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

It has been move than one month now. My one-month follow-up appointment, I moved to next Monday, so I don't have any objective measurements to report.

Yes, my intermediate and near vision have gotten better.I can read the computer screen without any issues. Reading is pretty good too.The only time I'm using my temporary reading glasses is when I'm reading my local newspaper on the subway during my commute. The newsprint is not white, but a greyish tone, and with not strong lighting on the subway I find I need my +1.00 reading glasses to read the paper. But in normal light I can read the paper just fine.

Night driving is signficantly better than when I had my natural lens with cataracts.With the cataracts, night time glare really bothered me (I don't no if I had starburst before, because the glare was the big problem). Now, glare isn't much of an issue much unless a oncoming car has very strong lights (high beams), and even then, it's not as bad as with cataracts.I see moderate starburst (strong with very strong lights) as per my prior post. Halo is quite mild -- exactly two halos and relatively faint.

The PanOptix and trifocals in general have a pretty stable defocus curve.But there are some distances were it's not quite as good (e.g. 100 cm).

I found a very interesting presentation from 2017 that a Calgary, Canada doctor gave on the PanOptix. In particular, the presentation shows bench badal images at different distances, and compares them to older Alcon bi-focals, as well as to FineVision and AT Lisa. The images are consist with something I read in another article about European surgeon's preferences -- a Dr. Daya really likes tri-focals, and says the only patients he think a tri-focal is not the best choice among premium lens is orchestra conductors who need to see clearly in low light at distance of 100 cm - 120 cm.... for conductors Dr. Daya suggests a EDOF or mono-focal.The bench Badal images show what he is talking about.

To find the presentation search for this phrase: "Panoptix presbyopia correcting iol thad demong"

thanks for the update

Hi Beaver:

I didn't time the steps - just can only give you my sense of how long it took, but uncomplicated cataract surgery is very quick. You might be there just over two hours in total, but a lot of that is just prep.

You arrive more than one hour before the actual surgery, so they can apply all the eye drops and give time for the pupils to fully dilate (you apply some dilating drops yourself before you leave for the clinic, but they give you many more after you arrive).

1, Laser portion, would be 5-6 minutes, including explaining what going to happen.I found the laser portion very comfortable. Actual time looking into the machine (laser maps eyes, does the incisions, and then breaks up the cataract) is very brief.... pretty sure it was less than one minute

2, 3: Extraction and implantation.You move from the laser room to the surgery room next door (so laser actually takes a few minutes longer than traditional blade due to need to change rooms). Preparation takes some time -- blood pressure and heart rate monitor, if toric lens will be used, some more measurement and markings to ensure precise placement, then "draping" face and eye. You might be in the surgery room for 30 minutes at rhe most, with a lot of that time being preparation. Actual extraction and implantation I think is less than 10 minutes.

4. Recovery room.No more than 15 minutes. I think most clinics in Toronto just use Ativan under the tongue as the only "sedation" to calm patients, and it's a very low dose pill.

5. No stitches. My understanding is that nowdays, stitches are pretty rare whether it's traditional blade or laser.

I think the time frames would be pretty similar at most clinics.

Sitting on the GO train heading to Union as I type this. Good to know someone on this forum is from Toronto that I can speak to .

Thx you for your breakdown on the the time frames. This helps a lot. Now i know what to expect.

Hi

I have a mix with edof and trifocal, my surgeon here in Denmark also made the slit lamp test, but he also made me do another test, with a pair of colored glasses and some colored images, where each eye saw different images, to see if the eyes could work together and combine the images into one.

But I guess these things are different from place to place.

Thx you. After my initial consultation, I was not comfortable with them i just want to get as much information before I go to my second consultation with the place Janus went to .

How are you doing with the mix of lenses now?

Yes, it is important to feel comfortable.

I am very happy with my vision, it is only 10 days since I got the trifocal, it is 6 weeks since I got the edof.

The trifocal is definitely the icing on the cake, and visual side effects is actually a bit less on the trifocal compared to the edof.

I am happy with the mix, two trifocals would also have worked very fine I think.

Two edof´s I would not recommend, if trifocals are an option, you simply get more in the package with trifocals.

Was the 6 weeks apart for the procedure something you decided on or recommended by the doctor? I like that there was a good deal of time in between.

The first place i went to wanted to do it back to back days. That really turned me away from them

The first place i went to wanted to do it back to back days. That really turned me away from them

I understand and we wil do it 1month apart. Still it seems it is getting more common...

Can Cataract Surgery Be Performed On Both Eyes At The Same Time?

If you have cataracts in both eyes, surgery typically is performed on one eye, and then a few days or a few weeks later, it's performed on the second eye.

This approach allows the first eye to recover and your vision in that eye to stabilize before surgery is performed on the fellow eye.

That said, modern cataract surgery is very safe and effective, and the rate of cataract complications is very low. This has led to some surgeons to begin offering simultaneous (or sequential) bilateral cataract surgery (SBCS) — in other words, cataract surgery performed on both eyes on the same day.

