Panoptix Lens for cataract but can’t read and intermediate vision is bad. Anyone else?

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I received a Panoptix lens implant in my non-dominant eye after cataract removal. The surgeon assured me it would let me read and work on the computer without glasses. He did warn about night time vision problems which are not relevant here. however, i have never been able to read or work on the computer with this lens! My near and intermediate vision is worse than it was when I had cataracts. In all my research online I have found no one this has happened to. Surgeon just said that the calculations they make are normally very very accurate but for some reason I'm just one of those people whose "vision system" wont work with the Panoptix. What is weird is he then tried to convince me to get Panoptix in my dominant eye, because these lenses work better together. He also suggested additional surgery to my eye to "tweak" it, but doing so would take away from the 20/20 ling distance vision the lens gave me, which is the only good thing about the lens so far. Then he wanted me to get Crystalens in my dominant eye, which admittedly wont get me good reading vision, and I can just wear reading glasses.

I don't need emotional support or any "attaboy, keep at it". I just want to know if there is ANYONE else out there who cant read or work on the computer after getting the Paniptix lens. I have searched the Internet and I can't find a single instance.

0 likes, 20 replies

20 Replies

  • Posted

    There are a couple of threads here started by claudiaRM that you should look at. She had a bad experience with close and intermediate vision. It seems they just "missed" with the right power of the lens. I have a friend who has Panoptix in both eyes and is not totally satisfied with close vision. She is mainly eyeglass free, but does use +1.75 readers for reading and close fine work.

  • Posted

    There have been many post from people who have had issues with the PanOptics IOL. As Ron mentioned check out ClaudiaRM post, where she extracted the PanOptics and implanted a monofocal.

    I would not recommend doing anything with the other eye until you have this issue addressed first.

    If you look on Youtube, Dr. Shannon Wong has extracted PanOptics in some patients in implanted Symfony and visa versa. For some people for whatever reason certain IOLs just do not work. You Might contact him.

  • Edited

    i had 2 panoptix lenses placed 2 weeks apart in

    January. Right eye was done first No issues good

    vision all around both near and far. Second one

    had blurry medium and distance vision from the

    very beginning and I am now about 8 weeks post op and it has stayed the same. Apparently the biometric measurements were off in second eye.

    Everything has healed well No inflammation. Dr was pretty upfront about it. Eye needs to be stable

    before they can do a laser correction. However to get my distance vision better I may lose some of my extraordinary close vision in my left eye. Ironic thing is my left eye had good vision to start with. Whole reason I did cataract surgery was because of my right eye which had developed poor vision over past year and a half. Seems your problem is just the opposite of mine. Hope we both eventually get it resolved

    Tom C

    • Posted

      I'm facing a similar problem to you, where reading is great - but anything beyond 6 feet away is blurry. I only had one eye done - my left eye (which is my non-dominant eye) - about two weeks ago. The eye also feels constantly strained - like an eye muscle strain. Did you have this issue? ....

      My ophthalmologist wants to do the other eye - but I don't! - Not until he fixes this eye. The other eye - when I wear a contact lens - allows me to see medium and long distance. If he messes with this eye, I'll lose all distance vision. So, I'm really worried - Not sure what to do.

      I did have an astigmatism in my left eye - but my doctor didn't give me a PanOptix toric lens. Could this be why I can't see medium and long distance? I don't know what to do at this stage.

    • Posted

      The best thing you can do at this point is have your eye tested by an optometrist to determine what power lens is required to correct you to 20/20 vision. It sounds like you may have been left a bit myopic. I would wait until the 3 week mark to get it done as your eye is still healing and will continue out until about 6 weeks. The test at 3 weeks will tell you if it is a bit off or a lot off.


      There is no rush to get the second eye done, and I agree you should get the first eye sorted out first. If the power is off and needs correction there are a couple of choices. One would be to explant the lens and put the correct power in. On the second try it should be accurate. The other choice would be a Lasik correction. If you are myopic then a Lasik correction should be straight forward. If you are hyperopic then it may be more difficult and a lens explant may be better.


      The other thing to keep in mind is that since this eye is your non dominant one, you could get a monofocal in the second eye. That would be a bit lower risk. If you can get good close vision with the PanOptix then the monofocal will give you good distance vision.

    • Edited

      Thank you for your reply. I think I'm hyperopic. My eyesight before the surgery was far-sighted - where my contact lens was +6.0 in the left eye and +5.5 in the right eye.

