Welcome to our “Complete Guide to the Synergy Intraocular Lens (IOL) implant. Choosing the right lens implant is a decision that can enhance your vision and lifestyle for the rest of your life.

In this section, we’re going to discuss the Synergy IOL, and give you a strong foundation of knowledge as you decide with your surgeon which implant is right for you.

Nowadays there are a number of excellent implant options to choose from. There’s no one-size-fits-all implant that’s the best for everyone. Your choice of implant depends on your eyes and your lifestyle and should be made in consultation with an expert cataract surgeon.

In this section we’ll cover the following:

  • What is the Synergy IOL?
  • How does the Synergy IOL work?
  • Are there any patients who should not get the Synergy IOL?
  • How does the Synergy IOL Perform?
  • Summary

Before we get started, please remember that the information and educational resources provided on our website are not a substitute for the personalized medical advice of a skilled surgeon:

Disclaimer:

This website does not engage in the practice of medicine and any information presented here is not a substitute for the medical advice, recommendations, and care of licensed medical professionals.

Every patient’s individual medical situation should be considered unique, and all treatments individualized accordingly based on the respective physician’s medical judgment.

With that out of the way… let’s get started!

What is the Synergy IOL?

On May 6, 2021 Johnson & Johnson Vision announced that the U.S. Food and Drug Administration approved the Tecnis Synergy intraocular lens implant (IOL). The Synergy IOL is designed as an “Extended Range of Vision” IOL with the goal of achieving independence from glasses for distance, intermediate, and near range vision.

How does the Synergy IOL work?

The Synergy IOL incorporates proprietary diffractive technology on its back surface that is a combination of the multifocal and “extended depth of focus” technologies from previous models of IOL’s. This diffractive surface is designed to provide a range of vision from distance to intermediate to near.

The lens design has a series of concentric rings that cause light to “diffract”, or scatter, in a controlled way which causes light to focus for distance, intermediate, and near focal ranges. These rings can also cause some light to scatter in a manner that causes glare, halos, and starbursts. Most patients are not very bothered by these symptoms… but some are. In the sections below we’ll get into the details of how the lenses performed for vision at distance,

intermediate, and near ranges… and we’ll also review the clinical trial data on how patients experienced glare, halos, and starburst symptoms.

Are there any patients who should not get the Synergy IOL?

Before discussing who might do well with the Synergy IOL, there are some general guidelines that Johnson & Johnson gives for those who may not do well with a Synergy IOL. These guidelines are also applicable to most other Multifocal and “Extended Depth of Focus” implants, though, there may be exceptions:

How does the Synergy IOL Perform?

To illustrate how the Synergy IOL performs and help guide your expectations, let’s review the FDA clinical study of the Synergy implant. If you’d like to review it yourself, you can access it here.

To summarize the FDA Clinical Trial, we’ll review the following:

  • Study Design
  • Distance Vision Outcomes
  • Intermediate Vision Outcomes
  • Near Vision Outcomes
  • Glare, Halos, Starburst Outcomes
  • How many patients achieved complete freedom from glasses?

Study Design

The clinical trial took place in 2019, and included 272 patients at 15 investigational sites. The study was a prospective, multicenter, three-way blinded, randomized study of the safety and effectiveness of the Synergy IOL compared to a control monofocal IOL, the ZCB00. (Note: In our opinion, the ZCB00 is an excellent monofocal IOL, and one of the most common monofocal IOL’s used in the United States at the time of the clinical trial.)

Patients were randomized to receive either the Synergy IOL or the control monofocal IOL. Patients were followed for 6 months. Outcomes presented below were from each patient’s 6-month follow-up visit.

Distance Vision Outcomes

The table below shows the data for the Synergy versus the Monofocal control lens for distance vision. “Uncorrected” refers to patients’ distance vision without glasses, whereas “best corrected” refers to how good patients’ vision was with glasses.

 

 

Intermediate Vision Outcomes

In the table below, we show the data for the Synergy versus the Monofocal control lens for Intermediate range vision. “Intermediate” refers to 66cm or approximately 26 inches. Examples of intermediate range vision may include computer, dashboard, and shelf at the store range vision.

 

As you can see there is a significant improvement in Uncorrected Intermediate vision for patients who received the Synergy IOL compared to the Monofocal control IOL.

Near Vision Outcomes

The table below presents the data for the Synergy versus the Monofocal control lens for Near range vision. “Near” refers to 40cm or approximately 16 inches. Examples of near range vision may include magazine or book range reading vision.

 

Once again, it’s clear that the Synergy IOL performs much better than the Monofocal control IOL for Uncorrected Near vision.

 

Glare, Halos, Starburst Outcomes

Finally, let’s look at glare, halos, and starbursts. As we often say, there is not one-size-fits-all best IOL, and there are trade-offs associated with every lens on the market today. The trade-off associated with many multifocal and “Extended Depth of Focus” implants is that, while they achieve improved uncorrected Intermediate and/or Near vision, this benefit may come with the unwanted side effect of glare, halos, and starbursts. Let’s see how the Synergy performed in this regard:

While most were either slightly bothered, not bothered, or did not experience these unwanted visual symptoms, there were more patients in the Synergy group who were either ‘very bothered’ or ‘extremely bothered’ by some of these symptoms, such as halos and starbursts.

 

How many patients achieved complete freedom from glasses?

The most common reason many patients elect for Multifocal or “Extended Depth of Focus” implants is to achieve freedom from glasses. Many IOL’s attempt to reduce patient’s dependence on glasses for distance vision and either Near or Intermediate range vision… but often not all of these ranges. The Synergy attempts to achieve independence for all of these ranges…. So how does it do?

At the end of the study patients were asked how often they reported wearing glasses or contact lenses…. Over 87% of patients reported wearing glasses “None of the time” for all ranges of vision. That is, 115 out of 131 patients who received Synergy implants reported being totally glasses-free 6 months after their surgery. This compares to only 3% in the control group.

 

Summary:

Overall, the Synergy lens is an outstanding addition to the toolbox of cataract surgeons, and it will make many, many patients very happy by achieving complete freedom from glasses. We all want a lens implant that works 100% of the time with no glare, halos, or unwanted visual symptoms. So while the Synergy isn’t perfect, its clinical trial results show that it’s proven to be highly effective in achieving complete independence from glasses at all ranges of vision for the vast majority of patients.

Sources:

  1. FDA Summary of Safety and Effectiveness Data (SSED) for the TECNIS Synergy™ IOL, Model ZFR00V • TECNIS Synergy™ Toric II IOL, Models ZFW150, ZFW225, ZFW300, ZFW375, TECNIS Synergy™ IOL with TECNIS Simplicity™ Delivery System, Model DFR00V, TECNIS Synergy™ Toric II IOL with TECNIS Simplicity™ Delivery System, Model DFW150, DFW225, DFW300, DFW375. Available June 15, 2021: https://www.accessdata.fda.gov/cdrh_docs/pdf/P980040S124B.pdf
  2. Tecnis Synergy IOL “Getting Started Guide”. Johnson & Johnson Surgical Vision, Inc. 2021.