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

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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.

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  • Posted

    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.  
    • Posted

      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. 

    • Posted

      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.

    • Posted

      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?

    • Posted

      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.
  • Posted

    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

     

    • Posted

      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. 

    • Posted

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

      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.
    • Posted

      @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.

  • Posted

    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.
    • Posted

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

      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.

    • Posted

      I had the Zeiss AT LARA fitted here in the UK by Professor Jan Venter at Optical Express precisely 1 month ago. I wore varifocals unable to see well enough to drive or read unaided. I was given the choice of the AT LARA or Abbot ZKB00. Opted for LARA, vision now significantly better than 20/20 reading and distance fantastic. No need for glasses even for fine work in dim light conditions. Generally getting used to a much brighter world (still find flourecent rooms too bright, and colours are incredibly vibrant. Continued visual issues at night including halos and visibility of the concentric lens rings in reds/yellows but this is generally improving and does not impair night driving. As a patient I could not be happier, in fact my wife is now going to go to the same lens this month. 
    • Posted

      Thanks so much for posting info on the Zeiss atLARA.  Sounds like they provide better near vision than the Symfony lens.  I seem to be more fortunate than most for the best vision I experience with Symfony.  Wish the atLARA were available in Canada.  Not sure when or if they will be.

      The brightness of everything you will get used to in time.  I recall having to wear sunglasses inside those early weeks.  

      Congrats on a successful outcome.  Sounds like you are enjoying your new vision.   I know many here would love to try the atLARA lenses.

      Just to clarify at night you still see many concentric circles around certain light sources like red traffic lights?  I see that too with Symfony IOLs.

    • Posted

      Did they give you Symfony option at all?  ZKB00 is a technis multifocal.  ZXR00 is the technis  Symfony which would be the LARA comparable. 

      Moorsfield hospital gave me Symfony and LARA option for EDoF lenses

      Congratulations on your outcome. 

    • Posted

      I had thought the LARA SMP technology reduced the concentric circles and night time halos. 

    • Posted

      Me too that’s why I asked to reconfirm.  Thought the benefit was a bit more range of focus with LARA and no concentric circles.  
    • Posted

      Nothing can replace mother nature I guess and for me the trade off of no glasses while some night light distortion was accepted and kind of anticipated doing all the reading on Multifocals including AT LARA. I have nothing but natural lens to compare with of course, but yes they are there at night. Turn signals and applied brake lights bring out the circles but not normal, its a question of intensity and again that is improving, must be my brain accommodating. Halos and shards coming out around headlights again are visible but seemingly less so over time. I don't expect based on the reading I did around European trials that I will not have them ultimately, but apparently they are less prevalent than other lens. Unfortunately I cannot compare! Again until we can clone real human lens the artificial is going to only ever be an approximation but for me the benefits outweigh the drawbacks and again I believe the effects are lightening. I will remember to update here again over time to comment on my experience and if indeed they get better or stay the same.

      I do a fair amount of night driving and would say it is actually either getting better or I am noticing it less

       

    • Posted

      No these were the only two options offered. It was interesting in fact my surgeon said that he is seriously considering using ONLY the AT LARA as the results have been so good. I know they have told me the results are better than average in fact I believe I have superior vision to before I wore glasses for both distance and reading, it is incredible but expensive. The shame is it is not so accessible at this cost for so many.
    • Posted

      They are not significant but I see them under specific conditions, too bad we couldn't trial different lens or one of each to compare ;-)

    • Posted

      Thanks for replying and I hope you post again in a few months.  Will be interested if your seeing the concentric circles lessen with time.  I am about 14 months from my surgeries - both eyes implanted with Symfony lenses at 53 due to cataracts affecting my vision and it could no longer correct with glasses better than 20/60 in one eye and 20/50 in the other.  I  wish atLARA was available in Canada but there is still no hint that they will be any time soon.  So Symfony was the only aEDOF lens available.  Still I am thankful I don’t need glasses for any distance. I think perhaps my distance vision isn’t as good as someone with their natural lenses.  My husband wears glasses and there are some things he reads in the distance better than I do - even though O test 20/20 for distance in RE and 20/25 in left.  I still work full time and appreciate being able to see my computer or read the paperwork and spreadsheets on my desk.  

