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
tamarinda Joe_M
Posted
I totally feel your pain and frustration. I had/have it too, from a Tecnis multifocal lens. First eye was so bad with halos and ghost images that I held off on second eye, and months later got a monofocal in the second eye.
The monofocal cancels out a lot of the effects, but not all. I am still deciding whether to exchange the first eye to another monofocal. That said, this setup does give me excellent detail, as you describe, and bilateral summation that gives a richness to thw depth of field.
I can say that just after seeing the first potential exchange surgeon -- who gave me a very cautious picture of the chances for an improved outcome: so cautious that if he were the only one, I wouldnt do the exchange -- well, after seeing him and crying for a day with disappointed frustration, I knew I just had to settle in and start being grateful for what I had instead of seeing the defects and saying, "See?! This is horrible!!" And whadya know, I think the darn things started to shrink.
In another week, I had an appointment with my original surgeon and we re-analyzed my case..and I felt myself craving something better again. And the defects have increased again.
So apparently attitude makes a difference, really.
I can say that even when I do see them, they don't startle me as much as they used to. Maybe that's just resignation but again, when I relax, the gratitude starts flowing. I can see detail at al distances (up to 17" near) better then most all of my friend without cataracts. I may choose to stay with this for the precise clarity, and put up with some halos and ghosting. And I'm hoping that once the deciding is finished, I find things shrinking from neuroadaptation.
Joe_M tamarinda
Posted
Hey Tamarinda -
I wonder if my decision to have both eyes done so close together was a wise choice, but it is too late now to second guess that part of the equation.
As for attitude, yes, I am sure that it does make a difference. The brain is an amazing thing, and always surprises me in what it can do. I just have to get out of my technical analysis of what is going on from a lens perspective and just deal with it for awhile as my brain comes to terms with it.
I know I am griping here about it, but I really do not sit around and think about it that much. My sole desire to write up my experience was for the benefit of others to know what may be to come in their cataract journey. Things I read said that this could happen, so I came in to this eyes wide open knowing there was a chance. I just held the thought that i would not be in the 10-15%... And I still may not be in the 10-15%. It is only 2 weeks out for my first eye and 1 week for the second, so I need to allow the time for adaptation. Let things do their thing for the next weeks/months/year and reassess then.
Thanks so much!! Have a great day!!
leonora53150 Joe_M
Posted
Hi Joe, I'm sorry your going through this , Your whole story is so similar to my story especially before the surgery . the one big difference is I see starburst not the halos.
I have a really strange question for you . Did you have any major dental work done before the surgery?
L
tamarinda leonora53150
Posted
Ok now I'm curious! Plee explain.
Joe_M leonora53150
Posted
Hey Leonora -
No, I did not have any dental work other than a bi-annual cleaning back in early October. Why, do you have a potential connection between these visual issues after cataract surgery and dental work?
DBS-KB Joe_M
Edited
Hi, I'm Kim.
I was diagnosed with ALS a few years back. As you might know, this terminal illness carries with it the potential to not have the use of anything but your eyes. Eye gaze software doesn't work with progressive lens glasses so I elected to get both eyes done with Panoptix Toric lenses. I had very minimal cataracts at age 64 and had prior lasik surgery in 2001 that regressed. During the past year or so my eyes got worse so, therefore, I decided to have the lens implants before I could no longer walk.
The right eye was done last Monday. It still feels irritated and it also feels like the lens is moving. The doctor said it was good the following day and said some people notice the slight moving but most do not. He gave me a thorough exam and I was seeing better out of my new lens than the other eye. He said it was about 20/40 and said it would definitely improve with distance coming first, mid-range coming next and finally up close. The mid-range is definitely better and today my reading also improved.
My left eye is scheduled a week from Monday but I might wait until the right heals more and I'm done with the drops.
I didn't take Versed because I had a reaction to it years ago. I took 10 mg. of Valium two hours before the surgery. It was not pleasant and took much longer than 10-15 minutes he said it would.
I tried popping my lens out of my glasses but it seems best to just not wear them. I am having some eye strain but nothing I can't tolerate.
The whole process wore me out.
I'm going to follow this thread. I had it done with a laser and there's no going back so I hope my eyes feel more comfortable as time goes on.
