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my Symfony IOL results after cataract surgery
I'd posted before asking for information about lens options before surgery, but thought I'd start a new thread now that I've gotten the lens where perhaps others can add their results as well with the Symfony lens. It is a new type of "extended depth of focus" lens that uses a different design than multifocal and accommodating lenses.
I had Symfony lenses implanted in both eyes the first week of December. By 1 week postop my uncorrected vision at distance was between 20/15 and 20/20. At near my vision was already about 20/25 (but fluctuating a bit it had seemed better earlier that day). Given its improvement since then I'd guess its likely 20/20 or so, I can read the small print on my eye drop bottles for instance. Not everyone achieves this level of near vision with the lens so people shouldn't expect to necessarily get quite as good a result, and should be prepared for the possibility for needing reading glasses at near. I suspect the fact that I'm comparatively young for cataract surgery, 52, might have something to do with the results.
I had originally only planned on having 1 eye done (since the other was 20/20 correctible still), but when the patch came off the next day I discovered it might be hard to adapt to the difference in vision between the two eyes even with a contact lens in the other eye. I might have quickly adapted if I'd taken the time, but I decided I didn't want to risk it, so I had the 2nd eye operated on a few hours later.
My intermediate vision hasn't been tested explicitly but I suspect is at least 20/20. That is based on my subjective sense of it being better than near and because of the design of this lens where visual acuity drops off in a continuous curve from far to near, so intermediate should be around the same as far, definitely better then near. That is one of the differences between this lens and for instance a bifocal IOL where vision may be worse at intermediate than it is at near or far. I spend a large number of hours at a computer and was willing to risk needing reading glasses occasionally for near in order to get better intermediate vision. Most household tasks and social interactions occur at intermediate distance as well.
Unfortunately the lens isn't yet available in the US yet, they are starting a clinical trial here which is randomized with a monofocal lens (there is a 50% chance you would get a monofocal) so I went to Europe for my surgery. I figured that at my age I hopefully may be using these lenses for a few decades so it was worth a bit of effort to get a better lens. This industry publication suggests it might be generally available in the US in a couple of years, and that some US surgeons find it interesting:
http://ophthalmologytimes.modernmedicine.com/ophthalmologytimes/news/us-surgeons-anticipate-new-iols?page=0,1
"the Symfony IOL might be available in the US by late 2016 or early 2017...
Of the IOLs discussed at the ESCRS Congress, Dr. Olson and Dr. Packer concurred that the brand new Tecnis Symfony Extended Range of Vision IOL was the most interesting as it represents a new concept for addressing presbyopia that seems to overcome the limitations of multifocal IOLs....
from what I’ve heard so far from respected and trusted surgeons, patients implanted with this IOL are seeing 20/20 at distance and intermediate with very usable, J2 or J3 near vision and are not experiencing any loss of contrast or perceptible problems with glare, halos or other dysphotopsias. So, it looks like they are having their cake and eating it too.”
I had considered the option of getting a trifocal lens which targets far, intermediate, and near (also unfortunately not yet available in the US), or even a bifocal with a small add so its focused more at intermediate than near. However the studies so far seem to indicate that the Symfony provides better quality intermediate vision. In addition multifocal lenses reduce contrast sensitivity which is useful for night vision, while reports indicate the Symfony is at least as good as a monofocal lens. The other thing the Symfony does is to correct for "chromatic aberration", an issue which is discussed in this industry publication which quotes one prominent surgeon noting:
http://eyeworld.org/supplements/EW-December-supplement-2014.pdf
" Cataract surgery with an IOL with an Abbe number greater than that of the natural lens (47) can improve CA, so that our cataract patients could actually experience better vision quality than they did as young adults. "
Although the Symfony uses a high Abbe material (I'm assuming its the same Tecnis material that article lists as having a 55 Abbe), it also has other features to to correct for CA to improve image quality. It seemed like a good bet the image quality for distance would be comparable, and perhaps even better, than a monofocal lens, or an accommodating lens.
