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Panoptix Puzzle

Posted , 4 users are following.

ecurb51
ecurb51

Hello all. About seven months ago I a detached retina in my right eye. This was repaired by pneumatic retinopexy (air bubble in eye and gel not removed). My vision was pretty bad at first: people's faces on the tv looked squashed and distorted, when I looked a line it was wavy and not straight, and text on cell phone and laptop was scrambled. In about 3 months this gradually became more normal, retina reattached. When it time for cataract surgery both the surgeon and the retina specialist said my retina was good to go and the retina in the left eye showed no signs of pathology.

I was going to go the safest route and just have a monofocal lens and the surgeon and I talked about it at consult and he said I would need since I am very near sighted and have astigmatism then I would need a toric monofocal ($1800/lens as it is considered premium) and I said OK.

My prescription for glasses:

OD Sphere -5.75 Cyclinder -2.25 Axis 003 Add +2.50 DVA 20/20 NVA 20/20

OS Sphere _5.75 Cyclinder -2.00 Axis 001 Add +2.50 DVA 20/25 NVA 20/20

OU DVA 20/20 NVA 20/20

At pre-op the surgeon said I would have distance vision but I would need glasses for reading and asked if I was ok with that. I asked about intermediate vision and he said I would need a trifocal for that and he said Panoptix toric would be similar in optics to the progressive glasses I now wore. He said it would be up to me but if money wasn't the concern ($3000 per lens) then I would be happier with the Panoptix and it's range of vision. so he chose to do the right eye first (previous retina detachment). So I had the right eye done 4 days ago. They left a patch on overnight and the next day I went to his office and the patch was removed. I was stunned by how poor my vision was and couldn't read anything on the chart. He said things would improve and he wants to see in two weeks.

My vision is considerably better in the Panoptix eye than the other eye but at this point is still falling short of what I had thought because after I decided on Panoptix i then did lots of research on studies from Europe, etc and you know 99.1% of patients saying they would do it all over again.

My vision grade after 4 days:

Near: D can read cell phone and laptop but difficult to see and blurry 12-20 inches. I really need readers at this point to read w/o strain.

Intermediate: B I can see my car dashboard and entertainment monitor fairly well

Far: C I can see much better than my left eye w/o glasses but vision seems still weak (I know I need the other eye done to really assess). I printed out a Snellen chart and my vision from the operated eye is 20/50. Daylight vision is pretty clear but dim lighting is not so good.

**Night vision: **D- I haven't evaluated this to much but lots of glare, halos, and starbursts coming from neighbors lights across the street. A lady was walking past my house last night with darker clothing and she like disappeared in the dark when I looked at her with my right eye alone.

I'm thinking it could be something in my right eye affecting my vision due to the former detached retina because it really screwed up my vision for a while is still probably not 100% normal. I know it could also be a surgeon miscalculation, refractive error, astigmatism not corrected right, not powered correctly, or something else.

If I go with the same Panoptix lens in my left eye it's a gamble because it could turn out exactly the way Panoptix is supposed to with all three ranges of vision but if it turns out like the right eye I don't think I will be able to drive safely at night. Glasses can correct the range of vision shortfall but not the night vision side effects. So I was thinking maybe a monofocal toric set for distance plano in my left eye as I'm thinking that will give me the best distance and night vision I can get to complement the shortage of vision from the Panoptix. Then I would have to wear readers but that may be the easiest path. Anybody got any thoughts on what you would do?

My surgeon is well credentialed- Harvard, UCLA, he said he does lots of Panoptix and seemed very comfortable suggesting it like he doesn't have much problems, has done over 10,000 cataract surgeries, friendly guy etc.

This is the lens that was implanted:

Acrysoft IQ Panoptix Toric UV IOL

TFAT40, PWR:+12.0D

CYL 2.25, +2.17 ADD, +3.25 ADD

I know it's still early but I am concerned about the night vision and the lack of better distance vision.

0 likes, 6 replies

6 Replies

  • RonAKA
    RonAKA ecurb51

    Posted

    Given your situation and eye conditions I am not sure a MF lens of any kind was the best choice. At this point I would suggest waiting 6 weeks until the eye settles down and you know where you ended up, before making any further decisions on the second eye. If you get good reading vision with the PanOptix eye, then there is an option of just getting a monofocal set for distance in the second eye.

    • ecurb51
      ecurb51 RonAKA

      Posted

      Thanks for the reply ronAKA. My original plan was to play it safe and go with monofocal toric lenses due to the unknown outcome on my right eye due to the previous detached retina and repair. No matter what lens is implanted in my left eye I am expecting at least better results due to no known eye pathologies. I'm not expecting perfect vision by any means. The Panoptix in my right eye is giving me good intermediate for my car but not my laptop. But I think you are right and I'm going back to my original thinking of playing it safe with a monofocal toric in the left eye. The next lens needs to give me the best distance and night vision I can get without regard to near or intermediate.

  • soks
    soks ecurb51

    Posted

    why did he implement acrysof panoptix? not that it impacts quality but acrysof panoptix is older lot and newer is clareon panoptix.

    you are high myope in both eyes so even your good eye is prone to retina detachment. good luck.

    • ecurb51
      ecurb51 soks

      Posted

      I did ask prior to surgery if he was going to use the Clareon or the Acrysoft. He said that he could use the newer platform but that he has had good success with the Acrosoft Panoptix and prefers the acrylic material. He said the material the Clareon is made of would make a YAG surgery more difficult. My previous detachment and retina repair seems to be a thing of the past but it's hard to believe I have a perfect retina since that happened and that could have caused me to not get the best vision from the Panoptix. I've just got to make the best decision moving forward with the other eye.

  • Sue.An2
    Sue.An2 ecurb51

    Edited

    Hopefully hold off 2nd surgery till you know where this eye ends up. It takes 6 weeks to fully heal so hopefully there will be much improvement in vision range. multifocsl/trifocal lenses generally come with more halos and glare at night (trade-off to seeing better at various ranges.

    Not sure how old you are but retina detachment can happen in younger cstaract patients (particularly males). if it were me I would go with safer route and get the toric monofocal in other eye (best corrected distance). This would also likely minimize the halo snd glare from panoptix lens.

    Wishing you well

    • ecurb51
      ecurb51 Sue.An2

      Edited

      Thanks for your comment Sue.An2. I'm 71. Yes I'm thinking the same thing for the left eye and just going with a toric monofocal and just concentrating on trying to get the best distance and night vision and not worrying about anything other vision. It would not make sense to go with another Panoptix if night disturbances make it unsafe to drive. I think the monofocal would help to tame the night vision, I've got between 20/40 and 20/50 on the Snellen chart not quite as good as I'd like, daylight vision is fairly clear, night time not so good, intermediate is maybe a grade B, Near vision is functional but not great at 15 inches

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