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
Night-Hawk 303z
Posted
Some surgeons shoot for about 0.5D of residual astigmatism and it can vary for a couple months after surgery too. So 0.75D isn't far off. I ended up about 0.75D-1.0D cylinder astigmatism myself after 2 years its remained pretty stable and even with that I have a lot of times where I can get better than 20/20 distance vision uncorrected or as good as 20/12 corrected with glasses in that eye. I have a Tecnis toric monofocal and that eye was originally almost 3.0D astigmatism prior to cataract surgery.
soks Night-Hawk
Posted
why would they aim for residual astigmatism?
Night-Hawk soks
Posted
I was told by the surgeon that the eye as it continues to age will tend to get up to 0.5D astigmatism over the coming years, so they want to compensate by starting with a little astigmatism in the opposite angle.
soks Night-Hawk
Posted
interesting. i wasn't told this. i ended up with -0.5 astigmatism and was a bit p****d that he didn't do LRI to address it.
W-H 303z
Posted
Give it time it is early days, specially for a Trifocal.
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45 years your brain has been used to doing things differently, not to forget thousands of years of genetic memory.
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Don't mean to be tough on you but comparing pre cataract vision to post cataract vision is bit unfair 😃 I have 20/12 vision ( or better) at age 46. If I get cataract I will take 20/25 uncorrected vision in a heart beat.
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Let me point out that you were heading towards blindness, so getting 20/25 uncorrected vision is a HUGE HUGE HUGE upgrade!!!! Hope things improve and you get EXCELLENT outcome 😉
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Btw did your surgeon give you any solid indication of when it is safe to return to hard sports?
303z
Posted
I talked to my surgeon's optometrist. She said that they did do incisions to reduce my astigmatism during the IOL implant, they just didn't tell me. While the surgeon is supposed to be one of the best around, and their office is similar, it's been frustrating to seemingly talk to a different person for each appointment, etc., as things like the astigmatism correction procedure weren't discussed or passed along to me - or my original optometrist - until inquiring about the less-than-sharp distance vision.
The glasses my optometrist prescribed are an impressive remedy to the distant vision and night vision issues. I can drive at night somewhat comfortably with the glasses, though I've noticed there are now starbursts in addition to halos around headlights. Near vision has a broader sweet spot range, but that 24-inch distance is still soft.
The glasses aren't a completely accurate prescription, more of a quick fix effort to experiment with. The surgeon's optometrist is going to try to get me in to see the surgeon so he can exam the eye. It sounds like if there's any added procedure to correct the astigmatism, it'll be up to three months from now to make sure the eye has settled completely.
One side note, I'm realizing that the moon is bright enough to throw halos, too. Everything is a tradeoff, just something that I never thought about - that enjoying a beautiful, crisp moon is something that I probably won't experience anymore. I guess I can photograph it, then view that image, but that's not quite the same. Just an observation more than anything.
soks 303z
Posted
best wishes for your vision improvements 303z. speaking about the moon i was at the observatory a few weeks back and trying to look at saturn rings through telescope with symfony eye i could not see anything. had to use my unoperated eye to see through the telescope so basically would need readers on the symfony eye. i do see halo around the moon with the symfony eye and the mom also creates positive dysphotopsia arcs for me.
Sue.An2 soks
Posted
Would like to try that - looking through telescope to see what the view would be like.
Guest 303z
Posted
Do you know what the glasses does, do they fix astigmatism or refraction?
It still sounds to me that refraction is off to the myopic side.
303z Guest
Posted
The glasses supposedly fix the astigmatism.
Guest 303z
Posted
Ok, sounds like you might have been really unlucky bout the astigmatism, but hopefully it settles at a better place than now.
cyclemom 303z
Edited
Thank you for posting this. I was diagnosed with cataracts four days before my 46th birthday (three weeks ago). I am also young for cataracts, however I was told mine was possibly caused by trauma. In December of 2017, I was in a Motor Vehicle Accident and took an airbag to the face (I'm 5 ft 1 inch and pretty much sit at the steering wheel lol) I thought my presbyopia was just getting worse and so I went for an eye exam. The Optometrist didn't even need to dilate my eyes to see that I had cataracts. I made an appointment with one doctor in the area and then decided to get a second opinion. The first doctors office uses johnson and johnson lenses so they don't offer the panoptix. I decided that if I had to get the surgery I was going to get the latest and greatest since I believe I have MANY MANY more years to enjoy good eye sight. I have to admit that after reading this entire thread and other threads, I'm just pretty much nervous beyond explanation. My first eye surgery is scheduled for November 13th. I think as each day goes by I get more neurotic about the whole ordeal. I'm also a bit off put about the whole thing since I can not recover any of this cost from my accident due to uninsured motorist. I decided to finance it because it's a once in a lifetime surgery (HOPEFULLY) and I might as well do it right.... right? I do see there is hope and that it apparently takes a little bit to adjust. I have a pretty decent astigmatism in one eye and not the other. The counselor told me that the Doctor doesnt like to over correct astigmatism so where I qualify for the Panoptix Toric version in my right eye and not my left, they will do the non toric for both. I don't want to wear glasses because of one eye so I'm REALLY going to express my concern since I'm having the left eye done first. I'm very nervous about the whole flicker issue, weird reflections, halos (although they can't be worse than they are now...knock on wood), and the lack of vision correction. I too am very active as I run, cycle and weightlift. I guess I'm going to have to learn what "take it easy" means again.Thanks for everyone that chimed in on this post, because it is all very helpful and puts me a little at ease......
