Cataract Surgery Just Completed - Sharing My Experience - PanOptix Tri-focal
Posted , 30 users are following.
I was a lurker for awhile before I registered and started posting.Just had my cataract surgery done (Right eye one week ago, and Left eye yesterday).
Thought I'd share my experience. To avoid wall of text, I’ll break it up into separate posts (which won’t all come today). Areas I'll cover include:
- Background
- Choice of IOL
- Laser vs Traditional Surgery
- Surgery Experience
- Post Surgery Experience
- Follow-up with occasion longer term updates
10 likes, 103 replies
janus381
Posted
TWO MONTH POST_SURGERY UPDATE
Experience so far has been distance vision was excellent day after surgery. Intermediate range steadily improved over a few days to one week after surgery. Last to improve was near-reading distance, but that too improved so that first I could read newspapers except in low light, and then around the one month mark, I could read newspapers on the subway. I'm not using temporary reading glasses at all now -- tough some extremely small print, I have some trouble with.
I had started a separate topic on early posterior capsule opacification (PCO), as in my one-month follow-up appointment, I was surprised my left eye vision was very blurry (I hadn't noticed this using both eyes). Doctor suspected early PCO, and wanted to see me again in another month.
Just had another follow-up yesterday, ten weeks after the surgery on the second left eye.And early PCO confirmed. Doctor can see the PCO now when looking into the eye.Since it's been over 2 months since cataract surgery, doing YAG now would generally be considered safe. However, waiting a little longer is safer as there is small risk that YAG done too early (before the IOL has fully seated) could cause rotation in the IOL. So doctor suggested I come back to see her in another month to see how things develop. I will likely have YAG laser done at the time of my next appointment (which will be 15 weeks after cataract surgery).
soks janus381
Posted
thanks for the update.
Sue.An2 janus381
Posted
I am experiencing something very similar. It is only when I close my right eye that I notice how blurry LE vision is. With both open RE must take over as I see fine. IT's been just over 2 years since my surgeries. Will need a doctor to confirm if it's PCO.
marc92577 janus381
Posted
Hi Janus,
First of all a big thanks to you and @Danish_Viking for the detailed way in which you are sharing your knowledge and experience. In less than a month I will undergo cataract surgery.
The ophthalmologist and surgeon noticed my cataract has worsened since my check-up last year and suggest to no longer wait.
Last year I did a lot of study about the different IOLs and after discussion with the ophthalmologist they suggested 2 options:
1st option was mix & match Zeiss Lara + Lisa such as Danish_Viking had done
2nd option was bilateral Alcon AcrySof IQ PanOptix
3rd option was bilateral Zeiss AT Lisa Trifocal
This year they said that in their experience in Australia patients that had bilateral trifocals (as 2, 3 above) were more satisfied with the results, especially for reading and intermediate vision acuity.
How is your vision now? Making further progress?
I am struggling a little to chose between option 2 and 3.
Below there are 3 defocus curve comparisons for different light/contrast conditions. In good light conditions VA seems to be better for Panoptix between 40cm and about 80cm.
In good light condition AT Lisa seems to perform better at very near vision 30 to 40cm and at more then 80cm but that advantage seems to fade away when less light 50% and lower contrast curves.
Sitting many times in front of a computer Panoptix seems to be an attractive option. Correct?
Panoptix has better light transmittance and Panoptix patients seem to have less issues with Halo and Glare.
With regards to the Blue Light filter of the Panoptix I have searched like crazy to find if that influences color perception but can't find any data. Plenty of studies and articles discuss the benefit or non-benefit of filtering blue light but no info about how patients perceive color before vs after surgery.
Do you perceive clear difference in color perception before and after Panoptix?
janus381 marc92577
Posted
I can't comment on EDOF vs tri-focal, but Danish_Viking's many posts give you a great idea of how he went along his journey and what he thinks of tri-focal vs EDOF.He has mix and match of EDOF and tri-focal. He is very happy with the results, but with one in each eye, he likes tri-focal better.
W-H also has done tons of research, and while his wife went with the more conservative route of mini-mono-vision, the doctor he found must knowledgeable used to promote EDOF, but now advise either mini-monovision or trifocals.My clinic used to use EDOF 2+ years ago, but only uses tri-focal as the premium option now -- and I believe this is case for most/all clinic in Toronto.
