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.