      This is why being able to read with this new PanOptic lens is so great. But I can't see anything beyond about 6 feet without blurriness. .... At the one-week mark (after surgery), I went to see my ophthalmologist, and he seemed focused on setting up a surgery date for the second eye, instead of fixing this eye. He mentioned doing an office adjustment (I guess that's the lasik adjustment?) in a few months - but that would preclude me from being able to swap out the lens for another one, right? So, I don't want him doing that unless we're certain this will fix it. I don't want to lose the reading vision - and still not be able to see medium/long distance.

      If I opt to swap out the lens, what happens if I lose the reading vision again?

      We originally talked about getting the Vivity lens in the dominant eye - so that I wouldn't face the "halo/starburst" issues so many other people face. He said this would lessen that risk. But the Vivity doesn't offer good reading vision - so I'd be relying on my left eye for reading.

      I go to see my ophthalmologist again in three days - so I'm guessing he'll pressure me again to set up a surgery date for the second eye.

      Do you have any thoughts about the eye muscle strain that I feel in that eye? My eyebrow is even raised slightly on that side, where I feel the strain. Have you heard of this before with anyone?

    • Edited

      Yes, you were hyperopic before surgery, but from what you describe the IOL power used has made you myopic (can see close, but not far).


      Yes, you want to sort out your first eye before you do Lasik or proceed with the second eye.


      The theory of the PanOptix is that when it is set for perfect 20/20 distance vision it will also give you good reading vision. So for example if they were to fix it with Lasik you should still have reading vision. The other way which may be better is to switch the lens out for the correct power lens. The sooner that is done the better. The surgeon should be able to get the right on the second try.


      The Vivity would be a choice for the dominant eye, but a simple monofocal like the Clareon may be better. The Vivity has lower contrast sensitivity.


      When you get a refraction test that will tell you if there is any excessive astigmatism. It is common for there to not be enough astigmatism to merit correcting it. The toric part of an IOL comes in fairly large steps. If you have less than 0.75 D of astigmatism it typically does not merit using a toric. Astigmatism also affects vision at all distances, not just at distance.


      I can't offer any explanation for the eye strain other than how are you dealing with having a PanOptix in one eye, and needing a +5.5 D in the right eye? If you are using a contact in the right eye, that would be the best way to do it. But, even with that, it seems you need a correction in the left eye too.


      The key to deciding what to do next is to get your eyes tested to determine what eyeglass prescription is needed. That will tell you where you stand.

    • Posted

      Thank you.

      When I asked him (last week) about whether a toric lens might have been better - and asked him what my astigmatism was - he claimed it was about 1.0 - but he was guessing as he didn't even look at my chart. (He pushes through so many patients each day, there's no way he'd remember without looking at my chart). I think he doesn't want to admit he made a mistake on the power.

      As for the eye strain - I'm wondering if it's related to the surgery and possible eye muscle damage. ..... My surgery day was weird. After he used the machine to destroy the cataract, he brought me back to a room to sit and wait for the second part of the surgery, where he'd implant the PanOptix lens. I sat there - with feelings of broken pebbles in my eyes - for over an hour while he did THREE other patient surgeries who were waiting for him to do their eyes! It was really bizarre. When I asked why he didn't wait to do the first part of the surgery until he was free to do the second part - he said "oh the machine came free so I wanted to get you in there." .... When he finally implanted the PanOptix lens, they must have given me too much anaesthetic because I was completely unconscious for that part - even though he told me I'd be awake.

      I've also started experiencing a new issue over the past 2 days. I'm seeing a "lightning rod" flash in the far left peripheral. It's happened several times - mostly at night. I don't think it's the "flickering" issue that many PanOptix patients have reported because there's no light shining in my peripheral when this happens. Not sure what this is - but it's scary when it happens.

      Anyway, I go back to see him tomorrow. Wish me luck.

    • Posted

      Cataract surgery can be a bit of an assembly line process. Especially with my first surgery done in a hospital, I lost track of the number of people that saw me before I got the actual surgery.


      My wife had toric lenses and she said it was a two step process. The surgeon saw her in one room to mark the eye for the toric angular position, and then she went into the surgery room a little later.


      I have also had this lightning effect. But, I only get it when in a dark location and there is a light source off to the side, like a street light.

  • Posted

    I dont have panoptix, but I have a similar issue. I expected to need reading glasses for close up, but not for simple things like zipping my coat, etc. So unhappy and dont know where to turn next....