      I haven’t noticed the concentric circles have lessened - I see them on red traffic lights, cars when they brake (not usually when brake lights are on and I am following).  Turn signals too and certain LED porch lights.  These lights also have to be a certain distance 40 or 50 yards away.  As I approach a traffic light they disappear.  Whether I have adapted or the glare which has diminished since the surgeries has gotten better can’t say but night driving has gotten better with time.

      Again thanks for sharing your experiences.

    • Posted

      I will keep you updated as time goes on. My wife is having hers done on 28/29 Nov and I have been sure to give her my perspective, I will have another perspective to share one she is done. Vision wise again I am thrilled be it distance or the tiniest of medicine bottle wording I can read everything and its like being born again!

      And Happy Thanksgiving! I am Canadian by birth been here in the UK since 1987 ;-)

       

    • Posted

      Did you get both eyes done?  Thanks again for sharing the experience. We do not have any other LARA patients. 
    • Posted

      Yes, both eyes, 4/5 September 2018. This was not due to cataracts just decided due to poor vision at all distances. Just completed my 1 month review. Vision continues to sharpen a month in very pleased overall even with the night elements which are noticeable but not significant. The tradeoff is well worth it and I will update on this link on how things go.
    • Posted

      How old are you?  When did your presbyopia (loss of near vision) start?  your surgeries were one day apart?
    • Posted

      That's quite fantastic.  LARA themselves do not promise great vision at all distances.  You may be the lucky ones who get great vision at all distances.

      Another question I have for you and Sue is if you see the concentric circles on brake lights during daytime.

    • Posted

      I only notice effects after dark and only when brakes are on AND I am sure its less noticeable a month in. I will continue to watch. As far as lucky I am but I actually think its not just the lens but the surgeon. Professor Venter was outstanding. No post op issues of any kind, no pain just great vision. He is getting great results with the LARA and suggested so good he my default to just this lens in the near future

       

    • Posted

      I am 55. Prior to my 40s I did not require any glasses. Problems were noticeable first in around 2004 (42) and I muddled through with weak 1.25 readers for a few years. Then around 2010 noticed distance was failing AND I had moved to 1.75 reader. Full Varifocals and fairly stable for the next 5 years but realising distance was getting worse. Surgeries were done 11 am over two consecutive days, weak eye first, strongest last. They are doing both eyes same day in 2 locations in the UK today but I was pleased with the separation of days it allowed me to compare old and new vision!

       

    • Posted

      Gordon:

      When you get a chance can you describe the overall size of the concentric circles and/or halos you see around bright lights? You described both halos and concentric rings.

      I went for a low-add multifocal (Restor 2.5D) over Symfony and one of the main factors was the size of the night artifacts. I see halos around bright lights (headlights, tail lights when brakes are applied, LED streetlights and similar). If I am stationary and look carefully, I can often pick out concentric rings in the halo. These halos are relatively bright but also pretty small. For example, around a headlight, the halo might be 2-3X the diameter of the light source but it typically doesn't extend out much past the car itself. This means it's a bit of an annoyance but I don't believe that it affect my driving negatively. 

      With Symfony, my expectation was a much fainter but larger set of concentric rings which, based on posts throughout this forum, will extend well beyond the dimensions of the car itself.

      I had only one eye done, and while I'm happy with my choice, the one negative I have is a very noticeable dip in clear vision between the two focal points. My second eye doesn't need surgery yet and I wear a multifocal contact which eliminates the mid-range vision issue, so I'm hoping an EDOF design will be available for me which works like the Symfony but where the concentric ring artifact is smaller and similar to the size of the halos I see with my current IOL. 

      The LARA is definitely something I'm continuing to read about and first-hand observations are invaluable.

      Thanks.

    • Posted

      Those are great questions.  I want to know the answer too.  I would like to think that LARA would have more circles than Symfony but those circles in LARA would be fainter than Symfony due to SMP.

       

    • Posted

      Cool - happy thanksgiving!!!  My dad is British so have a lot of family across the pond.  Love to visit them.  

