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experiences with Symfony IOL, or trifocal IOLs?
Has anyone here gotten the new Symfony IOL, or heard from others who have, or know more than the research you can find with google? It was just approved in June for use in Europe, but initial studies on the web seem to indicate it provides better odds of having good intermediate/computer vision, and better than the AT lisa trifocal except at very near distances. It refers to it as having an extended depth of vision rather than calling it multifocal (perhaps because it doesn't divide itself into 2 or 3 discrete focal points but in essence it must still have a range of focuses to provide "extended depth").
I've seen detailed threads about the FineVision but only brief comments on the AT lisa trifocal. Any more comments on any of these lenses? I'd be curious if anyone has more comments on getting a multifocal in only one eye with the problem cataract and wearing a contact lens in the other (which is still correctible to 20/20 with only an early cataract). The hope would be that perhaps before it goes bad a new generation of lenses might come out, like an accommodating lens that is more likely to work well than the ones out there now.
Any suggestions for good doctors to get them from, preferably laser cataract surgery? I'm open to considering doctors in any country since I'm in the US and will need to travel to get the lens, the UK would be easiest since I only speak English, but I'll consider other options. I've heard the Czech Republic may be cheaper but still have high quality clinics. Its worth a bit of hassle to get a good lens. I'm only 52 so I'll hopefully be using it a few decades, so thanks greatly for any information you can provide.
I've seen detailed threads about the FineVision but only brief comments on the AT lisa trifocal. Any more comments on any of these lenses? I'd be curious if anyone has more comments on getting a multifocal in only one eye with the problem cataract and wearing a contact lens in the other (which is still correctible to 20/20 with only an early cataract). The hope would be that perhaps before it goes bad a new generation of lenses might come out, like an accommodating lens that is more likely to work well than the ones out there now.
Any suggestions for good doctors to get them from, preferably laser cataract surgery? I'm open to considering doctors in any country since I'm in the US and will need to travel to get the lens, the UK would be easiest since I only speak English, but I'll consider other options. I've heard the Czech Republic may be cheaper but still have high quality clinics. Its worth a bit of hassle to get a good lens. I'm only 52 so I'll hopefully be using it a few decades, so thanks greatly for any information you can provide.
"Because pricing varies by procedure type, insurance type, and numerous other factors the information shown on this site is not exact pricing."
I don't know of any US health insurance that will cover elective surgery outside of the USA.
Unless, of course, you don't have any kind of health insurance.
I don't know of any US health insurance that will cover elective surgery outside of the USA.
Unless, of course, you don't have any kind of health insurance.
Actually I should have said I can get it cheaper than the cheapest surgery near where I live in the US (and cheaper than the US average). Within the US prices vary of course. This site gives costs for various areas in the US:
http://www.newchoicehealth.com/cataract-cost
http://www.newchoicehealth.com/cataract-cost
re: "trial where I might be given some unknown control lens"
I should clarify that I simply don't know at the moment what the alternate lens will be, I had the impression they didn't know yet. I imagine they must tell that to the patient upfront, and it seems like there are decent odds it might be the Tecnis multifocal since it is from the same company and available in the US.
Unfortunately the fact that a clinical trial is being done doesn't mean the lens will be approved anytime soon even if it is safe given the red tape and politics that goes into FDA approvals.
re: "Has Canada approved this yet? "
Not as far as I can tell, It seems like some countries follow the US lead, others the EU. I don't think its in Mexico either, where I know they do have the Light Adjustable Lens you'd mentioned in a prior post. I know they are working on multifocal variations of the LAL technique, but as far as I know those are still in the trial stage. I'm an early adopter, but not quite that early. I'd prefer to avoid early stage clinical trials done before any approvals have been granted anywhere.
Even if I don't participate in a trial, I do like the idea of considering a doctor who has participated in early clinical trials for other lenses. I figure the lens companies only pick doctors whose surgical skills they approve of and that they are more likely to have the resources to be a better judge of that than a patient will be. I may be wrong, but it seems like they logically would want the lens results to be based on the best possible surgical outcomes rather than a lens looking bad because the surgeons testing it didn't do a good job.
re: ". I hate how you hear news stories such as below and then you never hear any follow up. "
Yup, though often stories like that one involve early research which may not turn out to lead to anything viable, or it may take longer than expected (like the better accommodating lenses which have been on the horizon the last couple of years).
re: how the Symfony works, it is unfortunate there is limited information about it, but I can't wait too long for more. I don't know if you'd seen the other page on this site where I posted some clips from articles for more info:
http://www.medhelp.org/posts/Eye-Care/Are-my-eyes-getting-worse-because-of-Cataracts/show/2368182
I admit I would prefer to see more analysis of how it works, for instance what it means for how much light is available for each different focal range the way they have analyzed trifocals to show say 20% for intermediate or whatever (usually varying by pupil size&light conditions).