Although some results for the Crystalens look like it will similarly do well for intermediate while providing some chance at decent near vision, some showed a lower chance of good near, e.g. some of the studies listed for the March 2014 update in this government review:
http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/MedicalDevices/MedicalDevicesAdvisoryCommittee/OphthalmicDevicesPanel/UCM346413.pdf
Part of the concern I had with the Crystalens was that in some patients the lens does well, but in some it doesn't accommodate, which leaves it effectively being a monofocal lens ( but without things like the correction for chromatic abberation). There is also concern I'd read among some over whether over decades of aging anything would interfere with the physical movement of the lens, something non-accommodating lenses don't require. There is no perfect lens, so its partly a matter of placing a bet on which might work out well, and I figured that it was better to bet on something that didn't require the accommodation to work (in addition to other concerns regarding problems people have with the Crystalens, though those may be fewer in the newest versions). I hadn't searched to find the study behind the figure in this presentation, but it notes:
http://www.slideshare.net/alanglazier/accommodating-intra-ocular-lenses
that about half of Crystalens patients require reading correction. That may be in part because as it notes: ' "Pushing” does not equal “Sustaining” '. This issue is that someone with their natural lens still who is presbyopic for instance may be able to theoretically read a particular print size without glasses, but that the muscle effort to focus may be a strain to do for an extended period of time, and the Crystalens at least partly seems to require the same sort of accommodative effort. (though there is speculation it may be benefit from some extended depth of focus, which is what the Symfony is designed to use to begin with). I'll continue this in another post in a few minutes.
I had Symfony lenses implanted in both eyes the first week of December. By 1 week postop my uncorrected vision at distance was between 20/15 and 20/20. At near my vision was already about 20/25 (but fluctuating a bit it had seemed better earlier that day). Given its improvement since then I'd guess its likely 20/20 or so, I can read the small print on my eye drop bottles for instance. Not everyone achieves this level of near vision with the lens so people shouldn't expect to necessarily get quite as good a result, and should be prepared for the possibility for needing reading glasses at near. I suspect the fact that I'm comparatively young for cataract surgery, 52, might have something to do with the results.
I had originally only planned on having 1 eye done (since the other was 20/20 correctible still), but when the patch came off the next day I discovered it might be hard to adapt to the difference in vision between the two eyes even with a contact lens in the other eye. I might have quickly adapted if I'd taken the time, but I decided I didn't want to risk it, so I had the 2nd eye operated on a few hours later.
My intermediate vision hasn't been tested explicitly but I suspect is at least 20/20. That is based on my subjective sense of it being better than near and because of the design of this lens where visual acuity drops off in a continuous curve from far to near, so intermediate should be around the same as far, definitely better then near. That is one of the differences between this lens and for instance a bifocal IOL where vision may be worse at intermediate than it is at near or far. I spend a large number of hours at a computer and was willing to risk needing reading glasses occasionally for near in order to get better intermediate vision. Most household tasks and social interactions occur at intermediate distance as well.
Unfortunately the lens isn't yet available in the US yet, they are starting a clinical trial here which is randomized with a monofocal lens (there is a 50% chance you would get a monofocal) so I went to Europe for my surgery. I figured that at my age I hopefully may be using these lenses for a few decades so it was worth a bit of effort to get a better lens. This industry publication suggests it might be generally available in the US in a couple of years, and that some US surgeons find it interesting:
http://ophthalmologytimes.modernmedicine.com/ophthalmologytimes/news/us-surgeons-anticipate-new-iols?page=0,1
"the Symfony IOL might be available in the US by late 2016 or early 2017...
Of the IOLs discussed at the ESCRS Congress, Dr. Olson and Dr. Packer concurred that the brand new Tecnis Symfony Extended Range of Vision IOL was the most interesting as it represents a new concept for addressing presbyopia that seems to overcome the limitations of multifocal IOLs....
from what I’ve heard so far from respected and trusted surgeons, patients implanted with this IOL are seeing 20/20 at distance and intermediate with very usable, J2 or J3 near vision and are not experiencing any loss of contrast or perceptible problems with glare, halos or other dysphotopsias. So, it looks like they are having their cake and eating it too.”
I had considered the option of getting a trifocal lens which targets far, intermediate, and near (also unfortunately not yet available in the US), or even a bifocal with a small add so its focused more at intermediate than near. However the studies so far seem to indicate that the Symfony provides better quality intermediate vision. In addition multifocal lenses reduce contrast sensitivity which is useful for night vision, while reports indicate the Symfony is at least as good as a monofocal lens. The other thing the Symfony does is to correct for "chromatic aberration", an issue which is discussed in this industry publication which quotes one prominent surgeon noting:
http://eyeworld.org/supplements/EW-December-supplement-2014.pdf
" Cataract surgery with an IOL with an Abbe number greater than that of the natural lens (47) can improve CA, so that our cataract patients could actually experience better vision quality than they did as young adults. "
Although the Symfony uses a high Abbe material (I'm assuming its the same Tecnis material that article lists as having a 55 Abbe), it also has other features to to correct for CA to improve image quality. It seemed like a good bet the image quality for distance would be comparable, and perhaps even better, than a monofocal lens, or an accommodating lens.
