PanOptix blue light filter concerns

That is an interesting combination you have, and I've just read most of your thread on your experience - thank you for sharing it! You're right, the light distribution of trifocals and even EDOF's is a tradeoff, and a main cause for being undecided between Symfony and PanOptix. My doctor thinks PanOpix won't provide as good of contrast in various conditions. Specifically, we were discussing riding mountain bikes on trails that pass in and out of forest canopies - bright light to dark conditions, back to bright light, to dark conditions with bright beams of light filtering through, etc. Some things I've read state that PanOptix may provide the same or even slightly better contrast than Symfony, but almost as many articles and testimonials say the opposite. At least in regard to Symfony being lighter/brighter than other trifocals.

Do you notice any difference in contrast between your two lenses? I'd imagine you don't go around looking through one eye a lot, but figured I'd ask.

Well, fact is I have spend a lot of time comparing the two lenses in many different situations, I guess you just have to because you can 😃

When it comes to contrast I don´t really know how to judge them.

Colors are slightly more colorful on the trifocal.

White is slightly more white on trifocal.

Intermediate range have slightly more sharp image on trifocal.

Far range have slightly "thicker" image on edof, but more sharpness on trifocal.

In the dark there are far worse visual side effects on the edof.

Night vision in general seems very equal, I don´t think I would be able to tell the difference, only because of the extra side effects from the edof.

Night vision is great by the way, I love the good night vision I have now, compared to the poor cataracts night vision, but off course you need to get used to the halos and stuff around light sources.

I am very happy with my new vision, I enjoy all the things that have become so easy, and I enjoy not needing glasses.

If I should choose now, I would choose two trifocals, to be honest I don´t understand why Zeiss have started to make the edof, now that they had the trifocal.

About the Symfony being brighter - I think this is mainly because Symfony in the US have been compared to the old style bifocals that have been used in the US in the lack of a newer trifocal.

The trifocals are a much newer design, and are non comparable to the old style bifocals.

In the trifocal they are using some of the light that are lost in the bifocals, to create the third focal point, so the trifocals are much more efficient.

I guess you can sense that I would strongly recommend that you choose trifocal, if you are going for premium lenses 😃

Symfony is a great workhorse, it have given great vision to millions of people, but with the trifocal you get more near vision, without any sacrifice.

But off course that is just my opinion 😃

My guess is the same with some studies or the rare patient like yourself that has one of each, hopefully they're mostly bi-focal IOL's, or older trifocals.

It's good to hear you're happy with your night vision. For how much talk there is about halos and glare, there isn't much info or comparison of those phenomena to the halos, starbursts, and glare I'd imagine many of us have with cataracts in the first place. I'm expecting some halos and starbursts, but am hoping that they're nowhere near as uncomfortable as what I see now.

I replied earlier - I have one yellow-tint and one clear lens. I was out shopping for some readers and briefly tried on the blue tint lenses. I quickly took them off. I don't think you can compare the two. The main difference I notice is whites appear whiter with the clear lens. I personally would not make my lens choice based on the tint.

i think Janus381 is telling--no difference between an eye with cataracts and their yellow tint IOL, which to me means that a lens without tint will be different, just like it is with my situation. I was reading the info on the synergy lens and it mentioned that the blue filter is designed IN THEORY to remove some of the high energy blue light at that end of the spectrum to prevent it from bouncing around in the eye which may cause visual aberrations. However, people on this forum have tried yellow glasses at night and didn't notice much of an improvement--the rings were still there.

I have a monofocal IOL in my dominant Left Eye and a Symfony in my non-dominant Right Eye. I also did "micro-monovision",

Now that is definitely an interesting and brave combination! Kind of getting the best of both worlds. Half a diopter difference, so is the monofocal sitting right at plano or slightly under? How long have you had them?

I wonder how Monofocal + Trifocal would have turned out in comparison. Anyway you are happy and that is the main thing 😉

Hopefully in the future IOLs will come with adjustment knobs lol Actually touch would be better. You tap you eyelid to increase or decrease the diopter 😃

I wonder about your strategy W-H with a Technis Eyehance. Assuming it gives you an extra 0.5 diopter. Set it at -1 give you a near as if it is set at -1.5 and you get a little better distance. Set the other lens at -0.5 and you still get some better near. Add binocular summation to this equation and who know what the results will be.