It seems like the description must mean that rather than splitting the light up into distinct focal points X, Y, and Z, that the light is distributed over a more continuous range of focal points from X through Z. Even with a standard monofocal or multifocals the visual system has some "depth of focus" which leads to light coming in at a range of focuses around those concentrated distinct focal points, so that you can see better at distances in between X,Y, and Z.
It would seem logically that the Symfony's approach would seem to give less light at each discrete focal point within that continues range (rather than as in a multifocal more of it concentrated at discrete X,Y, and Z points), so I'm assuming the visual system must use light from within a short interval of nearby focal points, e.g. from the range of focuses between P1 and P2, rather than merely only using the light at precisely P1 or P2. Obviously an accommodating lens that accommodated well would be a better option, but despite some patients having luck with say the Synchrony, the current accommodating lenses don't seem a good enough bet to me.
re: "price in Europe for the lens is expensive"
Actually it appears that I can get the lens (for 1 eye), including travel cheaper than the cheapest cataract surgery with a monofocal here in the US. (even including laser cataract surgery if I decide to go for that). In some other European countries even with travel its comparable to the cost of surgery with a premium lens in the US (at least if you have a high deductible). It is a different tradeoff I know for those with a low deductible just covering the lens cost. However they might wish to factor in the higher odds of needing to pay for correction the rest of their lives if they don't get a premium lens, or the higher risk of needing to explant a US-approved multifocal due to concerns over visual artifacts (which are lower in the newer lenses available elsewhere).
As a US surgeon noted of course, even though this is a very safe surgery, you do wish to be sure you use a good surgeon with low complication rates, and who is likely to hit the refraction target well enough for a premium lens to live up to its potential. Those who aren't willing to do research and take some risk should stick to the US approved lenses.
I should clarify that I simply don't know at the moment what the alternate lens will be, I had the impression they didn't know yet. I imagine they must tell that to the patient upfront, and it seems like there are decent odds it might be the Tecnis multifocal since it is from the same company and available in the US.
Unfortunately the fact that a clinical trial is being done doesn't mean the lens will be approved anytime soon even if it is safe given the red tape and politics that goes into FDA approvals.
re: "Has Canada approved this yet? "
Not as far as I can tell, It seems like some countries follow the US lead, others the EU. I don't think its in Mexico either, where I know they do have the Light Adjustable Lens you'd mentioned in a prior post. I know they are working on multifocal variations of the LAL technique, but as far as I know those are still in the trial stage. I'm an early adopter, but not quite that early. I'd prefer to avoid early stage clinical trials done before any approvals have been granted anywhere.
Even if I don't participate in a trial, I do like the idea of considering a doctor who has participated in early clinical trials for other lenses. I figure the lens companies only pick doctors whose surgical skills they approve of and that they are more likely to have the resources to be a better judge of that than a patient will be. I may be wrong, but it seems like they logically would want the lens results to be based on the best possible surgical outcomes rather than a lens looking bad because the surgeons testing it didn't do a good job.
re: ". I hate how you hear news stories such as below and then you never hear any follow up. "
Yup, though often stories like that one involve early research which may not turn out to lead to anything viable, or it may take longer than expected (like the better accommodating lenses which have been on the horizon the last couple of years).
re: how the Symfony works, it is unfortunate there is limited information about it, but I can't wait too long for more. I don't know if you'd seen the other page on this site where I posted some clips from articles for more info:
http://www.medhelp.org/posts/Eye-Care/Are-my-eyes-getting-worse-because-of-Cataracts/show/2368182
I admit I would prefer to see more analysis of how it works, for instance what it means for how much light is available for each different focal range the way they have analyzed trifocals to show say 20% for intermediate or whatever (usually varying by pupil size&light conditions).
It seems like the description must mean that rather than splitting the light up into distinct focal points X, Y, and Z, that the light is distributed over a more continuous range of focal points from X through Z. Even with a standard monofocal or multifocals the visual system has some "depth of focus" which leads to light coming in at a range of focuses around those concentrated distinct focal points, so that you can see better at distances in between X,Y, and Z.
