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
kwilson2019 303z
Posted
A couple questions for monofocal lens people.
Are you having glare, star burst, side cresent glare issues?
What is the distance that clear vision starts, 4ft, 6ft, 8ft?
I am day 7 with a Panoptics lens in Right eye and disappointed with the amount of glare. I understand there was some to be expected. I do see a couple of rings, some star burst and a glow that is tolerable, these are rather close to the lights. The clarity of vision starts about 16 inches from face and very good from there on out. But the 'side crescent' glare and an angled star burst streak that covers entire vision is not going to be tolerable. Physician claims 'the brain will adjust and compensate in time. I just don't buy that. And the 'just get used to it' Is dangerous. Inside, lights to either side creates a crescent glare just off center of vision making me wipe, brush my eye as if there's fuzz or something on my eye. If there's a light on both sides I get the off center crescent glare and a blurry blob of glare in the center of vision. Forcing to look away, turn my head to see. Night driving is compromised. Head lights of oncoming vehicles, Street lights, the angled Star burst streak covers the entire road and cant see if there's a person, animal or objects in the road. So I am considering to swap for a monofocal in right eye and a monofocal for left eye. Providing monofocal IOL's don't have the glare issues and can get good vision starting 2-3 ft from face and there on out. Left eye has no IOL implant as of yet. After reading a few others here maybe its too early to decide and will postpone left eye IOL a month or so. Thanks to all that share their experience and results. Getting actual results from patients is far better than what physicians say or won't say.
el1812 kwilson2019
Posted
KWilson, hope you are feeling better now! Please can you update on your decision about PanOptix in your RE. Many thanks and all the best for you.
303z el1812
Posted
For me, Panoptix are still a really mixed bag at almost 2 and 3 months post-op. Outside vision seems very good during the day at most distances, but I have difficulty reading indoors quite often, especially in places like grocery stores that are brightly lit. I've been tearing up in some bright settings to the point of having to leave them. At best, it seems like in artificial light there are distinct soft spots between the best near vision Panoptix offer and the midrange vision. For me, midrange vision is essentially non-existent at this point, which is incredibly disappointing as that was a major factor in choosing(and paying for) trifocal lenses.
I see my optomitrist next week and am hoping to get answers beyond "it's too early to tell, let yourself get used to the lenses for another month or so".
derek40125 303z
Posted
Have your optometrist confirm that you aren't overcorrected slightly. I have a RESTOR 2.5D, which is a multifocal and my midrange vision was disappointing as well (distance was great). I tested contacts and discovered that midrange improved markedly without any degradation to distance my using +0.5D contacts.
At about 2 years post-cataract surgery, I had LASIK to adjust vision +0.75D (no charge as adjustment was included in the cost of premium lenses) and it has made a huge difference in the mid-range distances (and no loss of distance vision).
This may not be the case for you, but definitely get it confirmed and it's easy to test this out.
LaVonne2020 303z
Posted
I noticed your post is 3 months ago. I am experiencing the same thing as you did. I am scheduled for my second eye on Monday. Could you please let me know how you are doing and if you would suggest I do the second eye? I am very concerned.
Thank you!
303z LaVonne2020
Posted
Sorry to hear you're experiencing similar issues. I have an appointment with another surgeon on the 21st, as my optometrist appointment a few weeks ago essentially resulted in his suggestion of my needing glasses. My current symptoms are occasional inability to focus at midrange distance, especially with artificial light, and peripheral light sensitivity that causes my eyes to tear up. The optometrist essentially said that one eye is seeing like it's a -.5 reading lens, which explained why trying reading glasses while using a desktop computer didn't help at all. He thinks the surgeon may be able to perform a bit of lasik on one eye, but that the other eye is probably too close to warrant surgery.
Overall, my vision is much much better than it was with cataracts. That said, I don't know if I'd go with Panoptix again. It may be as simple as the surgeon just needing to zap my eye to get to where my vision is much better - the optometrist had me look through prescription lenses, which definitely drastically decreased the eye strain and discomfort from artificial light, and did help with some midrange clarity.
