Taking a lead from the positive style of the report by “decho” on 4 January, I’ll share my recent experience with Lentis Comfort lenses. I hope it is of interest but I make the important caveat that this not scientific data. It is my anecdotal experience. Whilst I hope it is encouraging, others may get different – better or worse – results than I did.
Background: I’m 59. I drive over 20,000 miles a year, I am a keen fell walker, and spend a lot of time in small boats. I also spend several hours a day in front of a computer. I have life-long myopia and astigmatism, and now ten years of presbyopia. I have worn spectacles for over fifty years, varifocals for the last 10 years. I am used to them but they are still a pain when in open boats and when walking in the rain. My prescription was -3.0 and -2.75 with astigmatism of -0.75 and -1.25, most recently with an add of +3.0 for the presbyopia. Then I developed cataracts.
I delayed and prevaricated for nearly three years; only one eye was symptomatically affected and so it was easy enough to put off the surgery. Finally, I had to take action. First priority was to find an experienced surgeon whom I trusted. Not difficult, as my husband is a doctor, so we have lots of connections. I had done endless research on the bewildering options available to an astigmatic, presbyopic myope but you can’t make the decision without expert advice, and so I enlisted the help of Eyedoc.
Distance vision was my absolute priority, but I did not want simple distance only lenses because of computer work. UK docs are using multifocal lenses but not enthusiastically. Eyedoc was not enthusiastic particularly as he knows about the driving I have to do. There is a high incidence of dysphotopsia and poor colour contrast which multifocal lenses which can make night driving difficult or even impossible. The manufacturers of multifocal lenses understandably do not emphasise these problems.
Eyedoc recommended Lentis Comfort lenses. They are relatively new. They are classified as premiere lenses (so in the UK either privately or on the NHS you are looking at paying a supplement of about £180) but are not truly multifocal. They offer distance vision and intermediate vision, but for anything closer than 60 cm, it means reading glasses. The intermediate vision is catered for by a wedge within the lens, not by concentric circles seen in the ‘conventional’ multifocal lenses. Eyedoc advised that it’s the circle boundaries that are responsible for the dysphotopsia and poor contrast. Thus, the big advantage of the Comfort lenses is that they don’t seem to have all the dysphotopsia problems reported with ordinary multifocals. Dr Google does not as yet have much information on Lentis Comfort lenses. What there is, is positive but most of it comes from company promotions, so it would be positive, wouldn’t it! A UK ophthalmologist – Brendan Moriarty – has had them fitted, and is very enthusiastic. (check him out on Google).
Despite the relative lack of information, because I trust Eyedoc, I decided to go with the Lentis Comfort, with LRIs to tackle the astigmatism. LRIs are a compromise treatment. It was clear that you only let a very experienced surgeon do LRIs on you, and Eyedoc met that criterion. Yes, in a significant number of cases, when the LRI incisions heal, the astigmatism may redevelop. But, a toric lens may slip on its axis, and it doesn’t need to slip much to give you a significant astigmatism. But if the astigmatism recurs after LRIs, there is always LASIK if you are determined to be spectacle free.
Finally, should I go totally for distance vision, or have mini-monocular vision? In other words, sacrifice a little distance acuity in one eye for a little near vision. That may be a valid option for some. Having had an increasingly dense cataract in one eye for several months, I was well aware that the brain will ‘see’ through the good eye, so the disparate vision was not my reason for rejecting mini-monocular vision. Optimium mini-monocular vision may facilitate a quick glance at the iPhone, but you will still need reading glasses in poor light or for small font reading. And I didn’t want to sacrifice even half a dioptre of distance vision.
So, final decision was Lentis Comfort lenses set for maximum distance vision, and LRIs to mitigate (? cure…Eyedoc said don’t hold your breath on that!) the astigmatism. Realistically, I was pitching for pretty good glasses-free distance vision for fell walking and boating, with glasses for driving and, of course, for reading.
I had the eyes done under local anaesthetic on consecutive Wednesday mornings. It was pain free; a little stinging from the eye-drops, but that was about it. There was no instant visual epiphany immediately after the operation. My eye was blurry and I got immediate and worrying dysphotopsia. It was like a firework display. I was driven home in the dark. On the motorway, oncoming headlights doubled and tripled with huge starbursts, all within a glittering ground glass circle, rather like looking at life through an illuminated London Eye. It was alarming. I went to bed thinking I had made the wrong choice of lenses. Next morning the dysphotopsia had almost completely resolved. My pupil was still huge from the dilating drops and so my vision was understandable blurred, and I think I was bleached from all the bright lights. Then, over the next 24 hours, the pupil went back to normal, and the blurring disappeared. Post-op check with Eyedoc all well. At 48 hours post-op my right eye vision was an amazing 6/6 with NO ASTIGMATISM. Fantastic. The second operation on the other eye a week later followed much the same course, although the transient dysphotopsia was not as pronounced. It took three days for the blurring to resolve. The eye continued to improve over the next week or so.
Three weeks later my vision is bilaterally superb. I’m delighted and so is Eyedoc. I have spectacle free vision in both eyes slightly better than 6/5 and no astigmatism. Both distance and intermediate vision and, in particular, colour contrast, is outstanding. Better than anything I have know throughout my life. Of course, even if you don’t have cataracts, as you age, your lenses do not transmit light as efficiently as they did when you were a teenager. Oh! To be a teenager again. Well, in terms of eyesight, at the moment, apart from reading glasses, I am. I can drive, I can work at the computer with ease. In bright light, I can read all normal fonts as close as 18 inches. But yes, closer than that, or in poor light (restaurant menus), I need the reading glasses. Night driving is not a problem. Oncoming headlights have very slight starbursts (but then, they always have had) and I suspect I am only noticing them because at the moment I am being anally analytical about vision. I went for a walk in the rain today. It was wonderful. No raindrops on my spectacles. No misting up.
I have achieved a better result than I dreamed of. Of course, Eyedoc knows what he is doing; under-predict and over-perform. That’s his business. In the meantime, my eye-wateringly expensive varifocals (two pairs – one normal, one sunglasses) are in the used toy box.
Will it stay like this? Who knows? I may well get some posterior capsule opacification but that can be lasered in out patients. The LRIs may fail and, if they do, that may be sooner rather than later. In the past, I have always said I would never consider LASIK surgery, and would persevere with spectacles. But now, for the first time, I have experienced life without spectacles, so LASIK might be an option. It would be hard to go back.
In conclusion, a great outcome. Lentis Comfort lenses (I have no connection with the manufacturers and nor does Eyedoc) were right for me.