      Is your wife having surgeries back to back?  Curious is that normal procedure in UK?  Here there is a wait between surgeries if both eyes need cataract surgery.  Minimum is 2 weeks.  My own were 6 weeks apart due to wait times here and my surgeon’ s schedule.

      Is she having atLARA IOLs too?

      I too have great nest vision with Symfony.  I can read most pill bottles if lettering is black on white.  If it’s white lettering on red or green - have more trouble with that.  Was expecting my iPhone or book to be held out further but that has not been the case.  Read very comfortably at 11 inches away.  Can thread needles or repair small screw when it fell out of my sunglasses.  So all in all no real complaints.  Do need good light though.  In dimly lit restaurants use the flashlight on the menu to read it.  It is very strange to get used to.  Upon waking for months my first thought was to reach for glasses that I no longer need!

    • Posted

      Not at all Soks - during daylight no hint of any concentric circles on any lighting whatsoever.  Only at dusk do they first appear.   Only other thing I do differently is have a light on at home when working on my laptop.  If in pitch dark there is slight glow around screens.  Had this with cataracts too - go ding I needed better lighting to read etc.  Cannot recall prior to cataracts if there was a faint flaw around TV or laptop in dark rooms.  But I do prefer to watch TV now with a light on.
    • Posted

      I had cataracts that progressed very rapidly at 53.  I think due to the cataracts forming or maybe my always needing distance glasses since childhood I didn’t experience presbyopia much.  Could still read without glasses.  With 6 weeks between my surgeries I compared the 2 eyes a lot.  Colours and brightness - huge difference.
    • Posted

      Correct Derek the concentric circles of Symfony extend beyond the vehicle or in case of red traffic light extends to the ground.  Mind you it depends on how far you are from light source.  As I get closer to light source rings get smaller and then disappear.  Sounds bad but rings are light and although I wish they weren’t there I see well enough to drive as they are faint and rings are less close together when they are big allowing me to see through them.  One does get accustomed and now they are part of my new normal landscape and I don’t spend time focusing on them when driving.   On really dark roads prefer to keep my eye on right white line.  Oncoming headlights are more of a distraction these days with the new types of headlights they have on cars now.
    • Posted

      I keep wondering if these rings being faint would disappear or become less prominent in a blended vision situation (or be worse because I'd have both small halos and large concentric rings). The halos I see through my Restor are bright and they are still easily visible with both eyes open. However, I also see a faint haze around letter at the neat vision point (depending on the color of the lettering and background). This haze completely disappears when I view the text through both eyes (my left eye currently with a multifocal contact). 

      The only comments I've found from someone with Symfony in one eye and a multifocal in the other are from David Taylor (whose son was a graphic artist). He had a higher-add Restor with Symfony and in his sketches, he doesn't show any lessening of the intensity of the halo or concentric circles with both eyes open. This is one of those things where it's a complete guess as to how someone will tolerate the results.   

    • Posted

      I think it will show you one of the two most time and both sometimes.  The reason I am saying this is with my left eye a light source looks like a large snow flake about 10 times the size of the light source.  With my right eye the light source is asymmetrical with a comet like tail to my left side.  With both eye open the brain decides to use the snow flake as it is symmetrical.  Sometime I see both a snowflake with a tail but for most part it tries to suppress the tail.  This is the case even when the snowflake is coming through my non-dominant eye.  I will have a Symfony in my left eye later this month so I will know whether it show me rings or tail or rings with a tail. 
    • Posted

      Soks I think you are completely correct on that the brain chooses which eye’s vision to choose from.  I see sharper through right eye than left.  There is .25 less of astigmatism is RE and I think I may see slightly better to read in left eye.  I see small differences when I close one eye then the other but when both eyes are open I see the better view each time.
    • Posted

      So perhaps the difference is I didn't have cataracts, I went for Lens replacement purely to get away from glasses. It may be in the case of cataracts they make you wait but for this Lens replacement its done over two days- even now 2 UK locations do BOTH same day. My wife is having the same AT LARA and same surgeon as me. I am hopeful her results are as outstanding as mine! I still start to look for my glasses or go to grab them off my head, I am sure in time that too shall pass.

