PanOptix and Other Trifocals: Reality Check about Halos and Starbursts

The percent of patents satisfied is all over PanOptix website and published in the product info for physicians (excerpts below).

“Table 24: IOLSAT: Satisfaction with Your Vision (Collected at 6 Months) All Implanted - Given your vision today, if you had to do it all over, would you have the same lenses implanted again? - 99.2%”

PRODUCT INFORMATION Alcon Laboratories, Inc.

The statistics I quoted previously are from the same source.

The percent of patients satisfied is all over PanOptix website and published in the product info for physicians and FDA (excerpts below).

“Table 24: IOLSAT: Satisfaction with Your Vision (Collected at 6 Months) All Implanted - Given your vision today, if you had to do it all over, would you have the same lenses implanted again? - 99.2%”

The statistics I quoted previously are from the same source... "PRODUCT INFORMATION Alcon Laboratories, Inc." filed with FDA.

I provided a link in a separate reply that is "waiting to be moderated", or people can search directly at FDA's website.

do you work for alcon?

I do not. Do you?

Call me suspicious when I see a 99% Plus diffractive IOL satisfaction number. You have to be really careful when looking at numbers like that, such as what clinical trial is the number coming from, how was the clinical trial conducted (example was there a control group), and how was the question asked in relationship to the goal of the trial.

Looking at Table 24 it shows 99.2% would have the same lenses implanted again, yet in the same table it shows 1.6% were very dissatisfied and 1.6% where dissatisfied. Yet most those people (in order to get to 99.2%) would have the same lens implanted again. Hmmm!

The funny thing is I am looking at implanting the Synergy IOL and its propaganda says higher patient satisfaction, from clinical trial results, than PanOptics. So I guess depending on what data one uses, one can make the numbers come out any way they want.

But let’s ignore all that for second. Here is why I am very very suspicious. I have talked to sooo many Ophthalmologist and many will not even implant diffractive IOLs due to the number of unhappy patients.

Again I am suspicious of how the number was obtained and triple suspicious that this represent the population (IOL implanted population) as a whole.

I will give you a wild example, and in no way am I saying this happened, but shows how the numbers can be misleading.

Example – Purely hypothetical:

Maybe in this clinical trial they did a super good job of patient selection. That means first they did not accept any questionable or borderline cases. If you had any eye condition other than cataract you were rejected. Even extreme short and long eyes thrown out. Too much astigmatism OUT! Then maybe they did a great job with simulations, showing the potential subjects the worse cases of halos, glare and starburst and if you did not like it you were rejected. Thus creating the best possible outcome. In other words this group is not representative of the population in whole, who get the PanOptics implanted.

no but you sound like one.

Maybe in this clinical trial they did a super good job of patient selection

These studies are typically funded by the manufacturers so there is certainly some truth to that. They choose favourable patients and top Surgeons for their studies. Surgeons have their own biases too though. Many who say they'd never use a diffractive IOL are basing that opinion on designs from 10 years ago like the ReStore which really were not very good. Or they only work in public health so would never have a chance to use them anyway.

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The only thing you can say for sure is that THESE patients in THIS study with THESE endpoints and THESE surgeons with THESE financial disclosures and the survey questions worded in THIS way asked at THIS point in time = "99% happy". It's not meaningless data by any means. But you should also probably take it for what it's worth. Ultimately every patient and every set of eyes is different and you should listen to the advice of your surgeon and perhaps get a few opinions and then make what you think is the best decision for you.

Perhaps I sound that way to you because I’m satisfied with my PanOptix (so far), and you work for J&J. You seem to know a lot about J&J Tecnis products.

OTOH... You’re probably real because you wrote, “i would give anything for distance vision with natural lens and age induced reading glasses. i m 45. sorry u r going through this.”

Either way... I’m real. And if you're real, then I’m genuinely sorry that your eyes don’t work as you wish. My surgery has been a success so far, and now I’m trying to give back to future readers the same way I benefited from people here previously who helped me. If everything goes bad and my IOLs explode in my head, you’ll be the first to know.