Halos and starbursts at night have become more tolerable, but are still there. As someone mentioned earlier, the halos are worse around lights that are farther away, and diminish as they get closer. For instance, an oncoming car a few blocks away has a very artificial, blurry look. Once it's within a few meters away, the light can clearly be seen, but there still is a little bit of a halo around it.
kwilson2019 303z
Edited
LaVonne2020, I am 4 months with PanOptix in RE and still have light issues. The side finger glare is much less but still there, I dont jerk or shy away as if some thing is about to poke me in the eye as before. I am yet to be bothered by the halo rings due to the extreme star burst effect. There is 6 very large, long rays from head lights, tail lights, street lights, any bright light at night, when there are mutiple vehicles the flares actualy covers objects that I can no longer see, people, mail boxes, animals, not a good situation. During the day if the sun is in my vision there are massive flares, sun glints from vehicles, any thing reflective, that extends across my entire vision in the right eye . Went to the lake to do some fishing an couldnt deal with all the massive constant flares off the water. The physician hit a very good mark on the proper strength and placement of IOL. I was -15 , 20/60 with contacts, in right eye and now 20/25 in right eye. So vision clarity during day light or well lighted areas is very good. Night vision is horrible, I can see better at night with left eye that still has catarac, I close right eye when there is too much light disturbance, day or night, its more than a nusance, dangerous at times. I came upon a vehicle crash one night there was so much light flares from the emergency vehicles, head lights, etc, I could not see the police officer directing traffic, very disturbing. I considered changing to mono but was told that I would need glasses for close and intermediate possibly far vision, physician had me wear some glasses that would represent my vision with mono IOL and it was as if there was no IOL at all, I couldnt see any thing near or far. Not sure if it was a ploy to persuade me not to change the IOL. Physician wanted to do left eye, I stated in a probably not so polite way that he wasnt touching my left eye untill right eye has improved or replace IOL. They have since suggested doing YAG laser but from what I have read that has worsened many people that have these star burst flare issues, and doing YAG makes changing IOL even more complicated.
I would like to hear more from others that have had the YAG procedure. Left eye has catarac and 20/60 with contact lense. Makes for a bit of depth perception issue, and dull night vision. But I will hold off doing left eye as long as possible.
Chris53317 kwilson2019
Edited
@kwilson2019 This is such a complicated situation and everyone seems to have a different experience. This makes it really difficult for the doctors to predict the outcome.
My distance vision was not great, 20/25 & 20/30, at my 2 month checkup, and my optician observed some cloudiness, using the slip lamp, . He sent me back to the surgeon who also confirmed PCO, and performed the YAG procedure on both eyes 3.5 months after IOL implant. Both eyes were 20/20 after but distance vision does not seems to be as sharp as I would like.
I experienced minor starbursts before the cataracts surgery, and the situation after with the MFIOLs seems about the same. I am not aware of any difference with halos or starburst before or after the YAG laser procedure. My RE has a fine vertical light shaft, but it does not bother me, and could be from the 0.75 astigmatism. Will find out at my 7 month checkup.
ayeaye Chris53317
Posted
hello. can I ask what do you mean by having a fine vertical light shaft?
you have the panoptix in that one eye?
ayeaye kwilson2019
Posted
hello. By physician giving you glasses to show you what mono would look like- do you mean.optometrist? but if you had a mono iol you would need glasses for near and intermediate, but would see far without them.so in glasses they would not need to do any correction for distance but only correction for near and intermediate, right? I have first eye in 10 day and I just decided to do monofocal toric and not panoptix, because I wont be able to deal with the most likely horrible night vision disturbances. I'm very nearsighted. I hate that I even need to get IOL cataract surgery. seems like everything is a trade off when you lose your natural lens. im only learning this all in 2 weeks of new research. nervous scared and so not looking forward to this. sorry about your issues with panoptix too. made me more decided to go mono toric..