Although some results for the Crystalens look like it will similarly do well for intermediate while providing some chance at decent near vision, some showed a lower chance of good near, e.g. some of the studies listed for the March 2014 update in this government review:
http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/MedicalDevices/MedicalDevicesAdvisoryCommittee/OphthalmicDevicesPanel/UCM346413.pdf
Part of the concern I had with the Crystalens was that in some patients the lens does well, but in some it doesn't accommodate, which leaves it effectively being a monofocal lens ( but without things like the correction for chromatic abberation). There is also concern I'd read among some over whether over decades of aging anything would interfere with the physical movement of the lens, something non-accommodating lenses don't require. There is no perfect lens, so its partly a matter of placing a bet on which might work out well, and I figured that it was better to bet on something that didn't require the accommodation to work (in addition to other concerns regarding problems people have with the Crystalens, though those may be fewer in the newest versions). I hadn't searched to find the study behind the figure in this presentation, but it notes:
http://www.slideshare.net/alanglazier/accommodating-intra-ocular-lenses
that about half of Crystalens patients require reading correction. That may be in part because as it notes: ' "Pushing” does not equal “Sustaining” '. This issue is that someone with their natural lens still who is presbyopic for instance may be able to theoretically read a particular print size without glasses, but that the muscle effort to focus may be a strain to do for an extended period of time, and the Crystalens at least partly seems to require the same sort of accommodative effort. (though there is speculation it may be benefit from some extended depth of focus, which is what the Symfony is designed to use to begin with). I'll continue this in another post in a few minutes.
Thank you for your detailed notes. Wish I had found this site before I had my surgery. Anyway, I'm 2 weeks post-op on left eye and 1 wk post-op for the right.
At my day-after checkups, distance in each eye was measured 20-20 with 1 incorrect letter bottom line. So, I'm very happy with that!
Reading was about 20-25 and 20-30ish on day 2, but I suspect it's a bit less now, especially with halo and glare on my phone. Should I expect continued improvement with my reading acuity?
Also, tonight I drove in the dark for the first time with my "new eyes." Quite a bit of halo, starburst and spider web things around lights. On day 2, my eyes were blurry but didn't have this much halo. Should I be concerned?
I have another checkup tomorrow and will ask. Hope I will continue to improve for another month or so, as I've heard it really can take that long.
Thanks for any feedback, it's appreciated.
At my day-after checkups, distance in each eye was measured 20-20 with 1 incorrect letter bottom line. So, I'm very happy with that!
Reading was about 20-25 and 20-30ish on day 2, but I suspect it's a bit less now, especially with halo and glare on my phone. Should I expect continued improvement with my reading acuity?
Also, tonight I drove in the dark for the first time with my "new eyes." Quite a bit of halo, starburst and spider web things around lights. On day 2, my eyes were blurry but didn't have this much halo. Should I be concerned?
I have another checkup tomorrow and will ask. Hope I will continue to improve for another month or so, as I've heard it really can take that long.
Thanks for any feedback, it's appreciated.
1 Comments
You are very early on so there is a very good chance of improvement. Most studies of IOLs don't even bother recording the incidence of night vision artifacts like halos until 3 or 6 months to let people get past the initial healing and neuroadaptation period where more people see them. Since you started a new page repeating the comment, I'd suggest making any followups there where I'll repost this.
Just had a symfony implanted. So far it's interesting. Vision is better. In day two have a shimmering or flickering effect. Do have halos and glare and a some floaters from the surgery. My hope is they go away. I'm still healing, but would like to know where my vision will end up. I'd say I need 1.5 readers for up close, which is just not that bad. Too early to tell on final outcome, bit I'm optimistic
Just had a symfony implanted. So far it's interesting. Vision is better. In day two have a shimmering or flickering effect. Do have halos and glare and a some floaters from the surgery. My hope is they go away. I'm still healing, but would like to know where my vision will end up. I'd say I need 1.5 readers for up close, which is just not that bad. Too early to tell on final outcome, bit I'm optimistic
1 Comments
I'm having surgery in a few weeks and haven't decided if I'm going with symphony or not. My concern is will I still need readers for up to 12 inch distance or not. I currently need them for example using my iPhone or reading small print within 12 inches. I have cataracts and astigmatism.