At this point, my right eye has improved to 20/30 and my left to 20/25. I can read my cell phone easily at 14 inches. No pain or discomfort. No remarkable visual disturbances. Only the halos and starbursts I have described elsewhere. Cataracts eventually would have caused me to be blind. Now my eyes work better than at any previous time IN MY LIFE! So ya... I’m pleased with PanOptix.

u have 2 posts documenting the same experience and in this one where the topic mentions other trifocals u compare nothing but post manufacturer garbage.

glad ur reaults are great!!

No need to be "hypothetical"... On page 12 the literature clearly states that selected patients "had no preoperative ocular pathology or macular degeneration at any time, and no major protocol deviations."

My problem with the research is that I think the sample size was too small. Nevertheless, Dr. Shannon Wong says his rate of IOL exchange for PanOptix is about 1 in 300, roughly comparable to what Alcon reports and what J&J reports for Synergy.

I certainly wouldn't recommend that anyone choose an IOL based only on one source, the rate of satisfaction as reported by the company selling the product. But judging from multiple sources, I think 1-in-100 to 1-in-300 is probably realistic. About 4 million IOLs are implanted annually in the United States. Even 0.3% still represents 12,000 failures in the US every year, and about 84,000 explantions worldwide.

I have no idea what you mean by "manufacturer garbage". Are you referring to material supplied by Alcon to FDA? If you have special knowledge that it's "garbage", please don't waste time telling me. You should contact FDA immediately and let them know that Alcon has been dishonest about their filings. Don't wait. Do it now! Do it for the good health of all of us! Thanks!

For those of you still reading while soks is calling FDA... The purpose of my original post in this thread was to provide a "Reality Check about Halos and Starbursts" when trifocals are implanted. To recap... Halos and starbursts WILL happen! I direct gentle readers to the original message in this thread for details and my first-hand analysis of halos and starbursts while using PanOptix. Will halos and starbursts always be a deal-breaking problem? Spoiler alert... No. Not necessarily.

dont tell me what to do. u r now boring me with ur garbage

I'm disappointed that you have claimed special knowledge about Alcon being dishonest in FDA filings, specifically calling those filings "manufacturer garbage", yet you won't take responsible steps to protect public health. If you have knowledge that any health provider purposefully has supplied incorrect information to a government agency, I strongly suggest you report the crime. Please do the right thing.

Explantation of an IOL is major surgery, with major risk and one might even have problems finding a doctor who will even do it. Things have to be really bad to do dig out and remove an IOL as this is a desperation last choice option.

I just find it odd / funny when you look at that data there were over 10% of the patients who were bothered quite a bit or very much from halos, yet apparently when asked, they would get the same IOL again.

But even if you ignored those numbers, I cannot get over the fact that 3.2% of the patients were dissatisfied or very dissatisfied with the PanOptics IOL, yet they would get the same IOL again. It just does not add up to me. Maybe they took the patients out drinking and asked them when they were lit up. LAL. I don't know.

I just think it is very misleading to the general public to the reality of this IOL or the Synergy IOL.That was my only point and I plan to get the Synergy IOL. But I go in with my eyes open. I just read so many horror stories about people getting a diffractive IOL based on the companies propaganda or the doctors suggests it without actually doing their own research into the pitfalls.

My friend that has PanOptix in both eyes would fit into the category of not being satisfied, but not unhappy enough to have the lenses explanted. She also says if she had it to do over again she would not choose the PanOptix, and save all the extra bucks she spent to get them. I wonder if the very high satisfaction number reflects just the ones that are not unhappy to the point that they will explant the lenses... Once you have them in your eyes there are no real "mulligans".

The only way I can rationalize these high 99% or 98% satisfaction rate with the PanOptix is that they are basing it on explant statistics. Most of these surgeons who offer these several thousand a lens options also offer a guarantee that they will explant them if you are not SATISFIED. And that is the key word. If you don't request an explant then they assume you are satisfied... It does not explain the very high rate of those claiming they would do it again if they had a second chance.

yes published by manufacturer - you don't think that is skewed?

You can be happy with your choice and that is ok but to advocate for 99% satisfaction? Like someone previously mentioned I have not seen any IOL with that high of a satisfaction rate.