Best IOL for visual artist?

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Thanks, all for these great conversations. 62 y/o artist/writer here. Cataracts worsening. Doc is encouraging Panoptix for glasses-free convenience. I am concerned about what I read inre: lack of contrast, ghosting, possible need for reading specs anyway. I do a lot of close work, image editing, publication proofing. Need things to be as tight and crisp as possible. Beginning to think I'll be better served with a monofocal and glasses - heck, I've worn them for 47 years already. Any other vision-crucial professionals with experience/views? Glad to learn all I can before surgery in 3 weeks...

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13 Replies

  • Edited

    If you have worn eyeglasses for 47 years and don't mind continuing to wear them, and you want the crispest vision possible and you are worried about contrast and ghosting, then, as you said, you would be "better served with a monofocal and glasses." It would save you a lot of money and it would be the simplest and easiest way to go.

  • Edited

    There is no way around this simple fact… you can have a large range of vision without glasses (quantity) or you can have the best possible quality. You can't have both.

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    Don't make the mistake I made. Had both eyes panoptix torric. Requested the new caleron panoptix which came out in 2022. This lense is made of new material that does not have the glistening problems of the older Alcon lenses. I specifitly ask the doctor for the caleron line. The receipt I got from the surgery center was the old style panoptix. I called and left a message for the surgeon a week ago and he has not gotten back top me. I will meet with him next week where I am sure he will give me some bull. I looked at the paper work I signed and it just said Panoptix torric lense. I call Alcon and verified by the series number that these were the old lenses. GET YOU LENSES IN WRITTING.

  • Edited

    I would have a couple of suggestions:

    .

    First if you are into visual arts I would get a lens with blue light filtering. It is a slightly yellow tinted lens that gives a colour spectrum very close to that of a younger adult with natural lenses. Clear lenses let in more light but result in a colour spectrum shifted towards the blues. In general the Alcon lenses like the AcrySof IQ, Clareon, Vivity, and Panoptix have blue light filtering. The J&J lenses like Tecnis, Eyhance, Symfony, and Synergy do not. Pretty much all lenses have UV filtering which does not change the visible colour spectrum.

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    The other option to PanOptix for eyeglass free vision overall wide range of distances is mini-monovision. It tends to have a lower risk of optical side effects like halos and flare. Normally the dominant eye is set for full distance and the non dominant set for -1.5 D of myopia. This gives a pretty much full range of vision from 12" out to infinity without glasses. And, this approach can be combined with glasses to cover other situations. I have this mini-monovision arrangement, but on occasion such as very small print in dimmer light I may put a pair of +1.25 D OTC readers on. I also have some progressive prescription eyeglasses that I wear for the ultimate vision. They correct any residual sphere and cylinder not corrected by the IOL. But they come of course with the issues associated with wearing glasses and the need to look up and down with progressives. I look at it as having two options for vision. One that I use 95% of the time is to be eyeglasses free. The other 5% if the time I do wear glasses. I tend to use the +1.25 readers more, and the prescription progressives the very least.

  • Edited

    My situation is similar and I've put a lot of thought into what I want. I'm tending toward thinking I monofocals set for close vision. I'm used to taking glasses off for closest vision and find it very convenient. Most of the time I will wear glasses set for intermediate vision, and take them off for close. For full distance vision, I will have a pair in the car and a pair by the TV, and that's pretty much the only place I'll need them. I find that the need for close vision pops up unpredictably throughout the day and so I want close vision built into my eyeballs so I don't have to go looking for special glasses set for close vision.

    Distance vision I can plan for and have glasses for that pre-positioned.

    Of course, you want to get any astigmatism corrected by the IOL.

    I would not take the risk of multi-focals.

    Mini-monovision might be nice, but I greatly value the extra bit of sharpness that comes having binocular sharp vision and so I think I would end up using glasses more with that strategy than with the strategy outlined above (both eyes set for close). With mini-monovision I would need glasses even for close vision whenever I wanted the best possible close vision.

    • Posted

      Thank you for your views, this is where my mind is lingering for the moment. I like that you said you can prepare for distance, while close vision is more momentarily necessary when at the desk and in the studio...

    • Posted

      Jim,

      Why do you say get the astigmatism corrected by the IOL? Doesn't some astigmatism help near vision, and if not, it be corrected with eyeglasses?

      Thanks.

    • Edited

      Getting astigmatism corrected with an IOL is really only necessary if you want good vision without eyeglasses. Eyeglasses can do a good job of correcting astigmatism. Some do not want to wear them however.

      .

      Yes, astigmatism can help reading a little bit by adding a little bit of myopia. However it can also cause distortions which hurt vision. The astigmatism I have does help reading a some, but it also causes a drop shadow on letters which pretty much offsets any benefit. Zero or close to zero astigmatism is always the best.

  • Posted

    I would strongly suggest staying away from PanOptix. I'm in web design, and do a lot of image editing. I'm coming up on three months post-op and have only fair computer distance clarity and all else is a bit blurry, including distance vision. Google PanOptix shadows around text - the ghosting effect of contrasting colors is very difficult to sometimes impossible to deal with when needing to eliminate a background in Photoshop. I regret my decision to get the lens but as of yet do not know what my next step is, except to have a second opinion from someone at Duke before proceeding.

  • Edited

    I agree with Lynda's comment. If you want crisp, clear vision please stay away from a multi-focal. This is from personal experience. I had my left eye done first with a multi focal & I've regretted it so much. Dr. decided to fit me with a monofocal in my right eye set for distance. There is a big difference with clarity between the two. A multi focal will correct for all distances but your vision will probably not be clear as there is a trade off to be glasses free. You will lose the clarity you are seeking. I have contrast problems & horrible ghosting problems in my left eye. Had I known this I definitely would have opted for a monofocal in my left eye. I have worn glasses since I was 18 mos. old so wearing them again would not have been an issue for me. I would rather have clear vision with glasses than blurry vision without. Cataract surgeon told me the only solution is a lens exchange which is way too risky for me. You will pay much more for a multifocal but your vision will not be as crisp & clear as with a monofocal. My best advice to you would be save your money & go with the monofocal. Good luck & I hope your outcome is what you are looking for.

  • Posted

    Hi all, and thanks for your input, this has been a really helpful forum. I talked it over with my optometrist (15+ years relationship) and who has a good working relationship with surgeon. Opt. assured me my reasoning process was sound, and we opted for standard lens with near correction. Just had 2nd surgery yesterday and am pleased with results so far. As a designer for print, I can already easily focus on paper proofs for image and type correction, and screen focus is good too. Oh, and it is nice to read with a book more than 4" from your face.

    To those who are awaiting their surgery: believe it when your friends tell you the color improvement will amaze... 😃

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