I wonder about your strategy W-H with a Technis Eyehance. Assuming it gives you an extra 0.5 diopter. Set it at -1 give you a near as if it is set at -1.5 and you get a little better distance. Set the other lens at -0.5 and you still get some better near. Add binocular summation to this equation and who know what the results will be.

You mean for your eyes/potential Symfony IOL exchange?

So...

Eyhance near eye -1.0 &

Eyhance far eye -0.5?

Sounds good in theory but maybe still bit conservative? Why not go for -1.25 for near. If Eyhance is really that great then you will still have plenty of binocular summation. I would go for -1.25 if it was my near eye, maybe even -1.5 if I felt super brave (which I don't) 😃

Anyway your choice might be dictated by the measurements you get for that Eyhance IOL.

Wait for some real world results from users. Don't rush into it though. J&J, Zeiss, Alcon.... all of them spout lot of marketing mumbo jumbo.

TECNIS Eyhance IOL has European CE Mark approval and is now commercially available across Europe, including UK, Italy, France, Spain and Germany. This product is not currently approved or commercially available in other countries. In some countries, TECNIS Eyhance IOL is covered by medical insurance making it an important option for patients when a monofocal IOL is being considered.

Why not get the B&L Silicon lens in your non operated eye and see if it helps your Symfony eye? If yes then you are done.

If not then replace the Symfony with the B&L too.

"J&J, Zeiss, Alcon.... all of them spout lot of marketing mumbo jumbo." -- i have to agree on this. extended depth, continuous range, pupil independent...

Thank you for sharing your experience. I never took into consideration ambidexterity as suggesting better potential to adapt. I'm lefthanded, which essentially means I'm a lot more ambidextrous than average!

Your experience reiterates the frustration of not being able to try these IOL's on like glasses - or even contacts - before committing to them surgically. I briefly discussed a similar IOL option with my doctor, but we both had concerns about depth-of-field difficulty or vagueness. That wouldn't be as big of a deal if I weren't so active in various terrain(mountain biking, skiing, etc).

Great to hear your experience on slight color variation with such a keen eye. And I may push my second surgery back a bit, too. I'm getting the far worse of two eyes operated on first, which is my non-dominant eye. It'll be interesting to see how I feel about having one trifocal and one natural eye for at least a couple of weeks. Probably not exactly the same, but a friend went through all kinds of contact scripts until finally listening to his doc's advice of trying one trifocal in one eye, which he said offered by far the best sight for him.

Do you notice any difference in distance vision between your two eyes?

"Why not get the B&L Silicon lens in your non operated eye" -- too greedy to give up intermediate.

Where is your Symfony eye strongest at?

"Anyway your choice might be dictated by the measurements you get for that Eyhance IOL." -- i dont think they have any way to measure how much near someone will get with any of the iols. they can only measure on the distance side. so it will be a trial and error with the actual surgery.

during day time it is very good starting at 22 inches. it does something weird around the lights. concentric circles and the small halos around lights are livable with. there is definite loss in contrast than natural eye as things are lighter in the symfony eye. lens edge glare is the most problematic.

W.H. Symfony vision is seamless. No weak points between your near (wherever that is - varies by individual) and distance. That is what I line about it. I can read some of the letters on line below 20/20 line at optometrist and reading doesn't really blur to the point I can't read it until 6 inches - but that is too close for reading. But great when I have to repair sunglasses when that tony screw falls out! I usually have elbow bent and 11 inches is where I am most comfortable reading.

Again I find all these distance things very subjective (lol Danish I know flies in face of controlled studies etc and I must have a bionic brain - although where the XXX was that brain when I struggled with Calculus. haha.)

are u left handed or ambidextrous (both-handed)?

No weak points between your near (wherever that is - varies by individual) and distance.

Hi Sue, yes that is what I thought (roughly) but I wrote that because Soks replied to my B&L monofocal IOL suggestion " - too greedy to give up intermediate."

Which is what prompted my question. So if he has "seamless vision from" near 22inches/60cm to infinity, how will putting B&L Silicon monofocal in the other eye (near, intermediate or far) going to make him give up intermediate vision?

Maybe reduction of intermediate binocular summation is what he means...although that can me avoided depending where the B&L IOL is targeted.

to clarify 'giving-up': i prefer binocular acuity over spectacle independence: that is why i said that. to restate: too greedy to give up intermediate even in one eye. if eyehance allowed intermediate to maybe 36 to 40 inches, i am willing to give-up the 18 inches in both eyes and not lose contrast and avoid the added glare.

