PanOptix experience
Posted , 89 users are following.
(apologies for starting a new thread, but my last one was more a question about PanOptix before I chose that route. Seems like it'd make more sense if someone was searching for info/testimonials that a new thread specific to my experience with the lenses. )
I'm 45, very active/athletic(competitive mountain bike racer, motocross rider, skier/snowboarder), and have been fortunate enough to have had 20/15 vision up until a few years ago. Not wanting to adapt to readers or other prescription glasses that accompany monofocals, I opted for PanOptix over Symfony partially due to the loose recommendation of my doctor, and mostly because once I was aware of their existence, the clinical studies I was able to find online seemed to show that PanOptix tested at least as good as Symfony in all manners, showed some level of reduced night artifact/glare/halos, and promised near-vision, in addition to midrange and distance vision.
I'm 4 days post-op of a PanOptix in my right eye, with the sole motivation of surgery to treat my rather severe cataracts. That eye was the worst of the pair, and now that I have what was considered my "good" eye as a baseline to compare the new lens to an old one, it's definitely a mixed bag.
Like basically anyone who's had IOL's implanted, the newfound vibrance in colors is phenomenal. There was a yellow wall that my old eye perceived as being gray the other day, if that's any indication of the difference. The day after surgery, my vision tested at 20/25 in the new lens, as opposed to 20/60 before surgery. I didn't have any eye issues that required glasses before surgery; it was simply the cataracts that was causing such poor vision. So, compared to my vision a couple of years ago, 20/25 is still technically a degredation for me.
Near vision is another positive with PanOptix, but it's admittedly a bit finicky with exact distance. Roughly 12-inches is the sweet spot where text is clearest. A few inches past or closer than that, and things begin to soften up. Text doesn't get too terribly blurry, and doesn't seem to progress into being completely illegible as distance away from the sweet spot increases, but there's an absolute sweet spot of near focus for sure. Midrange is somewhat disappointing for the claims and studies on PanOptix, as sitting at my desktop computer approximately 24-inches from the screen results in less-than-sharp focus. I have to get right up to within 12-inches of the screen to get the crispest focus, which is where the near vision focus is. Seems like these are almost bifocals and not trifocals.
Nighttime vision overall in the PanOptix eye is good. I don't notice a reduction in contrast like my doctor thought might be the case with the division of light to three points. It definitely didn't improve my night vision by any means, but it didn't seem to reduce it. My cataracts is very central in my original lens, so I actually see best at night when my pupil is dilated big enough to see around it.
Halos around all lights are very apparent, not only at night but during the day as well, and the halos even have that little spiderweb effect. One or two lights at a time, and it seems manageable. But, I just drove on the highway tonight and realized how much I was relying on my natural lens to see. With that eye closed, the PanOptix eye was creating such drastic halo that it seemed like it was keeping that eye from finding focus on anything. Truly blurred vision if there's more than a few lights, which was both scary and perplexing on what to do for my other eye as I can't imagine getting through the rest of my life without the ability to operate a car, walk through the city, etc. at night.
From the first day of surgery, I've also had a flicker in the PanOptix eye. The followup doctor(who I'd never met, and won't see again) said that's normal and should go away, but it hasn't really subsided in 4 days. I notice it gets much worse when there's light shining in from my peripheral.
Distance vision is worse with the PanOptix eye than my natural eye, which is disappointing. This discrepancy is amplified at night, especially if it involves reading street signs or things like neon lights.
I see my optometrist on Friday, and will share what he says about the debilitating night vision, flickering, and lack of midrange focus. Oh, I also noticed today that if the sun is directly in front of my vision and I have sunglasses on, that a reflection of the PanOptix IOL shows up in my sunglass lens. That wasn't expected, not sure if anyone else has had the same or similar experience with any other lens?
3 likes, 162 replies
derek40125 303z
Edited
Thanks for starting a new thread and please keep posting with updates. You're only 4 days out. Some people get great results right away but it can take longer. Also it can take time for the brain to adapt to multifocals compared to a monofocal. My vision fluctuated a fair amount and it was 6 weeks (once I finished all the same eye drops) before I achieved best vision.