It would seem logically that the Symfony's approach would seem to give less light at each discrete focal point within that continues range (rather than as in a multifocal more of it concentrated at discrete X,Y, and Z points), so I'm assuming the visual system must use light from within a short interval of nearby focal points, e.g. from the range of focuses between P1 and P2, rather than merely only using the light at precisely P1 or P2. Obviously an accommodating lens that accommodated well would be a better option, but despite some patients having luck with say the Synchrony, the current accommodating lenses don't seem a good enough bet to me.
re: "price in Europe for the lens is expensive"
Actually it appears that I can get the lens (for 1 eye), including travel cheaper than the cheapest cataract surgery with a monofocal here in the US. (even including laser cataract surgery if I decide to go for that). In some other European countries even with travel its comparable to the cost of surgery with a premium lens in the US (at least if you have a high deductible). It is a different tradeoff I know for those with a low deductible just covering the lens cost. However they might wish to factor in the higher odds of needing to pay for correction the rest of their lives if they don't get a premium lens, or the higher risk of needing to explant a US-approved multifocal due to concerns over visual artifacts (which are lower in the newer lenses available elsewhere).
As a US surgeon noted of course, even though this is a very safe surgery, you do wish to be sure you use a good surgeon with low complication rates, and who is likely to hit the refraction target well enough for a premium lens to live up to its potential. Those who aren't willing to do research and take some risk should stick to the US approved lenses.
re: "I looked at the Symphony accommodating but the few reports available suggested limited accommodation with varying degrees of success. "
I'm guessing you meant the Synchrony lens, the Symfony isn't an accommodating lens and was only CE marked in June. It does seem to provide some of the advantages an accommodating lens has like lower risk of haloes & glare than multifocals. It seems to provide better near vision than the accommodating lenses that are approved anywhere at the moment, though unfortunately perhaps not as good as trifocals for near (though often good enough it appears, and unfortunately no lens is perfect at the moment).
It sounds like surgeons are divided over whether the FInevision or the AT Lisa tri is the best trifocal option, though it seems like those with experience with both give the AT Lisa tri a slight edge overall, that it may vary with the patient which is best.
I'm guessing you meant the Synchrony lens, the Symfony isn't an accommodating lens and was only CE marked in June. It does seem to provide some of the advantages an accommodating lens has like lower risk of haloes & glare than multifocals. It seems to provide better near vision than the accommodating lenses that are approved anywhere at the moment, though unfortunately perhaps not as good as trifocals for near (though often good enough it appears, and unfortunately no lens is perfect at the moment).
It sounds like surgeons are divided over whether the FInevision or the AT Lisa tri is the best trifocal option, though it seems like those with experience with both give the AT Lisa tri a slight edge overall, that it may vary with the patient which is best.
Even living in the UK I considered going to Czech Republic, to the Gemini Clinic in Zlin, where they use the Femtosecond laser for the incisions and Astigmatism correction. This was for CLE, with no cataracts or other anomalies.
I eventually found a very local, and very experienced surgeon who used the Finevision, although not with the Femtosecond. I looked at the Symphony accommodating but the few reports available suggested limited accommodation with varying degrees of success.
With the Finevision having had a two year history, no negative reports and a very high probability of a spectacle free outcome I chose this as my preferred option, assuming the surgeon thought it a suitable lens for me.
I am spec free as hoped, with very little effects in some very minor situations, as per my diary on this forum. The holy grail of full accommodation is, I believe, some way away, and I wanted rid of specs.
Best wishes in your research before making this enormous decision.
Phil
I eventually found a very local, and very experienced surgeon who used the Finevision, although not with the Femtosecond. I looked at the Symphony accommodating but the few reports available suggested limited accommodation with varying degrees of success.
With the Finevision having had a two year history, no negative reports and a very high probability of a spectacle free outcome I chose this as my preferred option, assuming the surgeon thought it a suitable lens for me.
I am spec free as hoped, with very little effects in some very minor situations, as per my diary on this forum. The holy grail of full accommodation is, I believe, some way away, and I wanted rid of specs.
Best wishes in your research before making this enormous decision.
Phil
One of the problems is the dollar is so weak that the price in Europe for the lens is expensive. Has Canada approved this yet? Let me know what you decide and your experience. One other thing is I am confused about how this lens actually works. I under multifocal that create 2 or more focal points but how this lens is able to provide distance to close vision is not clear to me. I keep putting off the surgery as long as I can hoping for better options. I hate how you hear news stories such as below and then you never hear any follow up.
http://www.scotsman.com/news/health/scots-scientists-develop-laser-cure-for-cataracts-1-3242146
I doubt I would do a trial where I might be given some unknown control lens. That is ridiculous, unless it is the Tecnis multifocal.
http://www.scotsman.com/news/health/scots-scientists-develop-laser-cure-for-cataracts-1-3242146
I doubt I would do a trial where I might be given some unknown control lens. That is ridiculous, unless it is the Tecnis multifocal.
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