  • Posted

    me! I've had mine for about 2 months now. When choosing this lens i was told that I would be able to see using my phone but would need readers for my computer. I cannot see either without readers. I have a monofocal in my left and a Panoptix in my right. Im only 41 and my vision is basically gone/ruined. I developed cataracts due to being prescribed too high of a dose of prednisone for too long and needed to replace both lenses. I wish I had just removed the cataracts and gotten a clear/uncorrected lens for both and just continued with glasses and contacts for life

    • Posted

      An old thread here.

      Erica sorry to hear this. IMO there are 2 things when it comes to the Panoptix. 1 it is not for everyone, and Drs should be more carful about selection. 2 The Dr must hit the mark dead on of vision will not be what it should be.

      I almost made a mistake picking a Dr but lucky I moved on and found a better Dr before the surgery. My initial experience with the Panoptix was rocky but has settled very well. At this point I can read tiny Rx inserts, computer, TV, drive whatever clear as a bell. So if the Dr hits the mark things are what they should be but if they miss it’s a total miss all ranges.

      The other thing I realized before surgery (as left and right was 6 months apart) is that 2 of the same lenses is going to give the best results. My Dr even was very clear that this particular lens was designed to work in pair and that was the only way to achieve the fully expected results.

      Also what you were told seems odd as the whole point of the Panoptix is to not need glasses for anything. Being told you wont need glasses for phone but need for computer is sounds off to me. I assume they set your single vision IOL for distance and totally missed on the Panoptix. Not sure what your Dr told you just does not sound right. I can also tell you I had the Panoptix in my left eye for 6 months and cataract in the right and I had no need for glasses from 12 in to infinity. So what your Dr told you sounds off to me maybe go get a second opinion for sure.

      Again sorry to hear this as you should have had better results.

  • Posted

    I have multi focal Panoptic lens in both of my eyes. I regret selecting these lens, they were however recommended by my ophthalmologist. It has been two years since my surgery and I suffer from light sensitivity, tired eyes, vision is not sharp, inability to drive at night due to halos and glare from oncoming cars. I am totally unhappy with these lenses and I am currently exploring having them exchanged for a mono focal lens.

    • Posted

      Iguana very sorry to hear this more evidence that Dr should better explain things and take more time with patent selection and what they recommend.

      I am just curious when you say halos and glare it’s a broad term what exactly do you have issues with. What I mean is I too initially had these issues but they no longer affect my driving. I too did not have sharp vision for several months. Also when you say light sensitivity are you talking about just during the day at night or both?

      Having them exchanged is a big decision is it more that you're doctor missed the mark or just the general normal side effects that you expect with the multifocal lens that are bothering you?

    • Posted

      Yes, the doctor should have spent more time with me discussing my options. Basically, he handed me a pamphlet and advised me to go with the Panoptic lens because I told him that I would like to eliminate glasses.

      After I complained for several months about the extreme light sensitivity (day and night), constant glare from lights, sunlight and screens, tired eyes, vision was not sharp and inability to drive at night he told me that I needed a YAG procedure. He reassured me that things would get better after the YAG which they did not. Once you have a YAG, removing the lens becomes much more difficult. Most ophthalmologists don't have the skill to remove a lens after YAG.

      So, over the past two years I have seen many doctors. My cornea doctor referred me to Dr. Steven Safran who I had an appointment with this past week. He is located in NJ. When he examined my eyes he found a tear in my retina which had to be repaired immediately. I cannot proceed with a lens exchange until my eye recovers from the retina tear. You are totally correct about a lens exchange being a big decision. But it has been two years and my vision was better prior to the surgery than it is now.

      Two years ago, when I went to see my ophthalmologist, I had a pain in one of my eyes. He told me that I should have my cataracts removed and maybe the pain would go away which it did not. I later learned that cataracts do not cause pain. I have consulted with a few attorneys but so far, I haven't been able to find an attorney that is interested in my case.

      I plan on proceeding with a lens exchange but that probably will not occur until sometime this fall.

    • Posted

      I am so sorry for what you have been through. I always tell patients to seek two or more opinions before proceeding with cataract surgery. Find someone you trust, who listens to you, and with whom you feel comfortable. Research your surgeon. Don't be rushed. Don't let yourself be pushed into a procedure or a lens you are not sure about.

      Suing a cataract surgeon for malpractice is very difficult.

    • Posted

      Oh my what a shame hopefully you can take some legal action. Especially sounds like pain and YAG you were misled.

      Sounds like from the get go you were not a good candidate for a MF IOL. Also that you Dr maybe was more interested in the extra income of selling the MF lens and did not even check your eyes.

      Wish you the best.

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