Based on this, I would suggest two tri-focals. As to AT LISA or PanOptix, I think big picture the results will be similar.PanOptix has an intermediate focal point that Alcon believes is more suitable for modern life (at computer monitor distance). But I don't think you will get dramatically different results.I found good PDF presentation that shows some sample badal images (one eye only, so does not reflect added benefit from binocular summation when using both eyes) comparing PanOptix to other premium lens. Search for "panoptix presbyopia correcting iol thad demong" to find the presentation. While the presentation is prepared by Alcon (possible bias), it is very imformative.
My vision improved over one month, and I'm very happy with my vision one month after surgery. As per my last post, doctor suspected early PCO in left eye when I saw her just over one month after surgery. The PCO seems to be building (confirmed at 2 month check), so progress has stopped, and glare with PCO is a little worse now than in the first month. But that's due to PCO, not the lens itself. My surgeon will see me again in couple of weeks, at which time I will likely be getting YAG to clear the PCO.
I mentioned color in one my early posts. In the week between my two eye surgeries, I compared color in the right eye with PanOptix and the left eye with natural lens with cataracts. I did not notice any difference in color, with one exception being when I looked at my wood deck (stained pressure treated wood), the wood had more of a yellowish tinge when looking at it with my unoperated eye.
There have been a couple of other people posting their experience with PanOptix now. And if I recall correctly, I think they are also seeing exactly two faint rings around lights at night (same as me) -- so not too bad.
W-H janus381
Posted
I back what Janus is saying.
Get either 2 trifocals or do mini monovision. My wife's far eye will be done is 12 days time so the jury is still out on the absolute final verdict from our side... but it looks very promising so far.
Regarding EDOF, my surgeon said that his data just did not back the marketing. He was taken in initially but then realized that he was getting similar or better results with mini monovison and without the side effects. This surgeon does 1000+ OPs a year and has been in the field long time.
Another surgeon who is highly experienced looked deep in my eyes and then in my wife's eye and said DON'T DO EDOF! lol He was even against Trifocals actually. He is younger than the surgeon we went with but also VERY experienced.
Out surgeon said that in general don't pick your IOL based on PCO fears. Applies even more if you are younger patient as YAG will DEFINITELY be needed!!! If you need in 1 month, 3 months or 6 months.....it will come!
If I had to choose between Zeiss At Lisa and PanOptix, I would go with Zeiss. Although what is available will trump by subjective views.
My reasoning-
Deb03 marc92577
Posted
I can give my experience with regard to color perception. When I had a blue-light filter monofocal Alcon IOL implanted, I did not notice a difference in color between my Alcon lens and my natural lens. I now have a non blue-light filter B&L silicone IOL in my other eye, and I can tell a difference in color. The biggest difference is that whites appear whiter.
marc92577 janus381
Posted
marc92577 janus381
Posted
Thanks janus381, W-H and Deb03!
I'll get one more 2nd advice from a different surgeon who works with the Panoptix and the Zeiss Trifocal Lisa to come to a decision.
Will let you know how it goes!
marc92577 janus381
Posted
After speaking with a specialist I was guided to the new Tecnis Synergy as an alternative for Panoptix.
He was happily surprised with the results obtained with his patients but couldn't really share the detailed results due to privacy.
Here is some extract of what I found:
soks marc92577
Posted
thanks for sharing marc.
janus381 marc92577
Posted
Thanks for update.I posted about the Tecnis Synergy a bit too. Will be very interesting to see the experience with this lens, as it is a mono-focal that provides extended range of good vision.
It's not approved in Canada or the US yet. Europe was the first launch.
It could become the dominant lens choice for mono-focal.
Will this cannibalize sales of Tecnis Symfony (if it provides similar range of good vision with less potential for issues like starburst, halos, glare).
Will tri-focals still provide better near vision (presumably yes, but with potential trade-offs).
Guest janus381
Posted
Maybe you mean Eyhance?
W-H janus381
Posted
Synergy is the new and first trifocal from J&J.
janus381 marc92577
Posted
Replied in wrong spot. But thanks Danish and W-H. I was getting mixed up with Tecnis Eyhance. This Synergy lens is even newer, and will be interesting to learn more about it.