I wear glasses or contacts.
I wear glasses or contacts.
2 Comments
Unfortunately no one can tell you exactly how good your results will be since each person's natural depth of focus varies. The same lens in two different people will yield different results. All studies can show are average results (or sometimes the range found in the study), and patients online merely report their anecdotal results. Most patients report being free of glasses, and given the high % of people with smartphones that suggests most can deal with them. With a monofocal set for distance the odds are high you wouldn't be able to do much with a smartphone other than perhaps dial using a large font (though even that I hadn't checked on to be sure how likely it is). Monovision, setting one eye nearer, can help with a monofocal, but that helps even more with the Symfony and you can do a smaller degree of monovision and expect good results.
I don't know how large the screen is on your phone, what the font size is. In my case I've had no trouble using my smartphones without bothering to change fonts and just holding them at a natural distance without needing to even think about where I hold it (with one exception mentioned below). First it was with a 4.7" screen on an HTC One M7, now with a 5.1" screen on a Samsung Galaxy S7. Note: I upgraded phones for other reasons, I didn't factor in the screen size, I had no problem using the smaller screen on the old phone. With newspaper sites with multiple columns I do find it easier to read when I double-tap the screen to expand to one column (though I can read multicolumn headline size text and if I try I usually make out the multicolumn small font without going single column, I just need to concentrate to do so and sometimes find the right position to hold the phone to read the smaller font).
If you opt for micro-monovision that will increase the odds of having good enough near vision to read your phone. Holding the phone farther out might be of help if it turns out that 12 inches is a problem, or worst case trying larger fonts.
I don't know how large the screen is on your phone, what the font size is. In my case I've had no trouble using my smartphones without bothering to change fonts and just holding them at a natural distance without needing to even think about where I hold it (with one exception mentioned below). First it was with a 4.7" screen on an HTC One M7, now with a 5.1" screen on a Samsung Galaxy S7. Note: I upgraded phones for other reasons, I didn't factor in the screen size, I had no problem using the smaller screen on the old phone. With newspaper sites with multiple columns I do find it easier to read when I double-tap the screen to expand to one column (though I can read multicolumn headline size text and if I try I usually make out the multicolumn small font without going single column, I just need to concentrate to do so and sometimes find the right position to hold the phone to read the smaller font).
If you opt for micro-monovision that will increase the odds of having good enough near vision to read your phone. Holding the phone farther out might be of help if it turns out that 12 inches is a problem, or worst case trying larger fonts.
I had the symfony fitted a couple of months ago in one eye and am potentially having it removed. I'm going to try the Tetraflex instead.
The halos at night around headlights are quite severe for me with the symfony, I'm managing because my other eye still has the natural lens in, also I've had a separate eye test that showed a definite reduction in contrast sensitivity compared to the vision in my left eye; faint letters on the chart weren't visible at all with the synfony, it's a though it was a blank chart but could be seen with the natural lens. Looking at objects around the house, there just seems less detail compared to the eye with the natural lens. When looking at a person's face, lines seem to be smoothed out.
For some reason I ended up with a slight astigmatism after the surgery, which I believe is a risk for cataract surgery but even with wearing glasses to correct it the halos are there. With the astigmatism the accommodation doesn't really work, instead letters have ghosts that interfere and make the text unreadable but it does accommodate at least for text on a phone with the astigmatism corrected but not really enough for small print.
If there are ceiling lights above me switched on, there's kind of haze in my vision.
Even the TV has glare around it.
I suppose if I'd had both eyes done, I wouldn't notice the reduced quality in vision compared to the natural lens.
The reason I'm going for the accommodating lens instead; it's essentially a clear mono lens that can move, so hopefully won't have as bad halos or reduced contrast.
I may be a one-off but I'm pretty disappointed and just hope it can be removed safetly enough to have an accommodating lens put in.
The halos at night around headlights are quite severe for me with the symfony, I'm managing because my other eye still has the natural lens in, also I've had a separate eye test that showed a definite reduction in contrast sensitivity compared to the vision in my left eye; faint letters on the chart weren't visible at all with the synfony, it's a though it was a blank chart but could be seen with the natural lens. Looking at objects around the house, there just seems less detail compared to the eye with the natural lens. When looking at a person's face, lines seem to be smoothed out.
