Avatar universal


Thank you for your information about the Symfony lens. I am now almost two weeks after the surgery in my right eye (Symfony Lens).
The world is much brighter after surgery, I also see the colors as they are. (My left eye will be operated within a few days, also a Symfony Lens).
The results are a good distant vision and intermediate. I can read a computer screen quite well, near needs to improve. Near vision is at armlenght.. I should be prepared for the possibility for needing reading glasses at near.
Flickering sometimes when the sun shines bright. I see some halos around light sources at night but not disturbing. I have quite bad flaring from car headlights and lamppostst at night which is disturbing.
I can read my smartphone at armlenght, unfortunately not near.. I am satisfied with my decision to choose the Symphony lens on advice of my surgeon.
My question is if near vision will improve within a couple of weeks/months and will the flaring at night also be mild.

This discussion is related to Neuroadaptation after multifocal iol implantation.
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Avatar universal
You might consider talking to your surgeon about micro-monovision before having your 2nd eye done, which is setting the other eye to focus just a little bit closer in than the first eye to give you better near vision. Studies show that with for instance the other eye set to focus at -0.5D people average better than 20/20 distance vision  but have a bit of a boost in near vision, which might be enough to make your smartphone readable at a more comfortable distance.  The issue is that the difference is much smaller than full monovision so there is less reduction in things like stereovision since both eyes are used for most things still. Unfortunately results from studies are just averages and not guarantees,  a small minority of people do wind up needing reading glasses for near with the Symfony. Even the eye set for its best focus at -0.5D still average distance vision in that eye  between 20/25 and 20/20 according to their charts, which leaves binocular vision better than 20/20 on average.

I don't recall seeing any results on how long it takes people to get the best near vision with the Symfony. One surgeon commented via email that neuroadaptation is slower with the Symfony than with the AT Lisa trifocal, but he didn't quantify the difference.  I've seen reports that some multifocals reach their best results in a few weeks, others several months, and it likely depends on the person, and I don't know how the Symfony compares. In my case I think I was lucky and had 20/25 near in the first week (from my bast eye, the other was left a little hyperopic, a laser tweak to micro-monovision might help) at my best near distance, but I can read my smartphone at a comfortable distance, I don't feel like I need to hold it out further than normal.

Studies show night vision artifacts are reportedly about as common with a monofocal as with the Symfony, but unfortunately a small fraction of patients with any IOL will experience glare, halos, flares, etc. Many patients who see issues during the first few weeks see them fade as their eye's finish healing and they adapt to the new lens, but everyone is different. You may likely see the issues reduce over a few weeks or a few months, though unfortunately some tiny percentage will continue to have issues.
I'm a month into having the Symfony lens put in. My near and mid vision is excellent. Distance vision is still not sharp. Night glare from headlights is very disturbing. Does anyone have an idea how long it takes for the distance to sharpen up and if these glares improve with time? My doctor told me it takes time for this lens to fully reach potential since the brain has to adapt to the new lens.
If your distance vision still isn't sharp, its seems likely   that you were left slightly nearsighted. Unfortunately there isn't an exact formula to to determine lens power, it is based on statistics of past patients. Its usually fairly accurate, but can be off a bit for some, especially those who had high prescriptions before surgery.  I don't know if you had the lens put in both eyes, if you just had one then its possible the 2nd one might have better results and give you good quality distance. Otherwise they can correct distance vision with a laser enhancement (after they wait to be sure your vision is stable) or with glasses/contacts.

Many people have problems with night vision artifacts with any lens during the first few weeks after surgery (even monofocals) that they see subside. Most studies of visual artifacts from IOLs only consider results after 3 or 6 months to get a better idea of how many might have the issues over the long run.

Unfortunately I haven't seen any data yet on how long they typically take to subside with the Symfony, though even if I did the data would only be averages, some people take longer than others. I did recently see some stats for halos with a trifocal, merely on the perception of halos (presumably only a fraction of those who perceive them consider them a problem):

"Regarding the perception of photic phenomena, 90% of patients reported to perceive halos at 1 month after surgery, although 80% of these patients described these halos as not disturbing. At 3 months after surgery, the perception of halos decreased to 50%. ...

This perception of halos decreased in all patients at 3 months after surgery. Law et al. [5] also found a reduction in the perception of halos over time, decreasing from 80% at 1 month to 40% at 6 months after the implantation of the same trifocal IOL."
Avatar universal
I would give the reading glasses a little time
I had symphony lenses planted in both eyes four months ago and I have found my near vision has become near perfect over the last couple of months
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