Cataract surgeons who support the idea of SBCS point out that a significant percentage of cataract surgeries in some European countries are performed in this fashion with excellent results and no increased rate of complications.

Also, advantages of same-day cataract surgery on both eyes include fewer office visits, faster recovery of binocular vision for driving and other critical tasks, and a quicker return to normal living.

Simultaneous bilateral cataract surgery may be particularly helpful for people with cataracts in both eyes who are very nearsighted or very farsighted. These patients sometimes are unhappy when the cataract procedures are performed on separate days because they feel visually unbalanced after the first surgery.

When their significant refractive error is corrected with an intraocular lens (IOL) in the eye with the cataract removed, these patients can no longer wear their old glasses. And if the lens for that eye is removed from their eyeglasses, they may feel woozy, have problems with depth perception or even experience double vision.

But if these patients don't wear glasses while waiting for their second cataract surgery, they basically are functioning with just one eye (the eye that underwent cataract surgery). This also disrupts depth perception and binocular vision until surgery is performed on the second eye.

Despite these advantages, many cataract surgeons are reluctant to routinely perform cataract surgery on both eyes simultaneously. The risk of eye infection and other serious complications from cataract surgery is very low. However, if both eyes were to become infected or experience other serious complications at the same time, the results could be visually devastating for a period of time and perhaps even permanently.

Also, performing cataract surgery on each eye on separate days allows the surgeon and patient to evaluate the visual outcome of the first surgery, which might influence choices made for the second surgery. For example, if a multifocal IOL or an accommodating IOL is chosen for the first eye to provide greater freedom from reading glasses after cataract surgery, should the same IOL design be used on the second eye? Or might a different type of IOL provide a better visual outcome based on the results of the first surgery?

During your pre-operative eye exam and surgical consultation, ask your eye doctor or cataract surgeon to discuss with you the pros and cons of all your cataract surgery options — including simultaneous bilateral cataract surgery — to determine the best choices for your particular needs.

I had the edof in my dominant eyes first.

The wait between the surgeries was actually because I could not make up my mind, what type of lens I should have in the non-dominant eye.

The surgeon suggested the mix I have now, but I was unsure if I maybe wanted two edof´s.

So we set a day for surgery later for the non-dominant eye, so I had some time to try out the edof, so i could decide if I wanted another edof or a trifocal in the second eye.

I could have had surgery in both eyes at the same time, and I would without any doubt have preferred that.

After surgery your brain needs to adapt, and it all starts over again when you are having the second eye done.

Also the eye drops starts over again with the second eye, and you need to take a day out of your schedule to go there, and the rest of the day are waisted resting.

So If I should do it all over again, I would have them done at the same time, it just makes everything easier.

Thx for your response. I would like to have the procedure done as soon as possible with a week or 2 rest in between, but here in Canada it takes about 5 to 6 month once your doctor submits the referral.

Hi Beaver:

I don't recall what exact tests were done during the consultation; what I do recall:

They had me fill in a written questionnaire that covers some lifestyle things, such as how important is driving at night, whether you want to potentially be free of glasses, etc. Seems simple, but makes sense to ask these questions. (Does the other place do this too?)

The tests felt similar to what an optometrist would do for any regular eye exam. E.g. there was the air-puff test to test for indication of glaucoma.

There one is where you look into a machine at an image of a hot air balloon that goes in and out of focus.Looking it up how, this measures the shape and size of your cornea (I think the optometrist has this machine too, but not 100% sure).

I think I may have been tested with about 3 different machines by the technician before the seeing the doctor for slit eye exam.

I know had an optical coherence tomography (OCT) (has been described as like an MRI of the eye) done at my one month consultation after surgery to check the retina (because doctor suspects early PCO in left eye but wanted to check the retina again just to be sure there is no other issue). I don't know if I had an OCT during consultation (because I only heard the term OCT during my one month post-surgery exam.

I don't recall having coloured glasses test like Danish_Viking (but I don' think they are generally doing mix and match here -- just two tri-focals as the standard "premium" option).

Sorry I don't recall more details. I know when my wife was considering reflective lens exchange due to having problems with her contact lens, she felt most comfortable with Boechner and ended doing regular PRK laser correction (rather than refractive lens exchange). The other places felt more salesy.

Hi Janus

The other place did that as well with the lifestyle questionnaire. What differs is that all other test and measurements were completed before the slit lamp test and then they informed you of your lens choices.

The place I went to first, did the air puff test and next the slit lamp test which he then said my eyes were healthy and gave me the choice of lenses I can choose from. After that they took me for 3 other test. I would rather he did all the test first like you had before making a determination of what lenses I can have.

I agree, the first place is salesy. I was really turned off by every aspect.

I work near Roy Thomson Hall. If you are ever around that area during lunch, give me a shout. Would love to meet and speak to you.

Thx