For some reason I ended up with a slight astigmatism after the surgery, which I believe is a risk for cataract surgery but even with wearing glasses to correct it the halos are there. With the astigmatism the accommodation doesn't really work, instead letters have ghosts that interfere and make the text unreadable but it does accommodate at least for text on a phone with the astigmatism corrected but not really enough for small print.
If there are ceiling lights above me switched on, there's kind of haze in my vision.
Even the TV has glare around it.
I suppose if I'd had both eyes done, I wouldn't notice the reduced quality in vision compared to the natural lens.
The reason I'm going for the accommodating lens instead; it's essentially a clear mono lens that can move, so hopefully won't have as bad halos or reduced contrast.
I may be a one-off but I'm pretty disappointed and just hope it can be removed safetly enough to have an accommodating lens put in.
2 Comments
re: "accommodating lens instead; it's essentially a clear mono lens that can move, so hopefully won't have as bad halos or reduced contrast"
I would be careful before leaping to that conclusion. The FDA data for the Crystalens, which also matches that description, indicates a higher incidence of problematic halos with the Crystalens than with the Symfony. Some people get halos even with strictly monofocal lenses. The studies seem to show the incidence of problematic halos with the Symfony is in the general range of monofocals, higher than the best monofocal but lower than some other monofocals.
I haven't examined data for the Tetraflex since its not approved in the US and my initial reading didn't suggest it was an improvement over the Crystalens available here. Its possible it does have a lower incidence of problem halos, but I hadn't looked into it.
Most studies on halos are done after 3 or 6 months because more people even with monofocal see them initially before most fade after the first few months.
I know someone in town who had the Crystalens implanted, and he has complaints about his low light reading vision. We met in a well lighted auditorium after a lecture and he did an experiment with a near reading chart. He held a file folder over it to merely cast a shadow, and that was enough to cause his near vision to be reduced with the Crystalens noticeably.. but it didn't make a difference for me with the Symfony. We are about the same age (lighting needs do increase with age), but its possible it may be individual variation. In general however there may be some reduction in low light vision with an IOL.
It sounds like much your problem is due to the astigmatism, which can interfere with visual quality with any lens.. and I've seen some surgeons suggest the impact is less with the Symfony than with a monofocal.
I would suggest researching data on the Tetraflex before leaping to conclusions regarding how much it will improve things. It may be that if you do see halos with the Tetraflex that they would be less problematic for you than the sort you get with the Symfony.. but perhaps not. I don't recall how much near the Tetraflex has, its been at least 2 or more years since I looked into it.
I don't find any issue with the level of detail I see with the Symfony, but I got both eyes implanted a day apart so I didn't have time to compare, though in the hour I had to do while I decided whether to have the 2nd surgery and I walked around testing vision I didn't see anything that was a problem (merely a sense off imbalance between the two, if anything the Symfony eye seemed crisper). It seems better than I can recall having with contacts before I had a problem cataract.
I would be careful before leaping to that conclusion. The FDA data for the Crystalens, which also matches that description, indicates a higher incidence of problematic halos with the Crystalens than with the Symfony. Some people get halos even with strictly monofocal lenses. The studies seem to show the incidence of problematic halos with the Symfony is in the general range of monofocals, higher than the best monofocal but lower than some other monofocals.
I haven't examined data for the Tetraflex since its not approved in the US and my initial reading didn't suggest it was an improvement over the Crystalens available here. Its possible it does have a lower incidence of problem halos, but I hadn't looked into it.
Most studies on halos are done after 3 or 6 months because more people even with monofocal see them initially before most fade after the first few months.
I know someone in town who had the Crystalens implanted, and he has complaints about his low light reading vision. We met in a well lighted auditorium after a lecture and he did an experiment with a near reading chart. He held a file folder over it to merely cast a shadow, and that was enough to cause his near vision to be reduced with the Crystalens noticeably.. but it didn't make a difference for me with the Symfony. We are about the same age (lighting needs do increase with age), but its possible it may be individual variation. In general however there may be some reduction in low light vision with an IOL.
It sounds like much your problem is due to the astigmatism, which can interfere with visual quality with any lens.. and I've seen some surgeons suggest the impact is less with the Symfony than with a monofocal.