Nope right handed. I do have a daughter though left handed (my mother is left handed). Daughter also an omnivert.

But myself just regular right handed person like the masses.

I assumed that is what you meant. Having binocular vision isn't something to let go of lightly. Reason I did not want any type of mini or full monovision. The older you get depth perception issues cause falls. A preference I know but something I was keenly aware of.

I assumed that is what you meant. Having binocular vision isn't something to let go of lightly.

Why would he if he targets Eyhance for intermediate range ;-P

Reason I did not want any type of mini or full monovision.

The older you get depth perception issues cause falls. A preference I know but something I was keenly aware of.

Why did you not tell me before? 😃

Seriously though why would he lose 100% binocular summation. He will lose some but there will be plenty of overlap for older Soks to zip around in his rollator 😃

.

Can glasses not be used to equalize the eyes more and get it back?

with eyehance and mini monovision the binocular summation will be lost for a smaller range than it would be with normal monofocal. this will also mean lighter glasses to equalize the two eyes. now that is only if eyehance is not another technis marketing gimmick.

i would also seriously consider -0.75 in both eyes with an eyehance and wear glasses for distance only if i know how much near i would get with that combination before hand.

Sorry Worried - writing out my novel to you. while these msg came in. Wish I had the gift of using fewer words!

Re Binocular vision in your consult with surgeons was it ever brought up? In my early posts on forums as I grappled between Symfony and monofocals was this whole mini or monovision approach. My cataracts were too advanced to do any simulation with contact lenses. I suffer from migraines and motion sickness (especially on cruises or long car rides). A long time ago my doctor said it had to do with my vision - some people are keenly tuned into the tiniest bit of motion and their brain plays tricks on them. Why they say if you are sea to look at the horizon to try and get tour brain to adjust. Nowadays the medications work wonders.

Along with my desire to be less glasses dependent (although I didn't dislike wearing them at all - and it wasn't a deal breaker with cataract surgery) I knew I would have to go with monofocals both targeted for same distance. Otherwise I ran the risk of constant disorientation and motion sickness. Even with Symfony both ate targeted for same distance. Benefit is binocular vision and for whatever reason (Danish has all the technical terms) you gain an extra line on the chart of visual acuity.

H-ha! Yes, touchscreen adjustable IOL's in the future - there's a business for someone to aspire to. No doubt will test them in robots first.:)

Hi 303:)

I don't have any trouble at all with depth of field. Still see well in near-complete darkness outside at night.

I was unwilling to give up near vision, so the dominant eye (with monofocal Bausch & Lomb IOL) was set for -0.5D and settled at -0.25D, That's so small a degree of myopia (nearsightedness) that my optometrist said no doc would prescribe glasses for it. The only reason I need glasses for that eye at all (for driving at night in severe conditions) is that I chose not to correct the astigmatism in it (to save the $1500 charge not covered by insurance).

The toric Symfony non-dominant eye was set for -1.0D and settled at -0.75D, so the astigmatism is fully corrected. Even with this intentional difference in distance vision , chosen to ensure greater near vision, I see distance extremely well with that eye, much better than I did with multifocal contact lenses. My near vision is better than the bottom line on the near-vision eye test chart, easily see small print at less than 10 inches, and intermediate is superb.

My surgeries were in June and October 2018. At that time, my surgeons didn't recommend any trifocals. The EDOF IOL's have continuous range because they have 7 or 9 (don't remember which) rings of vision, much more than trifocal. I noticed the first day post-op as my eye chose the various focal points from near to far, but after that it became completely automatic.

Sounds like you've chosen a good option with the trifocal in the non-dominant eye. That leaves you many open options after it heals and settles. And always best to do the worst eye first.:) Having the trifocal in the non-dominant eye leaves you the option of the monofocal in the dominant eye if you find the night time driving artifacts too annoying, but those diminish noticeably after the first week for most people and continue to diminish after that.

Surgeons like to schedule both eyes close together because it is more cost effective for them. If you wait as long as I did, they have to schedule all the pre-op measurements again and determine any changes in current state of 2nd eye.

But after each surgery, most docs prescribe 3 sets of drops that you have to take for 1 week, 2 weeks, and 4 weeks. The drops cause blurry vision and the eye takes a while to heal. Even after I had the 2nd surgery, my first eye improved at the 6-month mark. So - definitely worth waiting for the 2nd eye if possible.

Wishing you the best! Let us know when your surgery happens and how it goes afterward.