Cataract Surgery - Panoptix Toric in both eyes - My Experience
Posted , 20 users are following.
I have been reading many of the posts on here and decided to add my experience with my cataract surgery that has recently been done. The info I read pre-procedure was very helpful so I want to share my specifics too.
First, some basic background. I am 55. I noticed my vision getting gradually worse for the last 5-6 years. Most of it has been everything looking smokey and foggy/cloudy, especially inside when looking up towards the ceilings and the lights. No glasses but for readers for books and computer work. Night driving was getting really bad with the glare from the scattering of the light due to the lens clouding up. It was almost light driving in a white out snowstorm at times, especially with these ultra-bright headlights people seem to think they need, but only blind everyone else. Anyway, to each their own...
I got my eyes examined and they confirmed the cataracts in both eyes. Right was worse than left, but both were bad. In the glare test, it looking like I was looking through dense cobwebs and everything got washed out such that I could not hardly even see the chart on the wall. It was definitely time to get something done.
I decided to go with the Panoptix Toriq IOLs for both eyes. I am still "relatively" young and wanted to be as free from needing glasses as possible. I only used readers, so didn't like the option of requiring glasses all the time, and the trifocals seemed to offer a lot of benefits. I scheduled the surgeries 1 week apart, starting with the left eye.
I won't go in to the pre-op stuff, as I am a big whimp when it comes to people messing with my eyes. I will say that I should NOT have watched all of the Youtube video showing the procedure as all it did was freaked me out, and I am a pretty level headed guy... Procedures went well. I had the laser assisted procedure, and the Versed did it's job well so I remember very little.
Healing has been non-problematic. I have followed all of the instructions for using the eye shield for 1 week after each eye procedure, and application of the eye drops per orders. I am now 2 weeks out from the right eye and 1 week out from the left eye.
Vision in both eyes is INCREDIBLE at all distances from about 10" to infinity. I do have moments of blurryness, but the doctor told me that is to be expected. The biggest thing for me was colors, and more specifically WHITE. Before the surgery, all whites looked off-white. When I opened my right eye after remioing the dressing from the first surgery, even though everything was milky and cloudy the whites really popped. I had to do the cover one then the other to take in the difference. I thought that was really interested.
Both eyes are now mostly clear. 95% non-blurry with short little stints of slight blurriness, mostly right after waking up and just for just a few minutes. All colors are much more vivid now across the board. I can see perfectly at all distances. I work A LOT on the computer all day, and no longer need any glasses at all.
Now for the down side. The concentric circles of light around each light source is currently TERRIBLE. It is the Christmas season, and every little light on the Christmas tree is surrounds by 3-5 concentric circles. Go outside at night, bright stars, street lamps, overhead airplanes; anything with a defined central light source has the rings. Now, picture that in your mind, now put yourself behind the wheel of a car with a string of opposing rush hour traffic vehicles and all of the headlights, with each headlight with those concentric rings of lights. For me, it is terrible. There is no better way for me to describe it. I knew from my pre-op research and lens selection that there was chance for this, but read that the halos were minimal; but wholly buckets... I brought this up to my surgeon and he confirmed that it was not uncommon, but that it should progresssively improve. Like I said before, I am only 1 & 2 weeks out from the implantation of the lenses, so I am hoping for the best.
Bottom line : Vision is now great, as I can see pretty much at all distances. The rings of light stink. If I were asked the marketing question "Would you do these Panoptix lenses again?", with the assumption that the rings of light will not go away, I would have to say definitely not as it is that bad. Ask me again in 1/3/6/12/24 months, and if things have improved as my surgeon says that they may, my answer may change.
Definitely take my comments of regret with a grain of salt given the short time that has elapsed. I am hoping for better results longterm, but I just do not understand how the brain can "adjust" for this... Someone explained it to me like the frames of glasses. After you wear glasses for awhile, your brain tunes out the frames and you do not notice them. That I totally understand as they are always in the same place. But with the circles, they are always moving in relationship to the light sources, so not sure ow the brain can adapt to that, when the rings are being introduced by the edges present on the trifocal IOLs. Hopefully I am missing something and things will improve in this area, as I really want to love these things.
