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Presbyopia Challenge | Jan/Feb '17

Faster, Higher, Stronger

Few things are more inspiring and memorable than the Olympic games. Even now, I can remember watching Carl Lewis sprint into history, Mary Lou Retton land perfect 10s, and Dan Jansen (eventually) skate to gold. If you’re a millennial, you probably remember Michael Phelps swimming to gold after gold, Usain Bolt dominating sprinting, and Simone Biles and Aly Raisman teaching Bob Costas about interviewing millennials.

The Olympic motto “Citius, Altius, Fortius,” Latin for “Faster, Higher, Stronger,” embodies the essence and goal of every Olympic athlete: pushing to do better in events where performance can always be improved. Similarly, in the quest to conquer presbyopia, we continue to push toward the unofficial Presbyopia Challenge motto of “Sharper, Smoother, Easier.” Okay, these may not be the most poetic words, but we want new technology that gives us (1) sharper vision, (2) smoother transition from distance through intermediate and into near, and (3) easier adoption with fewer problems—both for surgeons and for patients.

With the recent FDA approval of the Tecnis Symfony and Tecnis Symfony Toric IOLs (Abbott), we have generational improvement and a lens that can push toward all three of these goals. The Tecnis Symfony IOL is built on the Tecnis one-piece platform of mid-index, low-dispersion material and negative spherical aberration. It utilizes diffractive technology to further correct chromatic aberration and to extend the range of vision, making it the first-in-class extended depths of focus (EDOF) IOL for the correction of presbyopia. Because of its unique optical properties, the Symfony is …


When it comes to visual quality, the correction of aberrations is everything. The Symfony corrects the full spherical aberration of the average cornea. It is also the only IOL that corrects (instead of adding to) the chromatic aberration of the cornea for distance, intermediate, and near ranges.


Through proprietary use of diffractive echelette technology, the Symfony creates a continuous range of good quality vision from far, through intermediate, and into near. The EDOF characteristic means no inflection in the defocus curve shape and no drop-off in vision until the object is very close.


Because of its flat defocus curve, the Symfony is easier to target than even a monofocal IOL. Small hyperopic misses can still result in 20/20 or better UDVA. Small myopic misses may result in some decline in UDVA, but UIVA and UNVA would be improved. Further, the Symfony comes in an entire series of toric models, allowing for the correction of corneal astigmatism without the use of relaxing incisions. With appropriate preparation and counseling, this may turn out to be the lens of choice for difficult and even post-refractive surgery cases.


While no IOL is perfect, I have found the Tecnis Symfony IOL to be a boon to my career goal of conquering presbyopia. Because it is sharper, I can make patients with milder cataracts and higher expectations happy. Because it is smoother, I can help working professionals function better with their intermediate vision. Because it is easier, it reduces my chair time and allows me to offer it confidently to patients. I can only imagine what the next generation of IOL might look like. Perhaps we’ll know more before the next Olympics in the winter of 2018.

Daniel H. Chang, MD
Daniel Chang, MD | Section Editor
  • Private practice at Empire Eye and Laser Center in Bakersfield, California
  • (661) 325-3937; dchang@empireeyeandlaser.com
  • Financial interest: Consultant (Abbott Medical Optics)