Guest cyclemom
Posted
Hi
I understand your concern, truth is we are all nervous before the surgery, and it is always easy to say it was nothing, when it is all over.
But really, it was nothing 😃
I have a Zeiss trifocal in one eye similar to Panoptix, I am a big fan of the trifocal.
About visual side effects, in my case side effects are much less with the lens than I had with cataracts. When I had cataracts nighttime driving was not pleasant at all, even that I did it anyway. Nightvision is so much better now, yes there are halos and stuff around light sources, but nightvision in general is very good, I can see so much more than I could with cataracts.
We have had trifocals since 2010 in Europe, many people get these as clear lens exchange to treat presbyopia, and most people that get clear lens exchange are very happy wit their result, the clinic I used have a 98% positive feedback from their patients that have clear lens exchange in a third part online feedback system. And if you are having cataracts treated with the same lens, I guess you will see a bigger improvement than those who get clear lens exchange.
Off course this surgery and these lenses have their downsides, I am not trying to say that they don´t, but I think some of it sounds worse than it is.
About astigmatism, it sounds a bit strange to me they will not try straighten it out.
I have toric lenses in both eyes, both lenses are 3.0, and my astigmatism is reduced to only 0.25 each eye. I don´t understand why not try to fix it, I am really happy how it turned out for me.
About adaptation, true this can take a while with the trifocal, in fact I have heard about people that see an improvement even after 12 month.
In my own case I had full vision day after surgery, just as I had with the edof in my other eye.
Sue.An2 cyclemom
Posted
Hi cyclemom
can't relate to all your concern and worry. I too developed cataracts young st 53 and felt cheated. This must be hard to come to terms with for you st 46. Yes trauma (blow to the face can definitely bring on cataracts). Myself it was likely all the cortisone creams for eczema that brought mine on.
Are you now able to sue the person that caused the accident personally vs thru insurance co?
I live in Canada so our medicare system covered the surgery but not the premium lens I chose. Like you I felt I wanted the latest a available here which in 2017 was the Symfony EDOF lenses and I have had both surgeries July and August of that year.
If I were in your shoes I would question the astigmatism correction with a toric lens. My thinking is that you might end up having to wear glasses anyways for that and if your goal is to be glasses free as much as possible (although never a guarantee with all the variables involved) then why wouldn't the surgeon recommend a toric lens? Do you know what that number is for your astigmatism. If it id below 1 they don't usually correct. Sometimes they can do a procedure during surgery called LRI (limbal relaxing incision) to deal with the astigmatism.
The procedure itself concerned all of us but honestly it won't be painful - having my teeth cleaned at the dentist takes linger and more uncomfortable.
Do follow all the cautions afterwards regarding strenuous exercise. They tell you to resume normal routine in a few days nut consider their usual patient's age (and in this culture I know some pretty active 70 year olds too). So I wouldn't be lifting weights etc until minimum 3 weeks and it actually takes a full 6 weeks for eyes to heal. Me I wanted to be on safe side and what are a few weeks compared to rest of your life.
Wishing you all the best.
melodyNYC Sue.An2
Edited
You're the first person to suggest waiting to resume going to the gym. I do HIIT exercise classes every day over Zoom, where my heart rate goes above 150 at the peak. Doing these classes are really important to me as they give me energy, and keep me healthy. When I asked my ophthalmologist how long I'd have to wait after the surgery before resuming the classes, he didn't seem to know. At first he suggested a couple of days - then later suggested a week. So, I just wasn't sure. It's been 9 days since I had the PanOptix lens put in my left eye. I resumed my exercise classes two days ago, but I'm wondering if it was too soon. What made you decide to wait 6 weeks?
As for my eyesight following surgery --- I still feel pressure behind my eye. ..... Reading is great with the PanOptix - but middle- and- long distance is blurry for me - which is disappointing. I go back to see my ophthalmologist tomorrow, where I had originally thought I'd be arranging a time to do the right eye - but now I'm not so sure. .... Has anyone else had trouble seeing middle-and- long distance following surgery? If so, did it get better after a few weeks?
RonAKA melodyNYC
Edited
I don't think the concern about exercise after cataract surgery is over aerobic exercise. It is more about weight training and straining. I recall lifting weights over 15 lbs are supposed to be avoided for a couple of weeks. And there is a concern about contact sports where there might be some contact with the eye.
Sue.An2 melodyNYC
Posted
Hi at time of my surgeries I was a long distance runner. The pressure in your eyes from weight lifting or high impact exercise is present. Given benefit of vision over rest of my life vs sacrificing high intensity training for 6 weeks was a no brainer for me. I did exercise - long walks, biking (not straining).
Reason most doctors cannot answer that question is the age of their average cataract patient is after 70. I was 53 when I had my surgeries for cataracts. Normal exercise is different depending on your age.
Everyone can decide for themselves when they resume normal activities - 6 weeks is the normal healing time of uncomplicated cataract surgery so that's the time I chose to resume my long distance running.