Panoptix or something else
Posted , 10 users are following.
Hello! I have been considering an RLE for a couple of years and was about to commit to Panoptix but I just keep worrying over it. I am a -8.50 in both eyes and have been in glasses since childhood. I am 52 years old and wear progressive glasses 100% of the time. I can see perfectly about two inches from my face and can read my phone at about 5 inches, without glasses. Beyond that everything is blurry. I spend most of my day in the near to intermediate range for work. I am a weekend warrior with lots of water sports and outdoor activities. My night vision is poor and I do not drive after dark if I can help it. I am worried about losing my close vision even though it is so narrow in range. Is this something anyone is worried about, misses, or was able to adapt to not having post surgery? I would love to have less dependence on glasses and am not happy in my progressives most of the time. Contacts are not an option. I do not want to be in a situation where I have to tuck readers in every nook and cranny, but do not mind if i need them for super fine detail on occasion. I would rather be stuck wearing glasses for distance than for near. Would appreciate all feedback.
0 likes, 23 replies
RonAKA jim96821
Edited
That is a significant amount of myopia and I can see why you would want to be correcting it without progressive glasses. However, there are issues with multifocal lenses like the PanOptix and Synergy. Some people adapt to them and others do not. Some even dislike MF lenses to the point they have them taken out and replaced with monofocal lenses. Of course once you extract the natural lens there is no going back to them.
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One alternative to MF lenses is mini-monovision. You fully correct the dominant eye to distance and under correct the non dominant eye to -1.5 D of myopia. This gives pretty much a full range of vision with only very occasional need for readers. It can be done with monofocal IOLs, but since you have no cataracts I would suggest trying this first with contacts. You may find that to be a good solution until you really need IOLs due to cataracts.
jim96821 RonAKA
Posted
Thank you so much for your response. The mixed reviews with the MF lens exchanges are what have me in limbo. I did not realize mini monovision could be used for my needs. I am going to research this now.
Guest jim96821
Edited
If you don't have cataracts and can correct your vision with glasses I would not do any surgery, personally. Current implant technology cannot bio-mimic the human eye (yet… it may in the future) so they all have big limitations when it comes to the trade off between image quality and focus range.
jim96821 Guest
Posted
I understand that perspective. I can correct with glasses but I am unhappy with progressives. I have several different pair at big cost. I have such a narrow sweet spot for reading and it is depressing. I take my glasses off and read inches from my face but returning to glasses after this takes awhile for eye adjustment. Aesthetically, my lenses are so thick (thinnest money can buy) that I hate the way they look. I am distracted by the thickness out of my peripheral vision. Glasses are not ideal for me and my vision is the most upsetting aspect of my life.
Guest jim96821
Edited
Understood. Just understand that IOLs have drawbacks as well and you are considering an invasive, unnecessary, and irreversible surgery. If you understand that and still want to go ahead that is your decision. You may be very happy with the results! But if you are not, there is no going back. Not really (some surgeons will change a lens in extreme cases but the risk is much higher and a lot of surgeons will flat out refuse unless the issue is vision-threatening).
karbonbee Guest
Edited
You know, if the Eyhance IOL had been around ten or fifteen years ago, and I was aware of it's capabilities, or even of just IOL replacement surgery itself, I would have jumped on it despite no cataracts in sight! Compared to wearing glasses or contact lenses with high degrees of myopia, I'm not experiencing any negatives here. It is such a freedom to be able to just get up and decide to drive my car somewhere, without having to go through the extended dance of just getting my gas permeable contacts into my eyes without making a mistake that will make them even more uncomfortable for the rest of the time I'm wearing them. And that doesn't take into consideration all of the hassles and fear that you might blink the wrong way at the wrong time and flick one out, lose it and then the knowledge that if after crawling around on the floor for an hour looking for it, you aren't successful, that you're out $150 and might not be able to get yourself home. And then there's the always making sure that your eyes are half closed when leaning over an open toilet, or a sink with running water... just in case (still doing that now - old habits, lol). Having to avoid sitting in front of a fresh air fan, or whatever is blowing out of the vents of your car, or just having to worry about being outside without wearing sunglasses when there was a brisk breeze, let alone a wind. Remember the old Highlander films, "there can only be one"? Well that applies to wearing hard contact lenses. You can have the lens in your eye, or an eyelash or a piece of dust, but you cannot have both! At the least, it's really uncomfortable, and you have to find a safe place where you can take it out and rinse it, but at the worst, it's like someone is slicing your eyeball open with a knife to have both in there -- and if this happens when you're driving, well... And that's on a good day when your eyes weren't really dry so they felt itchy and scratchy just from wearing them.
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And then there's the glasses for high myoptics... even with high indexed lenses, they can be heavy and you have to be careful what kind of frame you choose, as larger or flimsy frames make everything worse. Glasses usually cost me around $1,000 every two years -- around $200 for a solid pair of frames and $800 just for the lenses. And for me, even when I was only around -9.00, everything I saw through my glasses was around a third smaller than it's actual size which made it really difficult to just walk down a street wearing them, or go for a walk in a forest, let alone ever learn to drive a car while wearing them. Sports were also a joke since once again, your depth perception was so screwed up.