    • Posted

      I will do that exercise for you, I guess already I am not paying that much attention to them. I will take note and update here asap.
    • Posted

      Similar to what you just said, I see the best when both my eyes are open.  THAT IS EVEN when I can hardly see anything through one eye.  The little bit that the bad eye sends through make the combined picture a lot better than the picture through the good eye alone.

      The 0.25 difference between the two eyes is manageable anything larger than that has the potential of distorting the picture when the brain starts using the bad eye.  My daughter has amblyopia in one eye and she was give special glasses with darkened lenses for her therapy.  When you wear them and look in the mirror, normal person should see his eye through the dark shade.  Amblyopia person sees only his/her good eye.  The other eye looks like the lens of those glasses is completely dark. 

      For normal person you will have very small duration moments where the brain will shut off your one eye when the lens goes dark in the mirror but come back on right away.

    • Posted

      I have observed that refractive specialists tend to space the surgeries close to each other.  One of my co-workers had both his eyes done at the same time.
    • Posted

      I am guessing in UK they treat clear lens exchange same as lasik and do both eyes close together.  If all goes well one wouldn’t question that.  Reasons provided to me for the wait is that they want the surgery to heal and IOL to settle so that if any adjustments need to be made they can make those for 2nd eye.  The IOL is 1mm whereas natural lens is 6mm somIOL will shift before settling and the target can be off .25 diopter either way.  Some people also experience a lot of blurriness due to drop regiment and don’t see well till those are over.

      It’s great you had. no issues with healing process.

    • Posted

      Yes agree both eyes together do see better than even one good eye open.

      Must be difficult for your daughter.  Will situation improve with time?

    • Posted

      wishing you well tomorrow soks. hoping for a good outcome.

    • Posted

      Thanks but my surgery is next Wednesday on 10/24.

    • Posted

      Good luck on your surgery - 10/24 is the one year anniversary of my own right eye cataract surgery!

    • Posted

      Sending good thoughts your way and wishing a successful surgery tomorrow and that you'll be enjoying great vision soon Soks.

    • Posted

      Thanks Night-Hawk. 10/24 is also my 14th wedding anniversary.

    • Posted

      Thanks Sue-An. Fingers crossed. I will have a hard time sleeping tonight.

    • Posted

      Good luck. I didn't sleep much either. Ended up working out a little better that way as I slept more after the surgery.

    • Posted

      i can relate - sleepless night and went in shaking like a leaf. It will go well.

      Happy Anniversary tomorrow.

    • Posted

      Will see each other on the other side more clearly tomorrow after your surgery. It's quick.... & painless... don't worry about the surgery just your drive into NYC. You will be fine to go to a good restaurant after the procedure and relax when its all over. Good Luck.

    • Posted

      as promised. just stepping out of surgery.

      i can see 2 concentric circles around waiting room lights.

      my vision is blurry but distance appears to be better than near.

      measurements coming today evening or tomorrow.

      if anything my triple vision is gone.

    • Posted

      very normal. your pupil is very dilated and can take several hours to wear off. hopefully by supper time things will be a lot more in focus.

    • Posted

      At least your surgeon isn't making you wear a bandage. For me, the irritation from the packing over my eye was worse than the pain (which was very mild). Definitely be patient in terms of assessing results.

      Now, go get some rest.

    • Posted

      5.45 PM update.

      Still very blurry. Feels like looking through smoke room. Like Sue said pupil heavily dilated. Doctor office asked to wait until 24 hours.

      I can read tv subtitles through the smoke.

      I had asked to be very involved in the surgery and doctor Raviv agreed. He gave me 3 Symfony lenses 16, 16.5 and 17. The measurement had recommended 16.5.

      During surgery he did ORA 3 times and asked me if I wanted to do 17 as 17 would give me -0.55. earlier calculation was -0.65 for 17.

      I asked what did ORA say for 16.5. He said -0.19. I made a very difficult decision to stay with 16.5. This will keep me far sighted.

      Hope things get better. There is lot of glow around the iphone.

