I am 29 and have cataracts in both eyes. I need surgery immediately, at least in my left eye. I have done extensive research and am fairly certain that nothing available to me here is going to give me what I’m looking for. I hold dual citizenship for the US and Germany. I am considering traveling there to get the Synchrony IOL (or the new version which is called the Synchrony VU.) The synchrony does not work for myopes, but I have never needed glasses, so I should be a candidate.
Now according to articles and dozens of studies available online, this lens really sounds like the cats meow. Data goes back to 2003, it technically has a longer track record than Crystalens does. It has appeared that FDA approval is imminent since 2008. (My health insurance won’t pay in Germany, and you have no protection in the event of malpractice there either, I was hoping I’d be able to just get it here.) Another bonus is they are using the femto laser for the surgery in most surgical centers there, and it’s supposed to have much lower complication rates as well as reduced healing time, and be much safer than standard small incision.
There are now two versions of the Synchrony available, one of them is the original one which has been in FDA trials in the US, and the other is the Synchrony VU, which is supposed to have a 15% improvement in near vision over the older version. (It also appears that this update to the lens is the reason why FDA approval has been delayed, they want to forget the studies on the first one, and move on to the newer lens before approving.) Studies indicate that something like 90% of study participants can see 20/40 or better at near, with many seeing 20/25 or better. It shows objectively measured evidence of up to 4 diopters of accommodation, and it continues to function even at 5 year follow up studies (with vision IMPROVING during that time) and AFTER YAG capsulotomy. Another interesting fact is YAG capsulotomy is almost never necessary, its very rare because this lens completely fills the capsular bag and scar tissue does not form. (Interestingly, cataract surgery does not raise your risk of retinal detachment, the YAG capsulotomy does because it creates a larger space for the vitreous in your eye to fill which can eventually cause it to peel off the retina)
Given my age, a lower risk of retinal detachment than every IOL in this country is a major bonus. Also, while interlenticular opacification was a concern based on the design of the lens, studies involving rabbit eyes have not shown any occurences. Human studies reported 8% of participants using glasses for some activities some of the time, with only 3% using them for some activities all of the time. In one study they determined that reading speed was slightly FASTER than with a monofocal IOL, and contrast sensitivity and perception of glare or haloes was identical, meaning, issues are rare. There should be no drawbacks to having a synchrony over having a standard monofocal based on study evidence. The ONLY drawback that can be found online is that the new version, the Synchrony VU, leaves a small percentage of patients one or two diopters myopic even after healing. They should be able to read while wearing their distance glasses, but they could require distance glasses. It goes on to say that if lasik is done on these participants, they had the same visual outcomes as the ones who turned out perfectly after surgery. It certainly sounds like it should revolutionize the market as soon as the FDA catches us up with the rest of the world.
However, when I called a clinic in Munich, the doctor told me that in 30% of his patients, there is NO ACCOMODATION whatsoever, and the lens is essentially a very expensive monofocal. He also stated that he had stopped offering the Synchrony VU and switched back to the older version because MOST people who got it were myopic and unhappy. He stated he has almost no requests for this lens. At another clinic near Dusseldorf, they used the Synchrony VU, but they told me that 20% of patients have NO ACCOMODATION. It made me wonder why these figures were not reported in ANY of the studies available, nor were they mentioned or even implied by any of the dozens of the doctors who have been singing its praises since it was first developed. One would think that if this lens doesn’t work in 20-30% of people, that information should be reflected in the studies, but its not.
Curious, I emailed three people whose names had appeared in studies about how great the Synchrony is. All had at least at one time, had a paid relationship with Visiogen and Abbot (the company that produces the lens) that had been disclosed wherever they made a mention to the synchrony. One of them replied to my email and said that he’d be happy to answer all of my questions on the phone, for $500 an hour, although in no way would the conversation constitute a doctor patient relationship. Just what I need.
The next one stated that my research was correct, many eyes were not able to accommodate at all, and even those that could were only able to accommodate very little. He had no idea why some could accommodate while others could not. He also stated that the lens has no UV protection at all, and going outside without sunglasses for any length of time would be dangerous. He stated that overseas surgeons have been less than enthusiastic about the synchrony, and he then recommended I do minimonovision with monofocals.
The response from surgeon number three was just as bad. He apologized, stating that he did not have the time to answer my questions and couldn’t advise me without seeing me. He stated that I was correct that many patients did not get much accommodation, and then said something extremely troubling when you consider its source. “I personally would not send my own family member to Europe to get the lens at this time.”
Okay. Obviously, there’s a problem here. First off, the studies are flat out concealing information. I don’t know if they are kicking out participants who cannot accommodate, or are basing visual acuity on both eyes together, so that even if one doesn’t work, they can still see close up from the other eye. I wouldn’t consider either one to be ethical. Secondly, if everything else about the Synchrony is true, (even if it doesn’t work for 1 out of every 4 eyes) why would everyone who is pushing this lens publicly advise me against it? Even taking into consideration that it may not work, I should still have an 87.5% chance of having at least one eye that can accommodate normally, with absolutely no drawbacks over a monofocal and a lower risk of retinal detachment. Why would one surgeon insist monofocals are a better option, and another tell me that he wouldn’t let his own family members get this lens? If I would only consider a monofocal here, and the Synchrony is touted as having all the benfits of a monofocal plus some and nobody can list any drawbacks then why is everyone warning me to stay away from it? Of course, they're being very ominous about it too, everyone tells me to stay away but nobody is willing to tell me why.
I can’t find anyone who has this lens, there are no user reviews positive or negative. The data looks wonderful, but the same people who published the data are telling me to stay away from it. That and communicating with Europe has been next to impossible. I’ve pretty much concluded I’d just have to show up there if I want it. I’m desperate enough to avoid the loss of all accommodation while still in my twenties to do it, but I really need to know the truth about this. Why am I being advised a monofocal is a better option when all research indicates that the worst case outcome with the synchrony is a monofocal?