.   In my case vision was bad.  I would have had to give up driving (it was unsafe for me and others).  But if you have the option to wait - then it would be in your better interest to do so.   Just my opinion though based on ‘what if’ for me.  

3

Hi soks

2 days ago, julian1967 posted a discussion "Problems adapting to my Zeiss LISA (Toric) trifocal IOL's".  Could be worth reading it. They all come with a period of "neuroadaptivity".

I wouldn't be surprised what is not yet approved by FDA may be available in Canada as precedent.

Experts claim:

Trifocals outperform accommodative, extended depth of focus,

while multifocal IOLs in general visual performance and regarding dysphotopsia.

Trifocal lenses produce fewer higher order aberrations such as halo.

clinical results using PhysIOL trifocal IOLs and found that

90% of patients had 6/9 uncorrected distance VA or better,

85% had 6/9 uncorrected intermediate VA,

and 95% had uncorrected near VA of J2 or better.

Toric trifocals showed similar results in astigmatic patients

In comparison, in patients implanted with the Tecnis Symfony extended depth of focus

84% of patients had uncorrected distance VA was 6/9,

86% had uncorrected intermediate VA was 6/9,

44% only had uncorrected near VA of J2 and better was recorded in

 

4

Thanks but I was asking about Zeiss LARA. Are there any reviews on the LARA?

LARA is an EDoF and LISA is a Tri-focal. 

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My left eye vision is unusable now. Triple vision. Night time weird artifacts.  Very blurry. 

I don't know how long my right eye will hold up. It has started giving light issues now. 

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Hi soks, The experts claims quoted in my previous reply is on atLARA Trifocal IOLs.

7

Sounds like vision is much worse than it was 8 months ago.   You may be in same position as I and cannot wait too much longer.   What is your surgeon recommending for timeframe?   I suppose the other eye doesn’t have a cataract and is compensating?

I tried to google to see if there was any news of when atLARA lenses would be available in Canada/USA.   Couldn’t find much on that.  These things take time - more so on this side of the ocean.

I would think only you and your surgeon can work out the timeframe that is best for you.

8

AtLARA is a new EDOF lens not yet on the market.   They aren’t trifocals.  As Soks mentioned Zeiss make atLISA which are trifocals.   The lenses Soks is interested in is next generation of EDIF (like Symfony) called atLARA.

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@soks & Sue.An, Thanks for clarifying that LARA and LISA are not identical twins.

I glossed over the article and came to a hasty conclusion.

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Surgeon is not recommending a timeframe. He says it is very early stage cataract but in the line of sight hence the vision degradation. 

My quality of life is affected. My other eye has the cataract but it is peripheral. But since two months lights are getting tailed so the cataract is arriving in the line of sight. 

Is LARA available in Europe / Germany?

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I believe they are still in pre clinical trials.  Might be worth reaching out to Zeiss.  I noticed they had a contact form on their website.  You could submit that question to them and get a feel for when and where they’ll be available.

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Hi soks, Dr. Balasubramaniam Ilango, Medical Director of OPTIMAX clinics in the United Kingdom, has been using the Zeiss atLARA lens in his practice since early 2017. However the OPTIMAX website does not include atLARA in their range of lenses used.

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Interesting - couldn’t find whether anyone was using atLARA yet.  Would love to read reviews of actual patients 

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Perhaps they are all happy with their atLARA IOLs implants. That's what Dr. Ilango stated.

Learned new things here every day. Am addicted. smile So many good advice from 1st hand knowledgeable contributors.  Just read al26912's reply to RichBr. His 2ndPara: "In my (his) case I (he) waited too long and the better instrument cannot penetrate pass my (his) matured cataract and need to settle with less accurate ultrasound measurement of my (his) eyeball length.  Lucky it turned out okay." So thankful that both our Eye-Surgeons did a superb job.

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Wait for Zeiss LARA.  Symfony has a lot of issues.   

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There is an article on ZEISS AT LARA 829MP on the Zeiss web site, which compares this lens with the Symfony lens.

If you go by Zeiss data (which may or may not be biased) in that article, while the night vision effects with the Zeiss LARA lens are less than those for Symfony, those are still significantly higher than those for the monofocal lenses.  In their 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 subjective ranking (1 being best and 4 being the worst) was 1.1 for the monofocal lens, 2.5 for the Zeiss LARA, 3.0 for the Symfony lens, and 3.4 for the trifocal IOL.

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Thanks for all the thoughts.  Looking at the ZARA design (SMP) I would almost think that it would show more circles although they would be lighter due to gentler slope.

Is there even a single patient review available?

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When was Symfony first available in non-US regions?

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I'm really interested in the first reviews too as I'm hoping this will be out and well liked when it's time for my second eye. However, in general, patient reviews of IOL's seem to be very hard to find. We might need someone who comes on this (or a similar site) in advance of the surgery in order to actually write a review after they are done.

Do a search on "Restor 2.5D Review" and you'll see what I mean, you basically just find my posts, journals and paid studies. Yet, this is for an IOL that ranked just behind Symfony (23% to 22%) in terms of premium IOL's being implanted in the US (by surgeon preference in the 1/2018 Review of Ophthalmology).

There must be thousands of this IOL being implanted yet practically no patient reviews, just paid studies and journal articles plus a handful of complaints. 

I think that Symfony, being a new design, has gotten more attention but I'm worried that we won't get nearly as much feedback about the next EDOF design unless it's people complaining about problems. I suspect that the main reason for the overall death of reviews is the average age of cataract patients puts them into the pre-internet era and they just don't think about reviewing something like an IOL unless they've encountered some serious issues. 

 

20

There was one case study done by Dr Pascal Rozot of Marseille and sponsored by Zeiss, that came through as balanced and unbiased. A clinical trial currently on in the US since May 24, 2017, comparing EDoF IOLs with a Monofocal Intraocular Lens, sponsored by Zeiss. Estimated primary completion date will be September 2018; and estimated study completion date will be December 2018.