    • Posted

      Pupil for me stayed dilated a long time. Only next morning could I see my pvr clock clearly (first time without glasses).

      I was fortunate that the drops didn't affect my vision. Some are and clarity varies until those are over and done with.

      Hang in there - hoping after a good night's sleep you'll be seeing much better.

    • Posted

      Very wise of you to stay involved during the surgery. I didn't, but wish I did. I only remember ORA once, but as it turns out they gave me Versed during the procedure.

      My right eye surgery was scheduled today for Dec. 3. After reading this forum for the last 2 months I feel I have gained a lot of valuable information, and plan to ask a lot more questions and be a more involved patient. I am very grateful to the people who have posted their experiences and knowledge.

      I had a lot of glare/glow in the beginning. I still have some but it is greatly diminished from those early days. Please keep us posted on your healing progress.

    • Posted

      9.40 update

      The smoky vision started clearing around 8PM . It was very frustrating and had me scared. Thanks Dennis for your email. The pupil is undilating.

      I can watch tv without glasses. There is still a feeling as if there is dirt in the operated eye. But cannot touch, rub or wash it.

      I took the morning drops before the surgery. In retrospect I should have put them after the surgery.

      For near vision I think it gets clear around the 16 to 20 inch mark.

      In terms of concentric circles. I saw one for a car braking near me. It does not appear all the time and is not bothersome yet.

      Other strange thing I see is for white lights I see only two circles. These are huge. Probably because of dilated eye. White lights are lights at the airport.

      Still lot of glare from internal lights.

    • Posted

      I think I knew what versed meant but I googled anyway.

      Yes I don't remember the surgery too but the doctor woke me up for ORA to ask me to look at the red light and to ask what I wanted with the lenses.

      I don't remember much after that.

    • Posted

      Don't expect optimal vision a day after surgery (eye is swollen & drops also have an effect). It is good to note your vision progress as time goes by... I found it took about a month for my best distance & close up results. I set up charts to check these. Let me know & I will send them to you to print. Have a good nights worry free sleep.

    • Posted

      I recall having streaks of light on inside lights like iphone or pvr coming out sideways whike eye was dilated. Due to Ativan they gave me I pretty mych was put of it till following day.

      Fingers crosssed this morning there is a lot of improvement.

    • Posted

      it is referred to as conscious sedation here. I have had it once for a procedure. You are awake with it but you font recall much. My cataract surgery only uses that on patients with dementia or other conditions where patient could not be still. For whatever reason he prefers patients fully alert.

    • Posted

      At the doctor appointment my distance vision was 20/30. I could correct to 20/20 with -0.25.

      I could see some letters of 20/25 at the doctor office without correction. For reading I was at 20/40.

      Driving through Lincoln tunnel I could see concentric circles when the cars in front of me applied brake. The circles are very faint and I would not notice them if I wasn't looking for them. I do not see the circles around street lights like the famos internet picture. That picture is very drastic actually. I am am looking for the circles because I think they are kind of cool.

      2 days after surgery, a weird right side tail glare has gone away.

      I can read the smallest print on the salt pack at about 16 inches.

      Overall I am very pleased. Thanks everyone for your support and educating me through this very difficult and frustrating eye condition.

      Special thanks to Sue.An and Dennis. I was worried Sue would be gone from the forum when it would be time for my surgery.

    • Posted

      Those are really encouraging results, Soks. Hopefully they will continue to improve over time and I'll be especially interested in reading your measurements from after you are all done with eye drops. Thanks.

    • Posted

      so very very pleased for you Soks !!!!!!

      As eye continues to heal those distances will improve. yes i know what you mean by looking for those circles and it not being as bad as feared.

      You will be continually amazed by daytime vision - especially after living with really poor vision for awhile now. I was becoming depressed with that yet so fearful of outcome. with so many negative comments here I still wanted chance to see better at various ranges. good on you for searching and researching right place for surgery.

      i likely will continue being here to give back to this great community for support I received and also may need again. been reading some articles on longer term issues as they are seeing younger and younger cataract patients not to mention people opting for clear lens exchange. in past people hot this procedure in their later years and IOL life expectancy only need for 10 to 15 years.

