on 4/28
Man you are tied in the grapevine. I just saw it at the FDA PMA site. I am reading through the 53 page Summary of safety and effectiveness now. Any word on when it will be commercially available.
I hate to be the first one in the US to get this lens, but I really can not keep procrastinating and waiting for more Real-World results to be published.
Hmm, I think I will be 2nd right after I hear back how it worked out for you, LAL.
I also saw some approval for Tecnis Symfony IOL, is that the Plus or something else.
Man you are tied in the grapevine. I just saw it at the FDA PMA site. I am reading through the 53 page Summary of safety and effectiveness now. Any word on when it will be commercially available.
I hate to be the first one in the US to get this lens, but I really can not keep procrastinating and waiting for more Real-World results to be published.
Hmm, I think I will be 2nd right after I hear back how it worked out for you, LAL.
I also saw some approval for Tecnis Symfony IOL, is that the Plus or something else.
the symfony one is the blue light filter symfony with yellow tint called optiblue. the synergy is default yellow tint.
i think synergy should be available in June.
I really have not taken the time to research IOL tints and their associated effect such as circadian rhythms..
From what I read Synergy is a Violet Light (very short wavelength) filter and keeps most of the blue light. This is suppose to help with LED lights and reduce halos from LED headlights.
I am now wondering if having different IOL tints each eye makes any noticable difference. I just looked into Kelvin Temperatures and lightening, when remodeling my house. I wonder if one IOL would be like Daylight and the other one be like Warm Color. I guess I need to do some research into this topic.
Yes it is same consideration for me as i have the non tint symfony. there are people with symfony/panoptix and symfony/synergy combinations.
Is this the lens you are going with soks?
yes
wishing you well soks. let us know how it goes.
A couple of other thoughts. I think getting this lens well centered/ placed is so critical, make sure you go to an Opthamologoist with lots of experience with premium IOL including Trifocal, EDOF and MF IOLs. I think you mentioned Vance Thompson Vision that is well known.
The other think I am thinking about is refractive targeting. For my current IOL I had them target Plano. I would normally recommend Plano or slight Myopia (assuming no monovision goals), but with this IOLs amazing close vision, I am wondering if slight hyperopia would be the best option.
Now that this lens is FDA approved I am writing an email to some of the Opthamologist who were involved in the US clinical trials, which were done at 12 sites. Sadly the doctor in Florida who was involved in the Syergy trial passed away.
Hopefully one of the doctors will reply to my email. I wanted to get your thougths or others before I sent out my email. I am not including the intro of my letter, just questions part. I guess I need to provide some background information so my question are clear. So below is that BG information and what I am asking their opinion on:
From what I read, this IOL combines EDOF with MF and the only other IOL I am aware of that obtains near vision down to 33 cm is the Tecnis MF 4.0, which came with large Halos.
I am OK with the Halos I see from my current +2.75 add MF, but I want to avoid an IOL whereby the Halos would be worse and it is unclear to me how Synergy is achieving that amazing close vision down to 33cm.
1)What has your patients experience been with the Tecnis Synergy vs the Tecnis low add +2.75MF in regards to dysphotopsias, especially halo size from light sources when driving at night,
2)Due to the amazing close VA, can you provide any thought on refractive targeting? For my current MF I targeted Plano, but with this IOL’s close vision performance, do you have any thoughts on whether slight hyperopia should be targeted instead.
3)From what I read Synergy comes with a violet filter. Any thoughts regarding issues of mixing IOL with different tints?
Keep in mind that the natural lens in the eye has blue light filtering. The clear IOL lenses on the market allow much more UV and blue light into the eye than the natural lens does. Alcon’s blue light filtering simulates the natural lens for filtering. Having a clear lens is actually unnatural to the eye, which cause some to speculate that they may cause long term eye damage. However I believe that is just speculation and I have seen no documented evidence of macular damage due to using a clear IOL. The experience here may be somewhat constrained by the fact that most get an IOL quite late in life, so the time for macular damage to occur is limited.
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I suspect that the Tecnis violet light filtering is somewhere between a clear lens and the Alcon blue light filter. It may be a way to provide the same benefits as the blue light filter but allows them to distinguish themselves from Alcon for marketing purposes. The main benefits would be in reducing chromatic aberration effects.
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A comparison of the filtering of the clear lens (SA60AT), blue light filtering (SN60WF), and the natural eye.
