Cataract Surgery Just Completed - Sharing My Experience - PanOptix Tri-focal

SHORT-TERM POST SURGERY and NEUROADAPTATION OBSERVATIONS

After the surgery, my pupils were still be dilated, so vision will be “weird” initially.

Next day, follow-up check with the eye surgeon. Test showed my distance vision was already 20/20. Wonderful! But my intermediate and near vision is quite fuzzy.Docotr noted that my pupils were still dilated the day after, so she was not surprised intermediate and near vision still fuzzy and said it would improve. With tri-focals it's normal fpr distance vision to improve first.

The PanOptix lens has both a UV filter (this is standard) and a blue light filter (several manufacturers have added this as they think it may help reduce risk of macular disease, while some other manufacturers don’t believe blue filter is beneficial). I compared the colors I see with my new Right eye (which has the IOL) with my left eye (still natural lens but with cataracts). I don’t notice any perceptible difference in color, except when looking at my wood deck is pressure treated wood with a semi-transparent still. With my left eye (natural lens with cataract), the wood has a more yellowish hue compared to my Right eye (IOL with blue filter), but difference is not major.

I have my left eye done the following week.Distance vision now with both eye is outstanding. Intermediate is getting better, but still fuzzy, and near is fuzzy (after one week in first eye and a couple of days in second eye). My surgeon says it can take one week to three months to adjust for the near vision. I did buy some reading glasses with the lowest power (+1.00) but will try not to use them too much (why later).

My exchange of posts with Danish Viking led me to look up articles on neuroadaptation and found some old articles that were informative. The articles are from before tri-focal were invented, but with tri-focals the brain is seeing three images, one that is focused and two that are unfocussed. The brain adapts to filter out the noise so that you can hopefully see clearly at all distances.

Search for: “New Lens, Same Brain: The Importance of Neuroadaptation” -- very old article, so much of it may not apply, but info of neuroadaptation is good.

And the next one I found really helpful and am trying out some of the suggestions:

Search: “Multifocal Neuroadaptation: Can Training Help the Brain?”

I only read this article this morning, but I’ve tired some of the training including eye exercises and looking at “Gabor Filter” images. I am sure I’m not imagining it, but my intermediate and near vision seems to be a little better already. I will do more of the eye “training” , and will try to avoid relying on temporary readers to speed up my neuroadaptation.

Also purchased my first pair of Maui Jim sunglasses, now that I don't need prescription lens anymore!

hi janus381, thanks for sharing your experience with PanOptix. i live in Toronto as well. Are you able to share the clinic and surgeon you used?

1-2 Weeks Update

It’s been two weeks since surgery in my right eye, and one week for my left eye.

My right eye was measured 20/20 for distance at the follow-up check the day after surgery.Intermediate and near vision was very fuzzy the day after, and doctor said my pupils were still dilated.After my left eye was done the following week, my intermediate and near vision still had not adjusted, so I purchased +1.00 power reading glasses and I could read my phone with that; trying not to use the readers too often. My ophthalmologist reassured me that for the Tri-focal, it’s normal for distance vision to be the first to improve, and the other distances will normally take one week to 3 months to adjust.

As I write today, I am extremely pleased with my distance vision with PanOptix IOL in both eyes. Since I’ve had glasses most of my wife, I don’t think I ever had crystal clear distance vision. My intermediate and near vision has improved. I can read my computer screen (but words are slightly fuzzy), and I can read documents and my phone if font is not too small. For newspapers, I need to use my temporary reading glasses. Still early days, but happy to be seeing improvements, and expect to have even better vision at intermediate and near as I my brain adapts to these lens.

Artifacts

I’m not seeing any artifacts in daylight or indoors; no artifacts watching TV or looking at the computer. Also no short-term sensitivity to sunlight (although I'm loving my new Maui Jim sunglasses!).

Before I knew I had cataracts, I was thinking over 30% of the cars on the road had bright high-beams on at night, when what was really happening was that I was having significant glare due to cataracts. After cataract surgery, I not having much problems with on-coming headlights. There are a few cars that probably do have high beams or misaligned headlights that bother me a bit (but not as much as before), but in general, no problems with glare.

I am seeing two very faint concentric rings around some lights. I see it more with red traffic lights and tail lights. That is clearly an artifact from the lens, but it’s very mild, and does not impair my night vision.

I am not sure a light should look like with “normal vision”. I am seeing mild starburst currently, but they don't bother me. For reference, I found some images on a photography site showing different degrees of starburst effect using a camera; search “SLR diffraction aperture starburst effects” – and you will see sample pictures of the starburst effect using a camera at eight different apertures. What I’m seeing looking at bright lights at night is pretty mild, I’d say looking at most lights, it’s somewhere between the f/5.6 and f/4 sample pictures from that photography site, and looking at very bright lights, the starburst effect is probably closest to the f/6.3 or f/9 samples. But again, they do not really causing any problems with night vision.

So night driving artifacts are not too significant after a couple of weeks, and may diminish with neuro adaptation.

Contrast Sensitivity and Low Light Vision

Low light vision is much better than before with cataracts. I can read street names driving at night. There is a powder room in our house with very dark walls and black fixtures and low lighting that I always found hard to see in before; it seems much better brighter now with the PanOptix lens.When I update next, I will hope to have more comparisons -- particularly after I return to doing yoga in dark studios, but I'm expecting to notice a significant improvement from before.

realized I can insert an image, but not a link. The link wasn't a jpg file, but managed to find a version in jpg that I can insert. Good reference from a photography site showing different degrees of starburst effect using a camera.What I'm seeing is probably around the f/5.6 or f/4, but with extremely bright lights, f/6.3 or perhaps as high as f/9.

Posted this in Autumn's discussions, but thought I'd add post here as well.

Good news for US cataract patients who have had move limited premium IOL choices, the latest tri-focal should be available in the US soon to finally replace the older generation bi-focals.

Alcon disclosed in it's May investor earnings call that it expects to get FDA approval for the PanOptix tri-focal in the US by late 2019 or early 2020.

Search: Newly independent Alcon leans on surgical unit while awaiting key product launches