kwilson2019 ayeaye
Edited
ayeaye, the 'test glasses' were the really obtuse goggle like with changeable lenses thing. Which I really question were doing what he was trying to prove that if I went with a mono IOL that I would lose all vision from near to far and would need glasses for all vision, he contradicted himself, making me feel he was trying to convince me to stay with the Panoptix. After such I'm not real confident in him now. Before the IOL surgery he stated with a mono IOL set for far vision, I 'might' need glasses for near/intermediate. And pushing to do the left eye real soon. He brought in another physician, his senior/superior, whom stated YAG would make the long streaks go away. From what i'm reading YAG may be creating the condition for some and also having no effect on others, with exception of the PCO cloudiness condition. I found some information on 'Eye World' about a Marie-Jose Tassignon, MD has developed an IOL with flanges that supposedly eliminates these light aberrations but is not yet approved for the USA and gives no other information describing such IOL. I am still researching for this IOL.
I really wished I would have found this site/forum 'patient.info before my surgery.
Chris53317 ayeaye
Posted
@ayeaye I have Ponoptix trifocals in both eyes. Bright lights, like headlight have halos (maybe 4 or 5 rings that doubles the size of the light) or as others have described it as a spider web. With the right eye only there is a fine shaft of like that goes straight up and down from the light source, like a thread, but it is distracting.
Thelionartist kwilson2019
Posted
how about seeing your smartphone? and working on pc ? and watching TV in dark room ? at night with light of room is on ?
assia99778 ayeaye
Posted
ayeaye - are you happy with your monofocal implants? Like you I'm very nearsighted with moderate astigmatism. I am extremley unhappy with trifocal Zeiss-IOl due to severe halos, spiderwebs and because intermediate vision doesn't work. I need glasses for far and intermediate vision, got induced astigmatism in one and residual astigmatism in second eye because of rotation. Though I'm thinking of lens exchange and getting two monofocal IOLs corrected for far vision. What do you see with those monofocals without glasses? Do you need glasses do figure out your clock in the morning? Do the glasses/contacts work well in the intermediate and near range with seamless reading? Thank you!
LaVonne2020 303z
Posted
This is my story exactly! Only difference is I was 20/40 pre surgery. Just saw a specialist today. He said do absolutely nothing with the nonsurgery eye until I see if I like the lens.At least 6 weeks. If I would have known this prior to surgery I wouldn't have chosen it. I have the flicker in my surgery eye, horrible spider webs on all lights, glare in the daytime. And this is with both eyes, close the non surgery eye and it is really bad. Keep me posted on what you decide. I am 11 days post surgery.
ayeaye LaVonne2020
Posted
hello. at 20/40 presurgery, why would you even need cataract surgery? this is all kind of new. I'm terribly nearsighted and am scheduled in 10 days as my one eye cant be corrected by glasses (lots of astigmatism)
and will have to do left eye because I'm only like one power away from.non eyeglass correction. I'm really so sick about upcoming surgery. learning that iol takes away what naturally lens have. was thinking for awhile pan optix but researching too many with nighttime visual issues. cant deal with that, so im.deviding toric mono for both
Sue.An2 ayeaye
Posted
Hi at best corrected 20/40 vision due to cataracts that is where the surgery is covered by medicare in Canada (and i assume other countries that have national health). If vision can be corrected with glasses or contacts to better than 20/40 then they will ask you to wait for the surgery.
ayeaye LaVonne2020
Posted
hello. you got the pan optix in one eye right?
kwilson2019 LaVonne2020
Posted
I was shown examples, comparisons of different IOL's of what the light aberrations would most likely be. The Panoptix had the least star burst and halo rings of given types. What I am seeing now is by no means like any of the examples I was shown. Feel I was 'sold'. Before I do left eye definatly will be getting other opinions.
ayeaye kwilson2019
Posted
hello. I believe the biggest tradeoffs with pan optix are the starburst and haloes you will see at night. I found on a website the actual.label of the panoptix the dr gets..and it's right there
LaVonne2020 ayeaye
Posted
Yes, only one at this time until the glares improve.