HELP:MY DILEMNA IN SELECTION OF VIVITY VS PANOPTIX FOR PATIENTS WITH PEX
Posted , 4 users are following.
I have been diagnosed with Psuedoexpholiation syndrone and am concerned that I may have greater future problems with the premium Trifocal lens Panoptix. If the zonular instability will cause the lens to shift I read that the EDOF lens Vivity might be less effected. My other concern is night driving with glare that occurs. I can't drive at night now because of LED lights. My ophthalmologist is pressing hard to use Panoptix in both eyes or just go with monofocal IOS vs Vivity. He says no problem he'll just put in a tension ring to keep them centered ! I'm reading do one eye with Vivity and the other Panoptix ????
I'm 77 now and don't want to lose my driving ability in 6 or 7 years.
0 likes, 13 replies
Lynda111 paul69633
Edited
A monofocal lens like the Clareon or the Tecnis 1 would be better for you. Your disease will make you cataract surgery more complicated. Find a surgeon who is experienced with your disease, preferably a cataract surgeon who is also fellowship trained in glaucoma disease or cornea and anterior segment disease. And get more than one opinion.
RonAKA paul69633
Edited
In general when the eye has issues, MF and EDOF lenses are not recommended. They have reduced contrast sensitivity and will likely have optical side effects like halos and flare at night. Monofocal lenses are the safer way to go. You can get both eyes set for near, and wear glasses for distance, or both set for distance and wear readers for near. A third option is to set one eye for near and the other for distance (mini-monovision).
paul69633 RonAKA
Posted
I know from my research that they are not recommended. My ophthalmologist says..shouldn't be a problem if using CTR (tensioning ring). I really very uncomfortable. I'm thinking of going with
a monofocal IOL on my dominant eye and consider a premium only on the second eye.
RonAKA paul69633
Edited
You can just do the dominant eye for distance with a monofocal and then another monofocal in the non dominant eye set for near (-1.5 D).
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If decentering of the lens is anticipated to be a problem you may want to find a surgeon that will use the Bausch + Lomb enVista monofocal. It is less sensitive to being decentered than a standard monofocal.
paul69633 RonAKA
Posted
So, not all monofocal are equal in that respect?
RonAKA paul69633
Posted
The average eye has +0.27 um of spherical aberration (SA). Older spherical lenses did not attempt to correct any of the SA with the lens. Later aspherical lenses were developed to correct SA. The J&J Tecnis 1 lens has -0.27 um built into the lens to fully correct all the SA. This provides very good vision, better than the original spherical lenses. The Alcon AcrySof or Clareon corects a little less and leaves you with about +0.1 um of SA. They claim people with "super vision" naturally will have about this amount of SA. B+L with the enVista have what they call neutral SA. They correct the SA to zero in their lens which means you will be left with the eye's natural +0.27 um of SA.
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The full aspherical lenses brings all the light to the same exact focus, but to do that the eye has to also be perfect, along with the lens placement in the eye. The enVista on the other hand is more tolerant to a less than perfect eye, and less than perfect placement in the eye. In addition the neutral asphericity increases the depth of focus (lets you see closer) over a full aspheric lens like the Tecnis 1.
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If you google Bausch Surgical enVista Aberration Free Optic you should find more information on the lens.
Lynda111 paul69633
Edited
Paul
I hope you can still drive when you are 82. We all want to maintain our independence as long as possible. But do look for a cataract surgeon experienced with your disease with whom you feel comfortable with. A Google search using the terms I mentioned earlier should lead you to one. If you live near an eye hospital or a medical school with an ophthalmology dept. that would be a good place to look.
paul69633 Lynda111
Posted
Loss of ability to drive will be a HUGE PROBLEM!! I live out in the county where no Uber is available I DON"T WANT TO MOVE TO THE CITY!!!
RonAKA paul69633
Edited
Don't forget that you can get prescription glasses for driving at night. They will correct any error left by the IOLs.
paul69633
Edited
I'm getting pressure from the Ophthalmologist to go with Panoptix both eyes. Says he is not anticipating any problems in decentering with my PEX condition. CTR will fix that problem. I'm really doubting that I won't have problems in the future. 50% of PEX patients develop Glaucoma not good!
laurie30147 paul69633
Edited
The doctor should not pressure you into any decision! If you spend time reading this forum, you will find people who love Panoptix and others who are miserable with it. It is not a low-risk choice.
Find a doctor who is more willing to listen to you. And do not schedule the two eyes close together. Let the first eye heal completely before making a decision about the second eye.
paul69633 laurie30147
Posted
Next week I'm going to speak with him. I'm hearing from more than one person that Doctors are clogged with baby boomers needing services (same for cremation services). I am not driving at night now, because of LED lights and PEX effecting star bursts and halos. Some Panoptix patients are complaining they don't drive at night because of halos. One eye at a time is the plan.
Lynda111 paul69633
Posted
See another cataract surgeon! The Envista Lens is great for you but may be hard to find.