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this is a great post rwbil. i feel hyperopia should be targetted with trifocal as the near power is fixed and does not change just because you made distance better.
in terms of lens centration. i think the lens auto centers based in the capsule size. they should have ability to center the iol on constricted pupil as my pupil constructs unevenly. if the lens was moved in the nasal upward direction my edge problems will great reduce.
also dr gabric said that synergy eye image is smaller than the symfony eye. is that standard experience?
have u had YAG on multifocal?
My concern is what effect, if any, there is when mixing IOL tints. I need to double check but I think my current IOL is UV blocking but no blue or violet light blocking.
I have not need YAG, cross my fingers I never do.
Yes, Dr. Gabric is a big supporter of Synergy and who better to get info from than an Opthmalogist that has Symfony in one eye and Synergy in the other.
He was talking about some picture he was looking at and contrast sensitivity; saying Symfony was better and provided a 10% larger picture. I am not sure how to interpret that information. First I have the Tecnis MF so not sure how it would compare in picture size.
Hopefully if there is Synergy CS loss, my other IOL will compensate. In a perfect world my hope is the Synergy helps me pick up a little more close vision and of course intermediate, so I can hit that tennis ball better off my racket and as long as the halos are no worse than my current MF, I will be Happy. I am not sure this will happen, but it would be so nice to pick up a magazine or book and be able to just read it comfortable without finding the sweet spot or having to find a good light and reading glasses. I cannot keep a pair of reading glasses when I need them on hand if my life dependent on it.
just guessing but thinking 10% bigger picture may refer to peripheral vision?
At one point I found a study where they implanted a blue light filtering lens in one eye and a clear lens in the other. I can’t seem to find it again using Google. I believe the reason for the study was unrelated to the filtering, but they came to conclusions about the mismatch as well. From my recollection there was basically no issues reported by the subjects in the study, in having a mismatched colour filter.
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I currently have a blue light AcrySof in one eye and a cataract in the other eye. They are very mismatched for colour currently. While the AcrySof has blue light filtering (yellow lens), the colours seem very bright and even blueish. The cataract eye in comparison is now quite noticeably yellow. But, unless I close one eye or the other I don’t even notice the colour difference. I would say that the brain just blends them.
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My thoughts are that a mismatch would be a non issue.
My ophthalmologist’s J&J rep advised today that Synergy will be available to him in late July or early August. I am his only patient thus far who is waiting for Synergy. I expect to have surgery in late August or early September. For patients with macular or corneal issues my ophthalmologist is now recommending Eyhance. I asked about any problems they’ve experienced with PanOptix. They’ve implanted several hundred PanOptix lenses; only about 5 patients have had problems. My only concern with PanOptix is the possibility of glistenings. Since I have amblyopia, glistenings is a potential problem that seems too risky to me. The vast majority of my ophthalmologist’s PanOptix patients are very happy with their result. I look forward to reading about any real world results with Synergy as it becomes available in North America. JJV’s announcement regarding Synergy’s FDA approval states it will be available in North America during the summer. Pretty vague. There is still very little information available online despite the availability of Synergy in Europe and Canada for some time. I realize that happy patients don’t usually seek out forums like this, so perhaps the lack of information is actually a good sign. I remain optimistic about Synergy, but must also remain open to other options.
If I was considering PanOptix the least of my concerns would be the glistenings. My surgeon told me that he has seen glistenings occasionally in lenses, but the patient never reports any visual issues requiring a lens exchange. I don’t know how amblyopia would change anything with respect to glistenings?
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I would suggest the real issues with PanOptix are halos and starburst effects at night, and potentially the inability to read in dimmer light. Since the Synergy lens offers similar or even more depth of focus I would worry it could have similar issues. If you don’t drive at night, or don’t care about those issues then either lens may be fine.
I too am waiting for the Synergy to be commercial available. Based on what I have read, my hope is that it does not split the light as much as a trifocal like PanOptix and thus provides better night vision.
The big worry is just how bad the dysphotopsias will be. I already have a Tecnis MF in one eye and am just hoping the dysphotopsias are not greater than that IOL.
I have yet to be able to find and talk to a doctor with experience with both Synergy and Tecnis MF to find out what results they are seeing.
Not sure why taking so long to become commercially available after FDA approval. After they clearly have the manufacturing process setup to supply Europe and Canada.
I think I will wait to see your and Sok Results. LOL!
Actually I do want to wait a little bit for some of the doctors I know with experience with Tecnis MF to start to implant them and see what their patients say.