      Again congrats on your new eye! looking forward to more updates as time goes on.

    • Posted

      Those are great results for your 2nd day out. Lack of positive dysphotopsia is very encouraging.

    • Posted

      A 4 inch improvement to reading would have been nice but that would have worsened my distance by another -0.35.

      When my next eye is done it will be -0.05 worse than this eye for distance which may give me an inch or two for near. The near is better in more light. I will wait on next eye as it can still correct to 20/20 with glasses. Bad eye could not correct beyond 20/60, blurry and triple vision.

    • Posted

      i am interested in longer term results also. Hopefully there are none for Symfony.

      My mother's working IoL has been in place for 24 years. This has not needed YAG and no PCO.

      The one she had PCO and YAG 7 years after surgery was lost to retina detachment so I am going to watch for that. i plan to see retina specialist regularly. Once or twice a year.

    • Posted

      I think by positive dysphotopsia you mean the halo around the lights at night. If so then that is gone after the first day.

      The doctor office said yesterday the reading won't improve much. They also said that the right tail is because of the Symfony lens and the brain will learn to tune it out. But the brain is not tuning it out it is just GONE.

    • Posted

      yes basically not the IOL that's a concern but study was about pco where the original thinking was first 2 years had higher incidences of it. But due to you ger ages they ate now seeing first incidences of pco after 8 years and YAG causing other issues like your mom.

      so far so good i havent noticed any deterioration in vision and i am over a year out now. will find that article to send you.

      i do believe your near will improve without seeing any compromise in your distance. my own experience was 20/20 distance 24 hours after post op and i could read 16 to 18 inches away. 2nd eye was 20/25 for distance but both eye together i am very comfortable at 11 inches and if i bring iphone closer only starts to blur at 9 inches. both eyes together see plano for distance however i am still unsure if that is as good a distance as someone with normal vision. my husband can still read signs further away than I can. perhaps that is subjective to each person I perhaps need to look into it more.

      i am thinking once your second eye is operated on you'll get even better near vision. what did your surgeon say on near vision?

    • Posted

      i would say it was more than likely due to eye being dilated and swollen after surgery. swelling can take more than a few days for some and everyone is affected by the drops. 3 weeks half of healing takes place. takes full 6 weeks to completely heal. i would say if you had those symptoms after 6 weeks it would be positive or negative dysphotopdia. And hopefully brain does adapt with time - for some it does not.

    • Posted

      It appears that PCO may be a function of age along with the surgery.

      One other thing which we had discussed earlier was two eyes together is better than each eye on its own. For me operated eye is 20/30 and the unoperated eye needs a correction of -2.0. But together without any correction I can see 20/25 or 20/20. I asked about this to the doctor and she said that the -2.0 eye still gives some peripheral information to the brain which results in better collective vision when using both eyes.

      My wife can see better than me with correction before cataract and also now with correction on the operated eye. I came with -0.25D and -0.5D glasses on the operated side of the eye and my normal prescription for the other eye. I do experience anisometropia with it. I would rather not wear any glasses than that combination (-0.25 and -2) which makes me a little out of balance.

    • Posted

      Hi Derek - not sure I can paste a link now that this forum has been updated a bit but here is a copy and paste from an article I was reading concerning pupil size and reading. Specifically mentioned is the RESTOR but author doesn't limit it to that lens but MF lenses in general. I bet it also explains why some with monofocal lenses get reading distance when targeted for distance.

      "Remember that reading problems are often related to pupil size. “At least once a month I see a patient with a ReSTOR implant and good distance vision but difficulty reading,” says Dr. Mackool Jr. “The surgeon who implanted the lens is perplexed and the patient is too. It turns out that all the patient needed was a smaller pupil to read. The functionality of the lens for reading improves if the pupil is less than 3.5 mm in size. If they use a dilute pilocarpine solution when reading, their problems go away. It also eliminates a lot of distress if you warn patients in advance about this possibility.”

