PanOptix experience 4 weeks after cataract surgery & advise on IOL for other eye
Posted , 15 users are following.
I am very glad to have found this thread! It helped me understand the benefits and drawbacks of trifocal IOLs and helped me decide on which IOL to use for my right eye.
I am 60 and started having problems with cataracts in both of my eyes in the past three years. The main problem was a deterioration in my vision, primarily in my right eye, which went from -8 to more than -16 in a couple of years. My other eye had -6 and it started getting worse too, but at a much slower pace. I have been wearing contact lenses for most of my life. During the past year I realized that I was seeing primarily through my left eye for everything in intermediate to far, while using my right eye for close up vision (even with contact lenses I could not see well past 6in!) - a kind of extreme monovision. It was difficult to watch TV or work on my computer, since my right eye was always blurry at those distances. I think that my brain has been trying to block my right eye and my left became the dominant (not sure which one was initially the dominant).
I decided to have a cataract surgery as things became quite unbearable and even dangerous while driving or running on trails. I do a lot of outdoors activities, such as mountain biking, trail running, sea kayaking and hiking, so I don't want to wear glasses for far vision. I also use my cell phone and AppleWatch a lot, so I needed an IOL that would keep me free of glasses, at least for everyday and outdoor activities.
After discussing my needs with my ophthalmologist and after lots of reading of individual experiences and clinical trials, I decided to use the PanOptix IOL. My ophthalmologist had the same suggestion and told me that since my vision before was so poor, I would see a great improvement and would not be dissatisfied with the results.
I felt quite prepared for the surgery and the vision during the initial adjustment period. the surgery was done on June 9. The surgery was successful and without any complications. It was quite strange experience but I felt no pain or discomfort. Initially everything was very blurry with a reddish curtain covering my vision. This got clear quite fast but the grey curtain remained for a few days. Within hours I could see far much better than before, so that was encouraging.
Within the first three days my vision improved, things became quite clear and the curtain got reduced. There was still some distortion in my vision, straight lines looked slightly bent.
Vision kept improving, especially for outdoors and distance vision.
Now, a month later my far vision is very good. using an eye chart I have progressed from 20/63 the first days to 20/30 in four weeks. Night vision is fine, with small starbursts that do not cause any problems when driving. My left eye with mild cataract has about the same size but different shape starbursts. During the first couple of weeks there was a strong lineburst going from upper left to lower right, but it has now been reduced. Intermediate vision is still not very good, but it slowly is improving.
Close vision is already lot better now, in terms of text becoming readable up to 12in - 30cm, but there is a halo around the letters, keeping the image still fuzzy. I can read the text but it is not very sharp with low contrast, when compared
I am overall quite happy with eye's progress and the quality of vision for far. Also night driving is not a problem, something I was worried about.
What concerns me though is that nothing is very sharp and high contrast any more, compared with my left eye wearing a contact lens. For example, reading text on my smartphone, I see the letters clearly, but they have a light halo around them. Even when I tried a pair of presbyopia glasses (+1.50), the fuzziness does not go away. Is this something that will go away eventually, as my brain goes through the neuroadaptation? I am planning to have another surgery for my other eye in a few weeks putting another PanOptix lens, but I want to make sure that I will not loose the ability to see sharp images for ever!
Does anyone had a similar experience that got improved after 4 or 6 months? Would things get sharper with more contrast later? If not, would it make sense to use a monofocal lens in my other eye and rely on the principle of monovision for close up?
I would appreciate any advise you might have to help decide on the second IOL.!
0 likes, 26 replies
gmag22 christos12855
Edited
By the way this is how mine looks
christos12855 gmag22
Posted
Its good to hear that the glow is minimized with glasses for distance. Can you also minimize it for close vision, for example letters and images on a cell phone or computer? That is where I have the most difficulty with, as nothing looks sharp with my right eye at this point. Text is readable, but the quality is low.
The glow I showed in the images was for large text, as I make the text smaller, the glow becomes proportionally larger. On my cell phone for small text it is equal to the width of letters. But it does not look like yours, as a number of images superimposed on each other, it is just one fuzzy glow around letters.