Joe_M DBS-KB
Posted
Hey Kim -
Yes, sounds like your first surgery was the day before my second. Many of your comments sound similar to the things that I have experienced. For the first few days, it almost felt like I had some dirt in the outer corners of my eyes, but Dr said that is where the incision was done. I got the laser assisted process too. I had Versed, and funny I can't take Valium as it makes me get VERY mean (had it during a procedure years ago). Funny how different people can be on things they can tolerate. Dr said we had quite the conversation in the operating room, of which I remember none. All the nurses came in during the day after follow ups and were still laughing about it. I was glad I was entertaining...!! 😉
It was hard during the week between eye 1 and eye 2, as my eyes seemed to be fighting each other. I had the same eye strain and headaches, but once the second eye was done, I have had no more headaches.
I do get the shadows on the outside of my vision. It is manageable. Also get some very sporadic flashing sensations like the lights are blinking, but nothing terrible.
On both of my eyes, the follow up on the day after surgery I had 20/25 in each eye, so was doing really well. I love the vision clarity for sure and colors are much more vivid. I didn't realize just how bad the clouding had gotten. It is just these halos/concentric rings that I hope diminish over time. If they do, I will be completely pleased with the procedure.
Good luck with your process. I will keep good thoughts for an awesome recovery and outcome!!
Guest DBS-KB
Edited
Hi Kim
I am very sorry to hear about your situation, my mother had ALS, although I lost her to another disease some years ago.
The first month after my surgery, i had days where i really felt i had something in my eye, almost like something was there, that was not supposed to be there, I think that is kind of normal. In my case artificial tears like Systane helped a lot, dry eyes is very common after surgery, and it can have this effect, dry eyes can also give a lot of other symptoms. You can not use too many artificial tears, so you can try if it helps and use as much as you like, as long as you wait at least 5 minutes before or after your other drops.
It takes about 6 weeks for the eye to heal, in this period you can experience all sorts of strange things, and the vision will also change from day to day, some days it will be worse, but it will get better again.
You can also search the thread Janus have made in this forum about his Panoptix experience, I think you could learn a lot from his experience, I think it will make you feel a lot better about your choice, Panoptix is certainly one of the best premium lenses on the marked right now.
seeherenow49806 Joe_M
Edited
Hi Joe:)
Having read about the rings/starbursts ahead of surgery, I chose one monofocal lens for distance and a Symfony EDOF for slightly more near. Like others here, I found that the monofocal IOL in the dominant eye effectively mitigated the night time visual effects in the other eye to the point of zero trouble. Even tho I still notice them occasionally, they don't bother me.
This mitigation happened inn 3 stages. First, after I finished taking all eye drops (about 1 month), they diminished significantly. Then at 6 months post surgery, I noticed an overall improvement in vision, including the rings. Then a few months later more improvement. Some of this is physical healing. The surgery is an assault on the cornea, so it's reasonable to expect it to take time to heal.
About blur - the eye drops themselves cause blurriness after each insertion. And once you're done with them, the eyes may experience dryness, which also causes blur. I use preservative-free vials of Systane or soothe for this.
For glare from LED/Halogen headlights, I wear light blue/turquoise sunglasses for night driving and have one of those yellow visors (attached to the regular car visor) which I flip down on dark (streetlight free) roads where those headlights are more problematic.
If you click on my name, you should be able to find more detail in a thread I started on this.
And YES! Gratitude is the key to best, fastest healing!
ayeaye Joe_M
Posted
Hi. I need to make my decision also between panoptix toric or just toric iol. I was wondering with the rings on the lense, how does that concentric rings ever go away? it's always there..Im.so undecided. I have very bad vision so the trifocal seems so desirable...but..should I stick to toric monoficals?
Chris53317 ayeaye
Posted
@ayeaye Part of your decision process should be based on how seriously you want/need to be free of glasses. If you do not object to using reading glasses or even progressives then your BEST vision will be toric IOLs.
With trifocal toric IOLs there will be halos and starbusts. The degree is unknown and some people cannot handle it, less than 5% (not sure of this percentage). The brain may adjust over time, could be after a year or maybe never.
An alternative for avoiding glasses, no guarantee, is monovision. There are lots of discussions on this forum about these topics. Spend a few days reading and absorbing the information, and then meet with your eye doctor or surgeon to find out what may be best.
Tom313 Joe_M
Posted
Thanks for your post. It was informative. I'm assuming you wrote it March 2020. I was wondering if you did a follow up. I'm looking at the same thing, Panoptix lens and I'm very concerned about the hallows at night as I'm trying to fix the beginning stages of cataracts. I'm turning 70 soon. I don't want to go through with this if it's not going to fix my night time driving issues. Would consider mono focal lenses but not sure if they can fix my astigmatism with that lens though Medicare covers full cost of mono focal.