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
Thanks Danish and W-H. Yes, I got mixed up and was thinking Technic Eyhance which was released in some countries in Europe in Feb this year. Synergy is only just being released. Will be interesting to learn more about this new lens.
janus381
Posted
Just had YAG Laser to get rid of PCO in Left Eye
So I had the YAG Laser Capsulotomy done late yesterday afternoon to get rid of the Posterior Capsule Opacification in my left eye. Procedure is quick and easy. And have noticed a big improvement today.
Brief summary of time line:
At the three follow-ups where PCO was suspected, doctor also had me do an OCT retinal scan just to make sure there is nothing else going on, and retinal looked good.
The YAG laser procedure is very simple. I watched a you-tube video on the prodecure about 20 minutes before mine was done, and my procedure was the same:
You are told you might see floaters for a few days. If I look for them, I think I see one or two at the most.
As the PCO progressed, I was starting to find reading on the subway in low light not quite as easy. Today, vision reading newspapers on the subway is very clear again.
kwilson2019 janus381
Posted
Inquiring to monofocal lens people.
Are you having glare, star burst, side cresent glare issues?
What is the distance that clear vision starts, 4ft, 6ft, 8ft?
I am day 7 with a Panoptics lens in Right eye and disappointed with the amount if glare. I understand there was some to be expected. I do see a couple of rings, some star burst and a glow that is tolerable, these are rather close to the lights. The clarity of vision starts about 16 inches from face and very good from there on out. But the 'side crescent' glare and an angled star burst streak that covers entire vision is not going to be tolerable. Physician claims 'the brain will adjust and compensate in time. I just don't buy that. And the 'just get used to it' Is dangerous. Inside, lights to either side creates a crescent glare just off center of vision making me wipe, brush my eye as if there's fuzz or something on my eye. If there's a light on both sides I get the off center crescent glare and a blurry blob of glare in the center of vision. Forcing to look away to see. Night driving is compromised. Head lights of oncoming vehicles, Street lights, the angled Star burst streak covers the entire road and cant see if there's a person, animal or objects in the road. So I am considering to swap for a monofocal in right eye and a monofocal for left eye. Left eye has no IOL implant as of yet.
Sue.An2 kwilson2019
Posted
Day 7 is really early. The brain dies adjust and the side flicker/glare does go away may take a few months. Right now the light catches the square edge of IOL. I had none of that for first lens implant but did have it after 2nd. It did go away. I think the edge either gets opaque with time or is shrink wrapped as time goes by.
Let some time go by before making the decision to exchange . An exchange can be done even if a few months go by and by then you will have had time to heal and see if there has been improvement.
soks kwilson2019
Posted
hi kwilson, thanks for sharing. is the side crescent glare always there? is this a flicker or an arc? is the angled starburst in the direction of the cescent? and is this only a night time problem?
on positive side near vision as 16 inches is great and so is seeing just 2 circles. u also dont have any gaps in vision. good luck!
Guest kwilson2019
Posted
Hi
I am sorry you have these problems, it must be really tough.
Your eye is far from healed, you really don´t know what you will get yet. And frankly, I am not sure all the disturbing problems your are mentioning are caused because it is a trifocal lens, as I understand it the side crescent issues are often caused because of the backside of the iol, and the backside are not different between trifocals and monofocals.
The side crescent issues started to come when the manufacturers started to make a sharp edge on the backside to prevent/delay pco.
Cataracts surgery is an emotional roller coaster, right now I can hear you are in the bottom of the loop, and I really hope you let more time pass, and let things settle.
Healing of the eye takes about 6 weeks if there are no complications, and before eye is healed and you are off the eye drops, you really don´t know what you got.
Dry eye can really make a mess as well, I was instructed to use plenty of artificial tears, and this can too play a part in visual side effects.
Right now you are in the healing phase, I know it is easy for me to say, but you really need to be patient and wait till your eye is healed, before you decide on anything like an iol exchange.
tamarinda kwilson2019
Posted
Hi Kwilson, I'm sorry you are having this trouble.
day 7 is early, I agree with others.
I have a Tecnis bifocal in one eye, had horrible halos and ghost images. Just got B&L monofocal in other eye 9 days ago. It makes me very happy.
The monofocal was aimed for +0.25 but on day 7 was at -0.5. So I am getting a smidge more intermediate vision with it. I.can see dashboard clearly, and my cell phone blurry but enough to type if need be.
I have a small wrinkle in the capsule which will go away as it heals fully (it is already improving) that creates a small Rod Maddox effect. I have had a few brief episodes of shaking/tremor on the left side that I guess are the healing/melding process.
There is some haze around some lights but nothing as bad as the multifocal eye. I have asked friends who do not have cataracts and they admit there is a small colored haze around stoplights too. We often forget that natural eyes have artifacts as well.
Headlights have some starburst with both eyes, worse with the bifocal. Monofocal has no ghosting or halos.
I too am deciding whether to exchange the multifocal: it will be at 8-10 months if I do it, because the highly specialized surgeon is so booked they gave me an appointment four months from when I called. I'll have two months with this monofocal/bifocal combo before having to decide on the exchange. (BTW, my bifocal settled at +.025 and I have clearest near vision at 17".)
Give it time, keep your mind open to anything's possible, and wait and see. (thats my favorite phrase now!) You may end up exchanging but you don't want to decide that yet because that's complicated surgery. At least a few months of trial is what most ophthos suggest.