I hope that this helps others. I will try and update as I have more time with the lenses and report on if things are improving for the rings of light.
1 like, 29 replies
Boston_Oat Joe_M
Edited
Joe - here's my weird eye experience. I wasn't a good candidate for trifocals, so I had monofocals implanted in both eyes. One is a Tecnis 1 piece and the other is a Acrysoft 3 piece (which i had to get as it was implanted in front of my capsular bag due to a tear in my bag).
I got the Acrysoft in first and my main negative was big lens flares from lights at night (different lens design, the glare presents as a flare, not concentric rings). I got my LE done a month after my RE and during that month the glares were pretty bad - i had the lens flares in my RE and the smeary haziness around lights in my LE with my cataract.
And then I had my LE done and got the Tecnis implanted. And know what, the lens flares in my RE have basically gone away. They're still there, but minimized and since I have no lens flares from my LE (different lens design), my brain basically cancels them out.
So I'd say give it time. If you're only 2 weeks post-op, wait for 4 weeks, maybe longer.
Give it long enough and Danish and the others with multifocals will chime in with their experience
Joe_M Boston_Oat
Posted
Well i can only hope and pray that my little brain can have the same kind of long-term adaptation. i know it is early in the process and i need to let things heal and get used to the new normal, but it has been disappointing given the level of just how bad the rings are, yet how good the "normal" vision is. Thanks for your insight and experience. i appreciate it for sure.
Mirko00758 Joe_M
Posted
Hi Joe, I'm really sorry for your disonfort.
Now should be almost 3 weeks after your second eye surgery. Are you sides effect improves or you still have the same problems?
I'm about to make the same surgery.
In my case no cataract but a strong hyperopia and astigmatism... My choice should be for a At Lisa but this sides effects are really worried me moslty because I need to drive back home during night when I come back home from work.
Joe_M Mirko00758
Edited
Mirk -
Yes, I am about 6 weeks RE and 5 weeks LE post-op. Went for my 1 month check and they said all was doing well and saw no issues at all.
I have not had any healing problems at all. Really no pain, just a few days of scratchy discomfort like I had a little piece of dirt in there. Dr said that is from the incision and totally normal and it would subside which it did in 2 days after each procedure. My vision is 20/20 & 20/25 in RE & LE respectively, so zero complaints there. Colors are awesome. I am not noticing any contrast issues, but not really sure I understand how that presents itself other than trying to read in low light and it being hard to make out the letters. Trifocals give me great vision at all distances, with no need for glasses at all.
The jagged concentric rings around light sources, mostly at night are still there and have not subsided at all yet. I do also see them in the daytime on things like sun glinting off a chrome bumper, where there is a strong point source of light, but luckily it is not causing issues. Just the night time lights for me, any light that is maybe 40 feet or more away. Driving in heavy traffic presents the biggest challenge, but not like what I had before surgery with whiteouts. I live in the country and all of the yard lights and radio tower lights on the horizon all have the rings of whatever color the light is; even planes flying over. I notice that the moon just has a smear of light around it, what I think others have called the halo effect, but for me not the distinct clearly visible jagged rings like around lights. LED lights are the worst for me, as those bulbs usually have multiple individual small LED elements, and I get the rings off of each one such that the rings are a muttled mess.
So all in all, it is going as expected. Given what I had pre-op with night time driving total whiteouts with heavy oncoming traffic, I will say that yes it has improved, even with the rings as I do not "lose" view of the oncoming vehicles as I did before. But the rings are really annoying. Hoping that they improve and become less noticeable as I heal, but I know it is all about how the lens is aligning in the eye and can change over time as it seats in to its resting spot. And also the brain has to get use to the new normal and do its part to help minimize the effect.