Hopefully the halos will reduce in severity too. Mine were never as bad as you described, but still quite noticeable. They did stop bothering me pretty quickly. How large are they? If you are looking at a headlight, does the halo extend much past the car itself? My opinion is that smaller, brighter halos end up being less of an issue compared to large, but fainter ones.
I also had flickering especially when a light source hit my eye from the sides. I couldn't sit with an open window to the side for a month or so, but that went away too.
Like you, I can also easily see my IOL reflected. If I shine a light in my eye while looking in the mirror and move them light back and forth, I'll see the IOL kind of flicker (sometimes shows up in a photo too).
Here's another weird thing to try. Close your eyes and look towards a bright light. Then open only the eye with the iol just barely and close it back to the point where you can see light but not enough to focus. When I do this just right, I can see the entire concentric ring structure of my IOL magnified so it looks vey large. Pretty interesting phenomenon.
Hope your vision improves and you have good results to report.
303z derek40125
Posted
The first few days, my halos were relatively small around bright lights - maybe just doubling the diameter of the light itself. That light and halo turns into a blurred spot, and last night in medium traffic those blurred halo spots seemed to have grown to the point where oncoming vehicle lights haloed out to the point of almost connecting between headlights.
I still have pretty bad starbursts from the cataracts in my natural lens, but I don't lose the ability to focus. That seemed to originally be the case with the halos of the IOL, but last night caused almost total loss of the ability to focus. I did notice that if I looked down at the road directly in front of me that I could focus on that. But everything that I needed to be looking at was blurred.
derek40125 303z
Posted
I remember a few times during the first few weeks post-surgery where my vision would seem to "lock" on one of the focus points (and I only had two not three to deal with). For example, if I was on a computer for an hour or so, and then stood up, my normally excellent distance vision was gone. I just couldn't get the "far" focus point to work. This effect went away completely after 4-5 weeks.
If you are getting very good clear focus at some times and not at others, I think that generally means that your IOL is set pretty well and there is a good chance that you'll eventually have excellent vision when everything settles down.
I also wanted to mention something else to you. Some of this is my opinion, not necessarily fact. I was young too, when I had my surgery (51) but I had already developed presbyopia (so I needed reading glasses). You still had fantastic vision. Most cataract patients are much older than you and their vision has already deteriorated due to age. Also, this age group would generally not be as dependent on computers and digital technology. This make it harder to compare outcomes among patients. Some of the newer studies are starting to recognize these differences. I’m typing this email on a 34”, 21:9, 1440P monitor which is one of several on my desk. My fonts and icons are small and I do a lot of CAD and design work. The monitors naturally are at different distances from my eyes. To me, “excellent” computer vision would mean something very different compared to someone on who is using a single 24”, 1080P monitor with relatively large fonts/icons and mainly doing email and web browsing. In the “near” focal range, I notice things like an out of focus “blob” around clear, in focus text. This varies considerably depending on the text and background colors. I would rate my near vision as “functional” since I can generally read (with very good lighting or on an electronic device). However, when doing critical tasks (and also oddly gaming) I end up wearing reading glasses which use the more-dominant far focus point of the IOL. I could easily understand someone else, with a different lifestyle, judging my near vision as “excellent” which make it hard to compare without knowing each individual’s expectations.