As others have said, this is an emotional process!! You're not alone in that.
ayeaye kwilson2019
Posted
hello..are your night vision difficulties more with the panoptix than if when you close the iol eye and only use your natural unoperated eye?
kwilson2019 ayeaye
Posted
makes no difference, 6-8 very long star burst streaks with multiple short ones with left eye closed or open. Physicians says give it more time and or wants to do a YAG procedure, which I'm not excited about. Have read from others may not help my condition. Only to make it even more difficult to do a swap later.
kwilson2019 janus381
Posted
Day 11 thanks to all for sharing.
I'm not in a panic just yet simply trying to decide whether to postpone left eye. If I can get arms length vision, intermediate, and distance with a monofocal without star burst I may just go that route for left eye and swap right eye from Panoptic to a monofocal also later.
answer to soks... the crescent is associated to bright light to the side of my vision. If light is on my left there is a half small star burst in let side of vision and a faint crescent on the right side of my vision if looking straight forward. If light is on my right the half star burst will be on right side of vision and crescent on left side of vision. If there are lights on both sides there is the small half star burst on both sides of vision and a faint blob of hazy glare in middle of vision, turning my head or looking a different direction glare goes away. It only occurs at a particular angle of the light and direction looking. Not a severe effect but enough to make me double blink, wipe my eye as if fuzz on eye lashes. Mostly when indoors, low light, lamp on table, bright light from a window, bright scenes on television. I havn't ventured into town after dark yet to see what 'city' lights will be like.
stepping outside after dark looking at porch lights, my vehicle lights is about the only night time effects i have viewed. No night driving traffic yet. The 'Maddox Rod' angled cross way burst streak is no longer there. Now I see more of the star burst effect, 7-8 rather lengthy rays, as I stand in front of my vehicle at 50 ft, rays reach approximately 8 ft from head lights. F/22 in image below...
what are others seeing after what length of time?
I hope these will subside. There are the 2-4 rings but very tight, close to head light, almost not even noticeable. I have had very faint star burst ever since wearing contacts. So some star burst is understandable but this is quite a bit, may effect night driving, especially if both eyes are effected.
janus381 kwilson2019
Posted
I was away on vacation, so only reading your posts now. Sorry you're having issues (with side glare).
I don't have a side cresent glare, so I can't comment. I know others who have side glare have posted it is related to size of pupil vs size of IOL.
But on your earlier comment "just get used to it" is dangerous; I would say give it time. Neural adaption is not "just getting used to it" -- it is a process where the brain learns to filter out the new images it is receiving and filters out the noise. I referenced some good article on neuro adaption in an earlier post. Look up the article "Understanding of neural adaptation may lead to better vision correction" for a good explanation.
Here's part of the article:
"In several multifocal lens studies that have been done for Food and Drug Administration approval, the patient satisfaction level is much better at the end of 1 year than it is a few weeks after the implantation, even though there has been no optical change during this period,” Dr. Holladay said. “That is, complaints of halos, glare and dysphotopsia are common in the early postop period, within a few weeks of the operation, and yet by the end of the year, 99% of patients with a multifocal IOL, which clearly reduces contrast sensitivity and provides halos and glare, are extremely happy with their vision and have adapted to the induced aberrations.”
The same process of long-term neural adaptation can be seen in patients who become accustomed over the course of several months to aberrations induced by excimer laser surgery
I would suggest give it some more time. Unfortunately, articles say it can take as long as one year to neural adapt, which is a very long time to wait and see. And not all issues will be resolved with adaption. If you can, yes delay the cataract surgery on your other eye for a few months to see if you adapt.
Guest kwilson2019
Posted
Hi
Just saw this post, because of Janus´ response.
It is difficult to explain these visual side effects, but I will give it a try.
It is about 4 month since my surgeries, and I have edof in one eye and trifocal in the other eye.
The edof have always been much worse than the trifocal, but I would say where edof makes f/22 the trifocal makes f/6.3
Within the last weeks, i guess about 3 weeks, side effects have become much less.
Edof have always made big starburst, but these are very transparent now, almost hard to see.
Edof and trifocal both makes some concentric rings around bright LED lights, but edof rings are about 3-4 times larger than the rings from the trifocal.
So I am a big fan of the trifocal, and not so much fan of edof, even that I am quite happy with my combined vision.
I have some crescent shadows in both eyes, at first I noticed it a lot, now I don´t think of it any longer. But If I look for it when light is coming from the side it is still there, but I have to look for it, to see it.
When I am out in the dark, sometimes if light is hitting from the side on the trifocal eye, there are some sort of half circle of light from top to bottom, but it disappears when I looks straight at the light.
In general I feel I have very good vision in the dark, with only a little bit of street lights I can see the road and stuff quite well, and I have no problems at all driving at night, I got a lot more blinded by the lights when I had cataracts.
hil_jac janus381
Edited
Thank you SO much for this info and sharing your experience. It has been most helpful! My surgery for my left eye is this coming Monday. Two of my biggest fears is the being able to drive at night and then, even more of a fear, not doing well with neuroadaptation. My doc says it will work better with the lenses in both eyes. However, the cataract in my right eye is not bad enough yet, and I will need a break between surgeries to save $$! I am praying this lens will do well and not cause me issues like more migraines! I feel like my increase in migraines are partly due to this cataract. So, if i can alleviate some if those, I will be so grateful. Again, thank you for all your posts You have helped ease my anxiety some!
janus381 hil_jac
Edited
Good luck with your surgery.
ayeaye janus381
Posted
thank you so much..the support is very uplifting!!🙂