PanOptix also splits the image into three, one for each distance, so it is probably same as your lenses.
christos12855
Posted
Has anyone tried to combine a Panoptix in one eye with a monofocal IOL in the other? Are there any issues to be concerned with?
This is what I am thinking right now as an option to maintain the ability to see images and text in high quality resolution and sharpness. If I have close vision with the PanOptix, than I would not mind having the monofocal focus only down to 18-24".
tyrion1 christos12855
Posted
I am very curious as to why your doctor did not recommend Toric for both eyes. My mother has the exact same Cyl powers of 1.25 and 1.5(astigmatism), and doctor suggested the Panoptix Trifocal. Curious as to why he didn't remmend Toric instead.
RonAKA tyrion1
Posted
You have to be careful in using eyeglass prescriptions to predict what astigmatism correction is needed for an IOL. Your eyeglasses have to correct for astigmatism in your lens as well as astigmatism in your cornea. If all or most of the astigmatism is in the lens, then that lens and the associated astigmatism is removed when the lens is removed. Sometimes the opposite can happen. The astigmatism in the lens can reverse the astigmatism in the cornea. Then the astigmatism gets worse when you remove the lens. The bottom line is that the only way to predict the required cylinder correction is to measure the topography of the cornea. That is what the IOL has to correct for.
christos12855 RonAKA
Posted
Thanks RonAKA for the explanation.
I will ask my doctor to see if that was my case. What he told me was that with my astigmatism I didn't need toric lenses, but he didn't specify if the astigmatism I had was on the lens or not.
mdumdei christos12855
Edited
I know this is way late on this thread but I came across it looking for answers, so thought I would respond. I recently had PanOptix put in both eyes. When the first was done, I did have some fairly noticeable ghosting, but after the second eye was done, near vision is very good (far too for that matter) -- and I had very good near prior to getting surgery so am not coming from a "was really bad" situation. I could always read fine, even tiny print without glasses and one of my concerns going into this was I would lose that ability. Didn't happen. Lit up things like bright white letters on my watch against a black watch face do have minor glow, but not enough to be distracting. I use a laptop regularly with it sitting on my lap so my eyes are probably 12" or less from the screen - nothing on it I can't read as easily as before and I am less than a week from getting the second eye done. Very happy with the outcome. YMMV.
007Bond christos12855
Posted
christos12855 i would love to get an update on your status how are you doing what did you decide what is the outcome.
Thanks
lknggem christos12855
Posted
You guys are so familiar with your lens strength. I asked the counselor many times about how they determine this. They certainly did a lot of tests and scans before the surgery. I really do not feel like I got a good answer though. I had surgery 24 hours ago with a PanOptix lens. I can only just see through the opaqueness. I can read the TV screen but everything is milky on all sides of my left eye. Everything I have been told (yesterday by surgeon and my eye doctor) says that this blurriness clears after days but can go weeks or months. I would be happy if I could see what I saw before the surgery through my glasses!
I was more terrified with the surgery because a good friend of mine had eye surgery for a retina issue, then they took out her cataract, and many surgeries later her eye is still blurred. My surgery was easy, went well and does not hurt. It is not watering like it used to, which is good. I just cannot see through it.
My counselor kept telling me how the "Forever Young" would give me trifocal. They did tell me about glare and halos and about blurry the first few days. They said I should be able to drive day 2. So far, I have knocked over a glass of hot coffee and dropped a glass of water. I don't think I am driving anywhere!
I have a large floating "dementor" - black cloud swirling in the eye since yesterday, which if it was floating in an ornamental glass would be fascinating, but it floats with my eye movement. It got so distracting that I put on my protection cover for my eye and placed a black patch over the top. My husband took the lens out of my glasses so I can grade school papers with my right "good" eye.
I see my eye doctor at 4:30pm today. What should I ask? I am supposed to have the second surgery in two weeks. I think I have to wait until this eye has some kind of resolution.
Thank you.
RonAKA lknggem
Posted
You really should wait a minimum of 5-6 weeks between surgeries until the first eye heals and you have had a full eye test to see where you ended up. This will allow for any needed adjustment to the power calculation method on the second eye. The surgeon should learn something on the first eye. Early vision is misleading as the eye is swollen fro the surgery and the internal pressure is likely elevated.