If I had it to do over again knowing what I know now, I would still pick these lenses as the improvement in vision is amazing. I am 95% satisfied. The rings are very annoying, but I will manage them given the alternative of getting nothing done, or almost as bad would have been to pick the monofocal and still have to wear glasses.
I hope that this helps. I am no expert by any means. This is just my experience. Good luck!!
Guest Joe_M
Edited
Hi
Sorry you are dealing with these problems.
I have a mix, with edof and trifocal, in my case the trifocal is by far the lens with fewest side effects.
It is about 5 month since I had surgeries, and side effects do change, actually it started to change rather suddenly for about one month ago.
I feel I have good night vision, I still think about how well I see every time I drive at night, but that said, I am probably easy to please, I have had cataracts first 45 years of my life.
Neuroadaptation and the brain "getting used to" is very real, and it is not that strange when it comes down to it.
It is similar to all new things we need to learn, just as when we learned to ride a bicycle, this is not an ability we are born with even that it looks very simple, it takes time for the brain to adapt and to learn to stay upright on the bike.
With new lenses in the eyes, the brain needs to learn how to use the new lenses and process the images that gets displayed onto the retinas, and it takes time, for some it can take quite long time.
Hang in there, you are right now in a phase, where you question your choice, and thinking what you might could have had instead, I think most of us have been there, I was in that phase right after surgery too, it is a phase you need to get through.
I have heard from others, that the change/adaptation came, when they stopped thinking about it, and maybe that have some truth to it.
Joe_M Guest
Posted
Thanks Danish for your reply. Yes, i hope things progress well over time I know it isn't fair to judge the outcome when the game of healing and adaptation is just starting. It is just the level of how bad this is that has me down. vision is great, and dont want to lose that, but cant wrap my technically focused logical mind around how my brain will be able to adapt so as to not notice the rings anymore. I guess time will tell. Thanks again! Merry Christmas!!
mike_tremblay Guest
Posted
Thank you for sharing your experience. I needed to read this. I am 3 weeks post-op. I have the announced halos. I also have shadows on the temporal sides of my eyes. As if I was wearing blinds. I have been told it would disappear within 6 months with brain adaptation. Nice to read that it is usually true.
Guest mike_tremblay
Posted
Your welcome.
I also had the shadows both sides, first weeks I noticed it all the time, but now I frankly don´t see it any more. If I really look for it, I can still see it is there, but I really don´t notice it or think about it any more.
mike_tremblay Guest
Posted
Hi, Danish_Viking. One month post surgery now and I still see the temporal shadows, particularly during near reading. I know now that I shall wait between 3 to 6 months for brain adaptation. I understand you had that condition and it disappeared rather drastically 4 months after surgery. Since our last discussion - and thanks again for helping my mental anxiety - I read elsewhere on this site that I could do eyes exercise to favor brain adaptation. I also read that brain adaptation requires not to focus on the condition. In other words, to stop thinking about it. These are two conflicting advices. What do you think? I want to have the best behavior to favor brain adaptation. I wish to put chances on my side to avoid additional surgery to address this problem.
Guest mike_tremblay
Edited
Hi
I have seen that eye exercise stuff as well, but I have also seen studies that does not conclude these exercises have any effect.
In my opinion, the best thing to do is to move mental focus on other stuff than the eyes.
I know it is really difficult, the time before my surgeries, and for a couple of month after surgeries, I was almost obsessed, I thought about my vision all the time, I questioned my choice, and there really was not a minute, where I did not think about my eyes.
Now I find myself forgetting all about my vision for hours, when I am doing other stuff, sometimes I still think how amazing it is, that I can see all these things I could not see before, but a lot of the time, I just don´t think about my vision any more.
About the temporal shadows, now that I read you post and therefore look for them, they are still there, but I don´t ever think about them during the day.