I would suggest researching data on the Tetraflex before leaping to conclusions regarding how much it will improve things. It may be that if you do see halos with the Tetraflex that they would be less problematic for you than the sort you get with the Symfony.. but perhaps not. I don't recall how much near the Tetraflex has, its been at least 2 or more years since I looked into it.
I don't find any issue with the level of detail I see with the Symfony, but I got both eyes implanted a day apart so I didn't have time to compare, though in the hour I had to do while I decided whether to have the 2nd surgery and I walked around testing vision I didn't see anything that was a problem (merely a sense off imbalance between the two, if anything the Symfony eye seemed crisper). It seems better than I can recall having with contacts before I had a problem cataract.
Hi Triggered, I have the similar issue with my operated right eye. I am seeing less details and haze, but it's better before the operation. My doctor put on a -1.00 contact lens then i can see 20/30 vs. 20/60. he also thinks it could be secondary cataract. I am not sure now, but would be curious to hear your replacement operation.
who is your L.A. doctor?
i am looking for a second opinion. i need an IOL and thought the symfony sounds my best option but my current dr says absolutely not, he wants to put in crystal lens. i hear crystall can have embedding issues so it stops accommodating in a percentage of people. when i asked why he simply stopped me cold and said no... i want a better explanation than "no".
i am in LA so am looking in this area...
thanks
i am looking for a second opinion. i need an IOL and thought the symfony sounds my best option but my current dr says absolutely not, he wants to put in crystal lens. i hear crystall can have embedding issues so it stops accommodating in a percentage of people. when i asked why he simply stopped me cold and said no... i want a better explanation than "no".
i am in LA so am looking in this area...
thanks
5 Comments
I would be curious what the reasoning is. Some doctors are experts in medicine, but aren't as familiar with optics and seem to confuse the Symfony with a multifocal, and some doctors had bad experiences with the old multifocals (and aren't even aware the newer multifocals have also improved quite a lot compared to old versions). Doctors are also human, and some can find an approach that works well enough for them like a particular lens, and be hesitant to risk trying something new.
The studies I've seen show a higher percentage of Symfony patients are free of glasses than Crystalens patients so it has a larger range of vision. That also means if you get the lens targeted for intermediate distance, it would also give more near vision. A small minority of the Crystalens patients reportedly don't get more vision from it than they would a monofocal, and there may be some higher risk of other complications, which is one of the reasons I didn't go for it.
In terms of an LA doctor, I don't know of any offhand, but you might start a new thread asking about good LA surgeons (since some people may not care about the Symfony and not read this long thread). Also many cities have either newspapers or magazines that publish a "best doctors" list every year that is based on asking doctors who they would go to if they needed treatment (figuring they are have connections to hear who is good and are better able to evaluate another doctor then a typical patient).
You might try searching the net for Symfony and LA (or Los Angeles) for any doctors already promoting that they are using the lens or looking forward to it, or who were involved in the clinical trials . You may even see hits show up in the trade literature if a doctor is prominent. Unfortunately LA is such a big metro area that often they might use the name of the particular area nearby city they are in rather than LA.
The studies I've seen show a higher percentage of Symfony patients are free of glasses than Crystalens patients so it has a larger range of vision. That also means if you get the lens targeted for intermediate distance, it would also give more near vision. A small minority of the Crystalens patients reportedly don't get more vision from it than they would a monofocal, and there may be some higher risk of other complications, which is one of the reasons I didn't go for it.
In terms of an LA doctor, I don't know of any offhand, but you might start a new thread asking about good LA surgeons (since some people may not care about the Symfony and not read this long thread). Also many cities have either newspapers or magazines that publish a "best doctors" list every year that is based on asking doctors who they would go to if they needed treatment (figuring they are have connections to hear who is good and are better able to evaluate another doctor then a typical patient).
You might try searching the net for Symfony and LA (or Los Angeles) for any doctors already promoting that they are using the lens or looking forward to it, or who were involved in the clinical trials . You may even see hits show up in the trade literature if a doctor is prominent. Unfortunately LA is such a big metro area that often they might use the name of the particular area nearby city they are in rather than LA.
You may find someone on www.ratemds.com in LA. I think it is a world wide site. Good Luck!
Still looking for an LA doctor? My excellent SF doctor who originally rec. the Symfony is now @ Doheny Ctr in Fountain Valley: Benjamin Bert.
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