aaron32806 derek40125
Edited
i am 4 weeks out from my right eye and two weeks out from my left eye. my sweet spot too is about 12 inches. i require huge amounts of light to be able to see the night vision sucks halos around lights makes driving nearly unbearable i still have the extreme flickering as well. i hope my vision settles because at this point i am having serious regrets. this has been quite frustrating to say the least so far
jacqueline78253 derek40125
Posted
Hello, I had Panoptix trifocal lens surgery 4 days ago in my left eye, and am having the same done in my right eye in 4 days. For me the halos are very bright, clear rings (3 rings) around every round light source, worse at night but also happens during daylight. Christmas tree lights, street lights, house lights, and especially auto tail lights and headlights. I didn't expect them to be quite this bad. I've had cortical cataracts that have caused star shapes and a lot of glare, and have never had good distance vision, so was excited at the prospect of clear distance, midrange and near vision. I thought a halo might be just a round glare around headlights, which I thought I could live with. I'm happy so far with the vision results in my left eye, as far as clarity so close to the date of surgery, but am sad to think that for the rest of my life I'll never see a round light the same- they will always have round rings around them. A friend has green Christmas lights on some bushes, every bulb has rings of light around them when I look at it. Even when looking at a lighted snowglobe- the little lighted sparkles inside have rings of light around them. I wanted to post this because I don't think I quite understood what a halo could be like. The other night I was driving in the dark, and a police officer had the red and blue flashing lights on while assisting two cars that had been in an accident on the side of the road, every one of the lights on those cars had 3 bright light rings around them, plus the tail lights of the car in front of me and an oncoming car. It was really pretty distracting and kind of scared me to be honest. I'm hoping it gets better with time. Has anyone else experienced this and with time, did it get any better?
RonAKA jacqueline78253
Posted
I think to some degree people get used to seeing the flare and halos, but it does not go away. One option you have is to get a monofocal lens set for distance in your second eye instead of another PanOptix. If you have good close vision in your PanOptix eye that should give you good reading vision without a second PanOptix. Only having the PanOptix in one eye MIGHT help you ignore the flare and halos from it.
derek40125 jacqueline78253
Posted
Hello Jacqueline:
My halos definitely improved over the first ~6 weeks, but they are still there and I have mostly gotten used to them. I will sometimes notice the halo, generally when looking at just a single light source (or a small number), but I also go long period of time without noticing them at all. For example, I drove about 2 hours last night in Los Angeles traffic and never thought about the halos once.
Generally LED lighting or other highly directed sources product much more noticeable halos compared to larger, more diffuse lights. Watching oncoming cars, halos are more noticeable with LED headlights. I rarely notice them when looking at older and less bright headlights. I can also look at moon without any halos.
Can I ask you how large they are for you (the halos)? Although the halos I have are not faint, they are also somewhat small. For example, when looking at an oncoming car, the halo doesn't extend far beyond the headlight (usually not past the edge of the car itself), so I never felt it was an issue driving. The other thing I noticed, when I tested one eye at a time (and I still do this) is that in my "good" eye, I would often see a "blob" of diffuse (less clear) light around the light source and this is the area where I would see the halo in my other eye. Once I figured that out, I just convinced myself that I was just seeing light sources in a different, but not necessarily "worse" way.
Let me know how the halos look to you, in terms of size. I'd also like to see how you adjust 6-8 weeks or so out. After a few months, make sure that the "target" distances where you see mostly clearly are correct for you lens. It turned out that I was slightly overcorrected and I lost my clear vision in the 8ft to 10ft range (before I hit the inner focal point). I had Lasik and they adjusted the focus and it made a huge difference for me.
nadine69440 aaron32806
Posted
I was wondering if things got better after second eye was done or if you chose a different lens for the other eye
nadine69440 jacqueline78253
Edited
It has been almost three months since I had my first eye done. I wouldn't get this lens in my other eye for any amount of money. I am wondering how you are doing now.
Joe_M jacqueline78253
Posted
I am roughly 3 years post surgery on both eyes. I have the same issue with rings that you describe. Look up Newton Rings and it will show a good example of what i see around every point light source. Mine are not limited to 3, rather the number of rings seems more dependent on the brightness of the light and is mostly noticed at night. Head lights, tail lights, street lights, christmas lights, even stars in the sky. In the daytime, i will see the rings around sun glinting off of chrome bumpers but it isn't as noticeable as at night. The rings have not gotten any better with time, but i think my brain has been able to finally just deal with them. For the first 6-9 months, i absolutely fretted over them and was second guessing my decision. I finally got to the point of accepting them, and things got better for me mentally. The rings are still there just like before but i now have to stop and think about thinking about them if that makes sense. Driving was not fun in that first 6-9 month period, but now it is no issue as my brain seems to just deal with the clutter caused by the rings. Vision wise, i am very happy with no glasses needed at all. Colors are great, not a lot of flashes but some when i get a light hitting the lens at just the right angle from the side. I did have to get the YAG laser process on one eye as the membrane was messed up causing some blurriness, but that wasnt the fault if the lens.