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Now don't get me wrong, wearing hard contact lenses were once a huge freedom for me since despite all of the potential drama, I was at least able to learn to drive a car, and able to play sports competently, etc, but, man, that doesn't begin to compare to the kind of freedom I feel now. I'm like, so this is what it's like for all of those other people... wow!
maura04015 jim96821
Edited
Since you are asking for opinions from know-only-what-we've-researched people on the internet or that plus the one solution they have.... I wouldn't have surgery unless I had cataracts and had to. No matter what you choose the best outcomes have decided limitations and the worst are worse than your present negatives. AND there are bound to be improvements in the next 5 to 10 years in what can be done.
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I tried progressives and hated them, didn't feel safe driving with them. When I returned them, a woman in the optical department told me how she wore computer glasses for almost everything, even there at work, and urged me to try them. The difference is they give you intermediate -- and that's more clear distance than just for computer work. I'm hard put to say exactly how far, maybe 10 feet really clear, up to 20 pretty good. Further distances good enough for me. I walk my dog, even at night with them and don't feel worried. I wouldn't drive with them. They also go right down to reading strength at the bottom, but since I can read without glasses and like it better that way, I take them off to settle in to read. So you might look into something like that and see if that could help you in some situations where the progressives are an aggravation.
jim96821 maura04015
Edited
I really appreciate your perspective and will give what you said serious consideration.
Guest maura04015
Posted
I would add that not all progressives are made equally. The first pair I had were horrible. I hated them and couldn't adapt to them at all. So I went to another optometrist and brought the glasses with me and explained the issues and they made me another pair and it was night and day. So much better. I got used to them very easily within a few days and ended up loving them.
jim96821 Guest
Posted
It is such a crapshoot. The first pair I spent almost $1000 on and could not see a thing. I was made to feel a failure and was out all the money. The second pair I ordered online from a store that offered money back guarantee. I could see instantly, without any need for adapting. They are still my favorite pair and cost a fraction of the price as the first ones. I am just so tired of ordering new glasses (online or in person) and still not being able to see well. Sure, I can get refund online but in person is making me go broke. I now have four pair of glasses that I have only ever worn for driving. My vision gets worse every check-up too.
RonAKA jim96821
Posted
I have had many pairs of what Costco calls Accolade Freedom lenses, and within the limits of progressives are very good. They are made by Essilor and I believe identical to Essilor Varalux lenses. I see the latest version that Costco is selling here in Canada is the Accolade Freedom 4.0. They have cost we in the range of $350-400 depending on frames. The latest pair I got were Costco Kirkland Signature brand, and are about $100 cheaper. They seem ok, but now I have been spoiled with no glasses mini-monovision, so I almost never wear them.
stephen53955 jim96821
Edited
A new no-line multifocal IOL called the ClearView 3 by Lenstec was approved by the FDA last year. It's supposed not be plagued by the issues associated with the PanOptix and is described to be "progressive lense" like. Challenge is finding physicians and/or surgical centers using it at this time. Call customer service and they can assist.
stefan64833 stephen53955
Edited
My brother-in-law just had these implanted at the recommendation of his opthalmologist. He is a lock smith and is reporting vast improvements in his over-all vision especially his near. Smooth transition of visual field between near to far. He says he has had no loss of contrast sensitivity or night vision issues. He actually complains that the inside lights seem too bright at night, but it could be from simply having the cataracts removed. He played golf last weekend and had no issues seeing the ball or reading the greens.
Sounds promising, but data does show there was an increased rate of visual disturbances in the Clearview group, relative to monofocals, and contrast sensitivity results were somewhat worse in the Clearview group. These results appear to be inline with other marketed multifocal IOLs results but its tough to make a comparison without a head-to-head trial. Actual driving simulation outcomes identified that the monofocals did performed somewhat better than the Clearviews. Somewhat worse than monofocals, still sounds pretty good for closer vision and the visual field range.
stefan64833
Posted
A quick update that brother-in-law is still reporting great acuity in vision even in dim light, but is now starting to notice night dysphotosia when driving and cloudiness in one eye, so I hope it's not PCO.
RonAKA stefan64833
Posted
The night dysphotopsia should be expected due to the design of a MF lens. And the ClearView lens is made from a hydrophilic acrylic material which have been found to suffer more from PCO than the hydrophobic materials. Lenstec of course claims that their material is different (of course). PCO normally takes some time before it develops though.
stefan64833
Edited
It's been beyond the 8 weeks from my brother-in-laws last surgery and he is reporting excellent results. No lingering or lasting issues from either procedure with regards to cloudiness or dysphotosia. He is extremely happy with results and 20/20 acuity. He went with plano in both eyes and can see near, intermediate and far with no drops in visual field transitions or changes with lighting. He's had a fantastic outcome from his surgeon and the Clearview 3 multifocal lenses. Hopefully, more RWE info and insight will be reported.