Choosing new lens with explantation of Panoptix.

Your have gotten a lot of helpful comments. After reading them all, I would add some more.

.

First as was mentioned there are a few things which impact how close you can see with a monofocal IOL. One is asphericity. Some aspheric lenses (Tecnis ) attempt to fully correct for it, and others (AcrySof) under correct slightly. Some basic lenses make no correction and are typically the lowest cost option. A non aspheric lens is kind of a poor man's Vivity lens as the depth of focus increases at the cost of a less sharp image at one distance.

.

The other factor is astigmatism. Astigmatism also increases the range of focus at the cost of a less sharp focus at any one distance. Whether or not one should target zero astigmatism is a controversial topic as achieving it can result in a reduction of reading vision.

.

Lighting level which in turn impacts pupil size is also a factor. With my -1.25 monofocal vision I can read the very smallest print on a reading vision chart if it is in full sunlight. However, as the light level goes down I have to move up a couple of print sizes to still read. Dim light is the real test of reading vision! Computer screens are quite bright so they are not as difficult as a printed page.

.

In my case my IOL lens has corrected my spherical error perfectly to 0.0 D. But, I have been left with 0.75 D of cylindrical astigmatism. That error I am sure helps me read better. I have an aspheric lens which corrects for 0.20 of the theoretical (population average) positive asphericity of 0.27. This would reduce my reading ability. Overall I suspect my reading ability down to about 20 inches with my IOL is probably about average.

.

I recall that glaucoma can reduce contrast sensitivity. It would be a bit of a flag in going with a lens which reduces contrast sensitivity. The PanOptix is probably worse in that aspect than a Vivity however. Since your surgeon is a specialist in glaucoma and as well as cataracts, she should be well aware of those issues. With the glaucoma factor it may however tilt the scales in favour of a 1 Vivity and 1 monofocal lens solution. It sounds like a split the baby solution, but I would see it as hedging your bets on the glaucoma possibly getting worse with age. The monofocal eye could make up for any loss in contract sensitivity in the Vivity eye. In a recent survey 25% of surgeons report using mixed lens solutions where the strengths of one lens makes up for weaknesses in the other. It is not an unusual or radical approach.

.

I also recall you asking about adverse issues with monofocal lenses. I have the AcrySof IQ Aspheric monofocal in one eye, and cannot report one single adverse effect. The colours are amazingly bright and vivid, and my distance vision and vision down to 20" or so very sharp. Night vision is better than my non IOL eye which has a contact. Both eyes display a slight amount of flare from street lights and headlights, but the IOL eye has less. There is no halo effect at all.

.

Hope that helps some

I think I responded to you in a different thread.

First North Florida. I live in North Florida. Where are you located? There are some top Clinical Trial doctors in Florida depending on your location.

You can have problems with any IOL including a monofocal.

If you go with IQ vivity I think doing micro-monovision of -.75D in the non dominate eye would provide pretty good vision overall.

You might check with Dr. Gulani, Jacksonville, FL, and get his opinion, as I have seen him post videos on implanting the IQ Vivity. You can search for them on youtube. I personally have never gone to him, but people come from all over the world to see him.

i hate my pan optix lens. I cannot see at night due to haloes around lights. can I have it removed?