If you think of it, we can also see our own nose, if we look for it, but we don´t go around thinking about it on a daily basis, and to have the nose removed because it is in the field of vision would be quite dramatic 😃
And I feel sort of the same way about the temporal shadows, if I look for them they are there, but I don´t see them, if I don´t look for them, and I don´t see my nose either, unless I look for it.
mike_tremblay Guest
Edited
"I was almost obsessed, I thought about my vision all the time, I questioned my choice, and there really was not a minute, where I did not think about my eyes."
Your experience described perfectly my current state of mind. I guess my challenge is to let it go and to praise my new vision without spectacles. For all visitors on this site looking for answers to their worries, I want to thank you one last time for your involvement here. Now, I have to quit reading this site for a while 
Sue.An2 Joe_M
Posted
Hi Joe - I have EDOF symfony lenses both eyes for little over 2 years. It will take several months for some of those visual disturbances to subside. I thought the trifocals would have less than the EDOF lenses but it really caries person to person. I do not see those concentric circles with inside lights as the light sources needs to be about 50 yards away and they appear at dusk and night. IE red traffic lights have these but as car gets closer they disappear.
Give it some time as it may improve. Don't have a yag if you develop pco as lens exchange not possible or very difficult to do. But I encourage you to hang in there as the brain does adapt and these subside with time.
Joe_M Sue.An2
Posted
Hey Sue -
Thanks for the feedback. Yes, everything I read pre-op with regard to the lens selection said that the Panoptix had a lower potential for the halos/rings. That was why I selected those particular ones.
As for my rings. I see them inside or outside, day or night. Take daytime driving, I will see the rings from where the sun is bouncing off chrome trim on an oncoming car. It is not difficult to handle in the daytime as there are fewer light sources that cause this to happen. At night, all bets are off. They really do not go away as things get closer, but rather the rings shrink their diameter to being closer to the light source, but I can still see them. It is when there are 20, 30, 40 or more varied colored lights in my FOV at various distances, each causing the rings of varied diameters (not a single ring, but 3-5 per light) based on the distance away, and it gets to a point that I cannot really even tell where the cars are, like the tail lights of the cars in front of me. In these cases, the scene is so muddled that my depth perception is impacted such that I am not confident where the car in front of me is any longer.
I am just hoping that it will improve over time as my brain retrains itself. Till then, I will just have to try and avoid night driving in heavy traffic so as not to be a hazard to others out on the road.
leonora53150 Sue.An2
Posted
Hi again Joe, Sue.An2 is right please don't have any YAG procedures done, until you know for sure it's the right thing. My starbursts did not clear 5 years now and 53 I just found out by the 10th doctor that my condition is caused from the square edge of the toric lens they used for me has caused positive dysphotopsia , my only solution would have been a lens exchange, however after the doctor performed Yag capsulotomy, sadly it wasn't an option .
good luck
L
Joe_M leonora53150
Posted
Hey again Leonora !
So why does the use of the YAG in performing a capsulotomy impact this? I have not had any issues so far (all 2 weeks.... 😉 ) with re-clouding due to this encapsulation. I am not understanding how the YAG procedure impacts potential lens replacement. Sorry if I am missing something obvious, but I can be a bit thick at time... 😉. Have a great day!!
Guest Joe_M
Posted
Hi
When the surgeon implant the lens, he is making a small hole in the front part of the capsular bag, but he leaves the back part of the capsular intact, to keep the vitreous gel in place within the eye, he does not want the vitreous to get inside the capsular.
When treating pco with laser, the surgeon makes a small hole in the backside of the capsular as well, to let the light get through. At this point, the lens have settled in, and the tissue around the lens makes a "seal" so the vitreous stays in place.
When doing a lens replacement with the yag hole in the backside of the capsular, there is a risk of getting in trouble with the vitreous.
Joe_M Guest
Posted
Ahh! Makes sense. I have not done any research on that and hope it is not an occurrence I have to deal with. Thanks for the clear explanation. Have a great day!!