Symfony IOL problems associated with halos/glare/starburst/rings

[Miguel20862]

So after reading all the reports from here and other sources it seems the general consensus is that there is a indeed high percentage most likely people implanted with Symfony will perceive some sort of visual night time artifacts in the form of halos, glare, and circles. Although they do vary between each person it's safe to say that the initial previous results from the manufacturers is not quite the truth than what was announced over a year ago.  I think despite a bit disappointing that these night lights effect has on the Symfony, I seriously would hope that the other trade offs in that these lens offer a significant amount of more increased range in depth perception would be worth having over a monofocal IOL.

My question is for the people who have had the symfony can you rate your halos and glare from lights on a scale from 1-10 of how bad they affect your quality of life in terms of unable to do certain tasks. I understand the most frequent complain about oncoming headlights from other cars as that makes driving a bit disorienting. Also note to mention about the several concentric circles that also very common with this IOL lens. Can people describe if these visual ratifications affect their quality of vision. Also wondering about watching graphics and design on a monitor with black/white contrast images on monitors/screens. Heard people saying their can be glare off these situations, (maybe movie theaters or computer animations gaming) I'm Wondering about pursuing a computer graphics design if Symfony might compromise the quality vs a monofocal IOL.

[JohnHaganMD]

I hope people with the Symfony IOL will respond. As I've posted elsewhere my wife just had cataract/IOL surgery. One of my partners did it. We used a monofocal Abbott ZA9003 with excellent results.  We did not choose toric even though she has about 1.5 D of astimatism. She is very pleased and see's 20/20 at distance without glasses and 20/15 with glasses.  Our out of pocket cost was $750 for everything.  I just saw a man in consultation from Iowa that had the Symfony, had it explanted and toric put in and still unhappy. Remember all these premium IOLs (some would call gimmick IOLs) add cost and increased risk of complications and decreased optics.

[Imabuglady]

I’m not happy with the symphony lenses at all I was told I would never have to wear glasses again. Still using cheat readers. My doctor says it’s because  of the extreme  dry eyes that I have. I’m getting a second opinion this week!

[mady301]

No Dr. can guarantee you will not need glasses for any reason.  Symfony provides distance and intermediate vision and some limited near.   The spiderwebs will always be there, starbursts may improve for a few months, most people find them acceptable, others never do.  If you are considering an exchange, do it as soon as possible.  Also, some people find enough relief after 1 eye is exchanged to a monofocal, but you will lose most of the close up vision you currently have.  Everything is a trade off, so you need to decide what is most important.

[mady301]

Also, there is a small % of people who still have glare and halos with monofocals-I know 1 of them-which can affect driving.   You will not see spiderwebs, but could see glare and halos.  Just a lot less likely.

[JohnHaganMD]

Compared with other types of surgery the complication rate with cataract/IOL surgery is very very low. The primary problem is people's expectation's exceed the technology. If this is due to inadequate explanation by surgeons/staff or the belief that after cataract/IOL surgery the person will have a new, healthy eye that is as good as age 16 is debatable. Thanks for sharing your experience.

[cookie101101]

Just saw this. What did you end up doing? I regret the Symfony EDOF. I am five months out and will see a new doctor next week. The starbursts look like concentric circles and are so bright. Can not drive at night. The starbursts are twice as big as the cars. I thought a car was coming when I was driving  (my husband was driving) through my neighborhood at night and my husband said it was a light on top of a mailbox. Christmas was like an acid trip. My Christmas tree was full of starbursts. Going out to restaurants and seeing all the ceiling lights as big starbursts is not a good thing. I am afraid to do anything as I might compound the problem. Horrible situation to be in. Hopeful the new doctor will be able to advise me well.

[JohnHaganMD]

You probably are headed for an IOL exchange.   The person only posted the one response so not likely to get a response. If you want to start a new post you might have more reply's from happy and happy Symfony patients.

