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PanOptix and Other Trifocals: Reality Check about Halos and Starbursts

Posted , 10 users are following.

author11
author11

I have PanOptix in both eyes. In a previous post, I explained my reasons for choosing trifocals over EDOF and monofocals. In this post, I want to unequivocally address questions about halos and starbursts.

Yes, I see halos and starbursts when I look at shining lights, especially at night. As far as I can tell, ALL PATIENTS who get PanOptix CAN experience these photopsias, or more precisely, they WILL experience them under certain conditions. This seems to be true about all trifocals.

When will halos and starbursts happen and to what degree? The variables seem to be... (1) A patient's location and surroundings and how eyes are used are strong factors... For example, if a person is inside all day, in nice bright pastel rooms, that person probably won’t see halos and starbursts. (2) The qualities of the IOL trifocal and the surgeon cause some patients to have better outcomes than others. (3) Your personal aesthetic and the way you perceive visual experiences will influence what you see... One person’s pretty starburst may be another person’s disorienting light explosion.

Alcon is tricky with their numbers that report photopsias because they ask patients if they had “not experienced (the phenomenon) or (were) not bothered at all”. They lump it all together and report 55.2% of patients did not experience or were not bothered at all by starbursts. An additional 16.8% were bothered “a little bit”, 16% “somewhat”, and the remaining 12% “quite a bit” or “very much”. Comparable numbers were reported for halos and glare (see PanOptix physician and patient literature).

So 88% of patients fall into the categories of “not experienced or not bothered at all” to “a little bit” through “somewhat”.

My guess is the phantom category of “not experienced ever at all” is probably zero or near zero. Speaking as a lay person, typing this while looking through two PanOptix, I suggest... What YOU need to know about PanOptix and every trifocal currently available is that you WILL PROBABLY (almost certainly) see halos and starbursts when lights shine directly at you. Typically, these are headlights and taillights, some streetlights, bistro lights, a bright flashlight, and so forth.

It... will... happen. At least in my opinion.

Will this necessarily be a problem? No. About 88% of people are NOT bothered “quite a bit” or “very much”. And (according to Alcon) about 99% would choose PanOptix again. Patients get good depth of field and no glasses, and happily trade off halos, starbursts, and other photopsias. That’s the deal.

That was my deal, and I’m satisfied with my choice.

1 like, 41 replies

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  • lucy24197
    lucy24197 author11

    Posted

    author11, thank you for the information. Your description clearly states that the numbers you use came from the manufacturer and that they were tricky with their numbers. But, much like defocus curves that vary by who's doing the study and sample size, it's some of the only information we have access to, and worth reading and thinking about. Multifocals weren't an option for me, but had they been, information you provided, combined with your personal experience, would have been helpful. Wishing you continued improvement.

  • helenmarier
    helenmarier author11

    Posted

    Panoptix has a web page with a contact function for feedback. I am resentful that they present misleading satisfaction surveys. Obviously their design folk focus on fun technology not customer satisfaction. And their designs don't seem overly robust. So many ways the surgeon can screw up. Who wants more surgery to correct toric problems or to get a new lens? We need to speak up. Ridiculous that starbursts last forever or flickering is just to be ignored. Sigh. I so feel tricked.

  • RonAKA
    RonAKA author11

    Posted

    Here is an article which compares the PanOptix to other trifocal lenses.

    .

    AcrySof IQ PanOptix Intraocular Lens Versus Extended Depth of Focus Intraocular Lens and Trifocal Intraocular Lens: A Clinical Overview

    Rachapalle Reddi Sudhir, MD, MPH,∗ Arindam Dey, MD, MBA,† Shovan Bhattacharrya, MBBS, MBA,† and Amit Bahulayan, PhD†

    .

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