      Dr. Mackool Sr. notes that this problem isn’t limited to the ReSTOR lens. “I’ve seen the same problem with other diffractive multifocals,” he says. “It turns out that a certain accommodative pupil diameter is optimal. If you don’t have that, you’ll tend not to do as well with the various lenses for near vision. It’s just the way it is. Of course, it would help if surgeons measured pupil diameter when deciding whether a patient is a good multifocal candidate, but I’m not sure that surgeons always do this.”

    • Posted

      Going to be a tough decision to make. My surgeon didn't test my near vision till after 2nd surgery. He repeated several times that reading would be better once both eyes done.

      Just replied to Derek and pasted portion of article I read on pupil size and reading. Optimal was 3.5mm or less. Would you know what the diameter is of your pupils in normal light conditions? I knew at their dilated size affects how well you see with IOL at night.

    • Posted

      Yes, positive dysphotopsia - halos, starbursts, ghosting and other aberrations as opposed to negative dysphotopsia - temporal shadow arc.

      My best 20/20 reading vison is at about 13.5 inches with my eye being about -0.5d. When I get my other eye done for plano, I expect my reading vision to not change much, maybe get better. My Symfony eye has taken over all near vision right now as my uncorrected eye requires +2.50 for reading and I have be unable to use my glasses for the last 2 months. I've been muddling through this as my right uncorrected eye also has some double vision due to the cataract.

    • Posted

      8 days out my worst symptom:

      I have Cinderalla vision. On Tuesday (6 days post-op), starting around 9PM at night I see large circles around light sources in dark outside. Mostly the upper circle arc. If turn my head backwards I will see the full circle. This circle is HUGE. The concentric circles do not extend to even half the size of this circle. So this circle or sometimes arc is concentric to the concentric circles. If I hold a light close to the eye the large circle will go away the concentric circles will remain. Driving is very difficult with this as these large circles keep coming and going creating a flashing kind of effect. Any advice on this? Is this IOL edge glare? Is this specific to Symfony? Is this negative dysphotospia? Other than the pupil constricting drops any remedies?

    • Posted

      hi soks - certainly sounds like negative dysphotospia or pupil dilating beyond lens. Did clinic provide you with an eye shield to wear at night? I was concerned about lens shifting do wore that shield 2 weeks at night. are you able to get an appointment with the surgeon to ensure lens is well centered and in place?

      If you look at a bright light to constrict pupils do those arcs/huge circles go away?

    • Posted

      If I look at bright light the circle / arc go away.

      I wear the shield for last week although it was required for only one day.

      I will contact the surgeon tomorrow.

    • Posted

      After reading it is type of dysphotopsia causing glare off Iol edge. Also this is more specific to iols that have square edge like Symfony. Negative dysphotopsia causes dark areas.

      They give alphagan drops to such patients for pupil construction and ask them to wait for few months. We will see and fingers crossed.

    • Posted

      I guess each surgeon has their own protocol for wearing if eye shield. I was an eye rubber so was super cautious - wore it for 2 weeks.

      Hoping you can get in to see your surgeon just to make sure there isn't an issue of IOL moving out of place causing these artifacts.

      I experienced a flashing after 2nd surgery whenever a light was perpendicular to that side. Experienced the flashing and thought it was the light catching on the square edge of IOL. It is one of the drawbacks of square edge IOLs but the advantage is they do a better job of preventing PCO. The flashing went away after a few months.

      If due to pupil dilating I don't know if there is another solution except the drops to constrict them. They work temporarily. As you get older the pupil won't dilate as much. I believe night hawk posted at one time the average dilation corresponding to ages.

      Many of these annoyances one gets accustomed to and brain tunes them out, but if me I would want to rule put anything with IOL with surgeon first. That IOL is shifting back and forth anyways for first 6 weeks prior to settling and adhering so small changes to your vision happen during this period as well. The drops too - vision for some are affected by those.

      Hoping it sorts itself out soks.

    • Posted

      Hey soks,

      Sorry I didn't respond yesterday. I think Sue.An is right, probably some kind of edge glare. Hopefully it will resolve for you. I hope you can get in touch with your surgeon and get some kind of answer. I still experience some "flickering" on the temporal side, in the beginning it kind of freaked me out, but it is not a constant thing and I only notice it occasionally now. Please let us know what your surgeon says.

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