[Miguel20862]

Hey cookie101101,
I’m really sorry to hear about your experience with the Symfony IOL. For my cataract surgery I actually ended up going with a standard monofocal IOL lens from Alcon. I was urged by my doctor and by others online that the Symfony was more riskier and monofocal being more safer, and Also eventually was told that I was not an ideal candidate for the Symfony because of my traumatic cataracts. It took so long for me to make a final decision and I had so much anxiety for a while thinking about all the possible outcomes... it’s been almost 1 year since my cataract surgery on my left eye and As far as I know my vision is really great (especially since before because my cataract was really bad /dense white) and I think could not be more happier with my end results. I have pretty much zero halos or problems driving at night time or looking at a high contrast situations on my computer monitor/ florscent lighting etc. nothing that bothers me really bad in terms of glare and halos... I do look through my operated eye from time to time and I do have trouble reading up close however. With both eyes I can still see everything far and near fine without glasses. But that will probably change when eventually I have to get my other eye corrected and replaced with an IOL lens from cataracts down the line. It’s not so bad in the other eye where It’s necessary to get the surgery so I’m not in a hurry to go through with it. I think for me I made the right decision because of the nature of my cataracts and even though I did lose some depth of perception really up close I don’t mind it. Also because I didn’t want to risk seeing any extraordinary side effects from the Symfony shape etc.

Anyways I hope you find some peace with your journey. And just know even though it may seem difficult that it’s not always as bad since their are people who are blind and wish to see even somewhat.

[JohnHaganMD]

Thanks for you informative post and I know you made the right decision.

[MrPresley]

I'm just like @Miguel20862 in that I have an Alcon monofocal IOL in my left eye only, because the right eye doesn't need anything done other than monitoring yet. My IOL was set in approximate parity with my non-surgical eye and after more than two years I have absolutely no complaints. Also no indication yet of needing a YAG procedure.

[JohnHaganMD]

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[Jim_in_Italy]

Dr Hagar, as always, offers sound advice: start a new thread. I would just make this comment: I had the Tecnis Symfony toric IOL inserted in 2015 in Europe, before FDA, approval, and could not be more pleased. Admittedly I was highly myopic +12D and astigmatic 2.75D, so almost anything would have been a vast improvement. But to your point, my glare/halos artifacts at night exist but not enough to hamper any activity. I don’t know if some of this is due to residual astigmatism or to the lens itself. Bottom line, from my personal experience, I could make a strong recommendation. BTW, from being legally blind before cataract surgery (I could do nothing without glasses), I now can do everything from reading small print at 10 inches distance to very good , if not perfect, distance vision. Only negative, they were expensive   Pls feel free to copy this to whatever new thread you start. PS: computerman ( I think that was his moniker) has posted excellent and elaborate comments for many years.

[Jim_in_Italy]

Correction to above, my astigmatism was -12D, not +12.  A frivolous Question for Dr Hagan, if I may, would I still be considered myopic because the shape of my eye hasn’t changed, or no longer “myopic” because I can see well at distance?  

[JohnHaganMD]

Hi Jim in Pasta Land.  Nice to hear from you again.   Your myopia prior to surgery was -12.   Myopia is always a negative number, hyperopia a positive number.   Astigmatism can be expressed in post positive and negaative numbers (like weight in Kgs and Lbs)  Refractively (current RX) you are no longer a high myope but structurally you are since you have an extremely long eye. Thus you are still subject to the same risks of pathologic high myopia: incrased risk of retinal tears/detachments, glaucoma and myopic macula degeneration, increased risk of damage from trauma to head/eye.  See an Eye MD every year rest of your life. Be sure to tell her/him you were high myope before surgery.

[Jim_in_Italy]

Thank you, Dr Hagan. Indeed in January 2018, I was diagnosed with glaucoma after an RNFL and optic nerve scan prior to a scheduled YAG laser for PCO. My IOP has always been in mid to upper teens and I am now on meds for glaucoma. There has been no change to the RNFL over the past year. And my field of vision is normal for my age. All this to say: I have long wondered if the original glaucoma diagnosis was based on “damage” to the retina layer DUE TO high myopia rather than high IOP. Or possibly because of the perfusion pressure because I was taking blood pressure meds at bedtime. And I have sleep apnea!  BUT I have decided to take the glaucoma meds anyways as a precaution. (IOP now holding at 14) And take the blood pressure meds during daytime. I am surprised, as I imagine you often are, how often all these dots are not connected by either doctors or patients. Thanks again for your great work on this website.

[JohnHaganMD]

Happy to help.  One of my interests is beta blockers and I find physicians continually do not ask/look for side effects. I personally have had damage to my hearing due to too LOW of blood pressure while on beta blockers.  Many of the questions you ask cannot be definitely answered. So keep on keeping on.

[Jim_in_Italy]

I didn’t know of your special interest in beta blockers. I was prescribed beta blockers for both hypertension and glaucoma. AND I suffer from bradycardia!!! Needless to say, when I did my research and questioned my 2 physicians, both dropped the prescriptions for timolol and the blood pressure med (whose name escapes me). All this to confirm your point: ASK before prescribing

[JohnHaganMD]

Agree