On a satisfaction scale with the PanOptixs, if asked 2 months after both eyes were done, i would have given it a 4 or 5 on a 1-10 scale. Now i would give it an 8 or 9. I initially had contemplated having them removed, and now i am so glad i didn't.
Guest 303z
Edited
Hi
For some it takes a couple of month before the brains accepts the three images and at all clears up, for some it only takes hours, it varies a lot from person to person.
I know it is frustrating where you are right now, but keep faith, I am absolutely sure that your vision will improve a lot the nest couple of month.
Lens flickering is very normal, I had that too, as I remember for about one month.
There can also be other reasons for the lack of vision quality beside brain adaptation.
Some get worse vision because of the eye drops, and will not get full vision before eye drops have ended, and dry eye can really make a mess as well.
You are very early after surgery, things will become a lot better.
About visual side effects, for most people they will get a lot less, but it takes time, for some it can take up to a year.
I have worst side effects from the Lara, it have never really been a problem, but noticeable.
I am 4 month after Lara implant, and the last couple of weeks side effects have changed rather sudden, I almost have to look for the starburst now, it almost feels a little strange that it have gone away like this, or almost gone away.
But days are different for me as well, it all varies from day to day, I think it could have to do with dry eye, but I don´t really care any more, I am just happy that I can do all that I can do.
So hang in there, things will become better! 😃
LaVonne2020 Guest
Edited
Did you receive the PanOPtix lens? I had my first surgery On Friday and I see spider webs terribly at night. My biggest complaint. Very debilitating.
Guest LaVonne2020
Edited
Hi
I have Zeiss Lisa Trifocal in one eye, and the Lara edof in the other eye.
Side effects like spiderwebs, halos and stuff is very normal with these lenses.
In my own case side effects started to change rather sudden after a couple of month.
Now I am 6 month in, and side effects have reduced a lot, things do change.
I still see concentric rings around strong light sources in the dark, especially from led lights, but night vision in general is very good I think.
I know it is very hard to be patient, but you really don´t know how it will turn out, before some month have past. Even between 6 and 12 month some people find that side effects faint.
Hang in there, things will be better!
lindameme LaVonne2020
Posted
hi LaVonne - just saw your post and was wondering if your halo problem went away - i also had the PanOptic Apr 29 & May 14 and horrible halos still
mommycat63 LaVonne2020
Posted
hello I just had my 1st eye done yesterday...close up vision is still blurry...worried it won't be as good as they said it would...how are you doing??
tsp1 lindameme
Posted
I had my right eye done with the PanOptix on April 29th also. I am having such issues that I have not made a decision yet to do the other eye. I am 66 years old and had cataracts. They were not debilitating yet but did not want to carry 3 pairs of glasses around. One for up close, one for far away and sunglasses. I am 3 months into it and have about 4-5 rings around headlights, street lights etc at night. My distance vision during the day is bad. Everything is blurry. After some time documenting, I realized it was the glare because inside I had no problems. On top of everything, they told me I have dry eyes and it caused a lot of pain, burning and feeling like I had something in my surgery eye. I didn't have this before surgery. I have determined if I have my other eye done with the same lens, I will not be able to drive in the daylight. I cannot read signs until I am right on top of them. And already I have something that is torn behind the lens that they need to laser if I decide to keep this lens. It cost $2200 and I was so hopeful but it is looking like they may need to take this lens out and replace it with a regular lens and go back to wearing readers. If any of you have had the glare issue with these and found it went away after a period of time, please let me know. I hate to undo what I already had done but I am told I need to make a decision sooner than later. Thanks in advance.
donna96316 tsp1
Posted
how is your vision now? did you keep the panoptix or have them removed?