Hello everyone, I had my cataract surgery this past Thursday 10/24 with no complications. My doctor said everything went very well. I have no pain or anything. I'm on Ketorolac, Prednisolone, and Moxifloxacin drops 4 times a day currently. I decided on the Symfony because I wanted clear intermediate vision since I'm a software engineer. I was given the option of monofocal initially, but my doctor said he could also do Panoptix or Symfony. I did a LOT of research here and on the web and decided to go with the Symfony. I have an astigmatism so I was given the toric ZXT225. Anyway, the day off everything was clear as far as colors and brightness, yet nothing was in focus. The next day it got a little better, however things weren't still "sharp" in the intermediate to far distance that the IOL is supposed to be good at. Today is 2 days post surgery and nothing is sharp...feels like no improvement since yesterday. I know it takes different amount of time for different people to get acclimated to their new lens so maybe I'm just being anxious for no reason, but can anyone with the Symfony toric tell me if they saw improvements early or later (weeks or months)? I know full well that night vision would be an issue and I already see starbursts with white lights, especially LEDs. I also see spider webs with red and yellow LEDs, but honestly the night vision issues don't bother me. Even oncoming vehicles while walking my dog don't bother me. The thing that does bother me is that nothing I look at with my left eye is sharp. My non-op eye is sharp as I could expect at 42 years old...
Hi naheyes - I have 2 Symfony non toric lenses. Hopefully you have a 2 week follow up and a 6 week one with surgeon to check that everything is as it should be.
Some eyes react to the post op drops and things don't get sharp till those are over with. There could be swelling too affecting your vision. Again your surgeon should check that.
2 days post op - i wouldn't be overly concerned. My first op everything was sharp within 24 hours but 2nd one took longer.
Is your other eye affected by a cataract too? You mention things are sharp through that eye so perhaps no surgery is required on that eye.Your brain may be trying to meld the 2 views with IOL and natural eye.
Sending good thoughts that all will be good soon for you.
I don't have the Symfony lens, but an AcrySof monofocal lens which was put in 18 days ago. My surgeon has you come in 24 hours after the surgery for a check. At that point they tested my vision to be 20/30. It improved noticeably over the first 3 days or so to about 20/25. After that it may have improved a bit more to be close to 20/20, but it is not obviously 20/20 based on my home eye chart. No hope of reading the 20/15 line. I will go in to see my optometrist on Tuesday to see where I am at more accurately. My surgeon's routine is to do an examination himself at 24 hours, by an optometrist at 2-3 weeks, and again at 6 weeks. He said not to consider an eyeglass prescription accurate until 6 weeks. As far as closer vision goes, it is better than I had expected with a monofocal lens with a correction for full distance. I can read a computer screen down to about 20 inches with the IOL eye. After that it starts go get harder. Computer screens are pretty bright, so I think that helps due to the pupil size constricting and the depth of focus improving. . I think the main issue with vision after cataract surgery is that you have had a hole put in your eye, the natural lens broken up and sucked out, and a replacement lens put in. While they are very good at controlling the pain of that, it still causes significant trauma to the eye, and it swells up to some degree. That swelling affects the vision until the shape of the cornea returns to normal. . As far as what could go wrong, the main issue with a toric lens is that it is at the right angle. It does not have to be far off to cause a reduction in vision. The lens has a mark on it so the surgeon should be checking to see that it is at the right angle, and also centered on the eye. Those are the things you should be asking about. I believe there is a limited time after surgery to make any necessary adjustments to the lens position. Mine was not a toric, but I would expect those are the issues that would be checked at the 24 hour examination.
I'll be in this coming Thursday for my 1 week post op appointment. I was just kind of worried that something might be off, ie measurement or IOL moved or something. Thanks for the reassurance though. Just wanted to see if it was normal to see this blurry.
Thanks for your reply. I know the toric lenses are slightly more complicated with the issue you mentioned and I'll definitely be asking about that. Although I'm sure my doctor would tell me since I'll be bringing up the blurriness. I guess it's just wait and see (or not see) time.
I think at this point the main thing is to keep taking the drops exactly as prescribed. They are what will bring the swelling down and prevent infection. The moxifloxacin is an antibiotic and the prednisolone a steroid. Some surgeons also use a NSAID like the ketorolac to reduce the pain and potential inflammation.
how is your near vision with the symfony eye? is everything blurry at all distances?
i got my symfony at age 42. the night issues very minimal after surgery but they progressively got worse. could be because of PCO. i have not had YAG to know if they resolve.
i am a bit suprised you didnt opt for panoptix.
Yes I'm blurry at all distances. However, my binocular vision is pretty good, great even so my right eye must be compensating a lot. Before my surgery, my left cataract eye caused me to blink quite a bit because it made everything noticeably foggy.
I did a lot of back and forth as to whether I should get the Panoptix or the Symfony. In the end the biggest concern I had was glistening. I spoke with my doctor about my choice between the two and the fact that I really don't read up close much and he said the Symfony would be what he would go with given that fact. Maybe the glistening issue is overblown, but I didn't want to take the chance of any light scattering on top of possible PCO. If I can get my computer vision on track (along with distance) I'll be one happy camper.
Yep, I'm on my drops as scheduled.
Just an update, I still see no improvement...what I notice though is that if I close my good right eye and cross my left eye with the IOL, things get sharp...I'm guessing that doing so changes my eye pressure? Hopefully my check up in 2 days doesn't reveal anything to worry about.
my surgery was on 10/24 two years ago when i was 42 at the time with Symfony.
I actually made a typo on the date, it was Thursday 10/22. I started this thread 2 days later on 10/24.
ok good. coz i am not happy with the outcome.
Sorry to hear that, I'm hoping I'm not disappointed also...so is it just night vision you don't like? How about everything else?
10/28/2020 Wednesday 6 days post op: No improvement in my vision. Things are still blurry at all distances, not extremely blurry as with my cataract, but if I look at text or anything with fine lines, there is ghosting. 1 week post op check up is tomorrow. I'm hoping that my IOL isn't shifted or rotated since I got the toric. Will post another update after the appointment.
10/29/20: 1 week post op, told my doctor about my concerns... He checked and found that my lens has rotated about 40 degrees, basically negating the astigmatism correction. Will be having another surgery in a few weeks to correct it.
A quote I found: . "A frequently cited study describes how just 1 degree of misalignment results in 3.5% of residual cylinder; 3 degrees of misalignment in 10.5% of residual cylinder; and 30 degrees of misalignment in a total loss of the toric’s astigmatic correcting effect." . 40 degrees is a brutal error. Given that you have this amount of error, and the surgeon did not do an eye exam at the 24 hour mark, I would be looking for a different surgeon if you plan to do the second eye. Although it could not account for an error this large, AcrySof lenses tend to be more "sticky" than Tecnis lenses due to the material they are made of and they rotate less after implant. But, with an error this large it has to be more than just the lens material.
it should be a relief that you know the cause and can fix it.
I trust my eye doctor. He said I'd be his first rotation case in 2 years. I don't think he'd lie about that kind of thing. He was very concerned that I was concerned when I walked in and reassured me that he wouldn't leave me dissatisfied. While I'm not happy about having to do another procedure, I'm happy that he identified the issue and he's fully confident on getting the rotation right.
Absolutely. I'm glad my doctor actually listened and was really reassuring that he wouldn't leave me with this vision.