Received toric PanOptix yesterday
Posted , 18 users are following.
I've been lurking in the cataracts forum for weeks now -- I'm 47, diagnosed with cataracts in both eyes (probably from taking a statin for at least the last 10 years - it's a risk factor for cataracts). My left eye still sees pretty well, but my right was blurry enough that I couldn't read with it and saw lots of glare during night driving. I spent the last few weeks trying to decide on the right lens. I had the surgery yesterday, so I thought I would pay it forward and describe my experience.
I was struggling to decide among a monofocal, the restor 2.5D, and the Symfony, and feeling pretty stressed about it. Then my doctor emails me that the PanOptix trifocal was just approved in the U.S., and it was now the best choice for me. I think the first surgery in the U.S. was 9/4, so I'm definitely one of the first. I have 0.75D astigmatism, which he said wasn't worth fixing with a toric lens; better to do astigmatic keratotomy.
So, yesterday was my surgery, at noon. As most people have experienced, the surgery itself was not bad. The worst was probably waiting to be rolled in after being prepped. Though I was definitely sedated, I remember every part of the procedure. The most surprising aspect was my doctor says he's now going to give me a toric lens after all, and not do the AK. But I went to one of the top surgeons in my area so I trusted him.
Afterwards, they did not give me an eye shield, saying it wasn't necessary for small-incision surgery. The worst issue yesterday was the dryness and the scratchy feeling, like there was a piece of sand in my eye. I took a couple of doses of tylenol over the day. My vision was hazy and blurry, but I knew not to judge anything that soon. My eye looked completely normal to my girlfriend, maybe the area was just a little swollen. I took a 3 hour nap, and slept plenty that night as well. The doc called in the afternoon to check on me and told me I could use Refresh drops (the single use kind - no preservatives), which definitely helped.
This morning my vision was definitely improved, but still hazy and blurry, probably from the remaining dilation. I also saw flashes of light in the lower right corner of my field of vision, mostly when I moved my eye around and there was a bright light nearby. I also saw a dark floater on the very right side of my peripheral vision.
I drove to my 9am follow up, where they dilated my eye again (great). Doc said all of the symptoms I was experiencing were normal. The lens position was good, and there was a lot less inflammation than he would have expected -- he even reduced the length of the steroid drops (those sting the most, so, score!). They tested my vision and I could read a good number of lines, but they didn't say what my vision was. I asked about the last minute decision to go toric and he said he did an interoperative measurement and the astigmatism was now between 0.75D and 1D, and since AK was not a permanent fix, he decided it was worth the small overcorrection that might result.
As the day went on, my vision improved until my right eye could see distance as well as my left, which was great. The scratchiness is a bit better, now it feels like a hair instead of sand, and not quite as dry. The flashes are still there. With my normal contact lens in my left eye, by 8pm I could read about the same on the computer with each eye; maybe the right eye being just a tad worse. Doc said it will take a little time to adjust to the trifocal, and I should avoid using reading glasses if I could.
One thing I noticed comparing the eyes is I could really see the yellow tint from the cataract in my left eye compared to the right. There is still glare from lights in my right eye that just about matches the glare in my left eye from the cataract, but it is definitely better than my right eye had been before surgery. I assume this will improve over the next few days. Doc said it could take a week for all of the above issues to resolve, or improve.
So far I am optimistic and encouraged by my status. I will report again tomorrow or the next day.
3 likes, 40 replies
W-H DavidBEsq
Posted
DavidBEsq
Posted
Update 8 days from surgery: the dryness and feeling of something in my eye have all but disappeared. The flashes in the corner of my eye are much better, but still there a little when there's a light source directly above or to the side. Quality of vision is excellent, though the close up reading isn't there - still blurry. I need about 15-18 inches to read, which is fine, and computer vision is great.
Now that I've been out at night some, I can report on glare/halos/starbursts. They are definitely there, especially around certain headlights. And, they are there day or night (though worse at night, obviously). Primarily 2 rings of light, and some general glare. But, they are small, and even if they never improved I think it's a fair tradeoff. Something a bit more distracting is when there is a light source at a certain angle the lens catches the light and I can see a smudge of light in a segment of my vision. Again, even if it never improved, I could live with it.
Of course, I can't compare this to what a monofocal would be like. How bad would my computer and reading vision be, in exchange for no glare/halos? No way to know. I may have a tougher decision when I get my other eye done someday, as I suspect the glare issues will be worse when it's the same in both eyes. Of course, things may change as it's still early.
Guest DavidBEsq
Posted
Nice to hear you have a great result! 😃
I am not sure you should expect much more close up vision than 15-18 inches, I think this is quite normal with a trifocal, and it would surely be a lot worse with a monofocal.
About halo and glare, if you close your other eye, only looking through the Panoptix, I think you know worst case scenario, if you choose to have the same lens in both eyes, I don´t think you need to worry that it would be worse than that.
In my own case, I have two different lenses, edof and trifocal, that makes different types of halo and starburst, but brain tends to take the best it can get, so the halo and starburst are less when I see with both eyes, than when I see with one eye at a time.
coppp DavidBEsq
Posted
Thanks for the update! Would you consider your glare/halos/starbursts mild or moderate? Or scale from 1-10?
DavidBEsq Guest
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Yes, I didn't realize the "near" focal point was that far out, but it's been fine. If I need to look at something closer I use my other eye or reading glasses. It's rare.
Good to hear re: not being worse with the same lens in the other eye.
DavidBEsq coppp
Posted
coppp - hard to assign a number. The cataracts in the operative eye caused glare/starbursts /halos (shorthand: "artifacts") that was pretty bad - driving at night, especially in rain, was becoming a problem. I also have mild cataracts in my other eye that cause lesser artifacts, but otherwise doesn't affect the quality of my vision much. The Panoptix artifacts fall in between the two, and they're a little more "structured". They do not extend that far away from the light source, which is important, as I've heard Symfony ones can.
However, this is counter-balanced by the fact that except for the artifacts, I can see very well - even at night - with no apparent loss of contrast sensitivity. Driving safely is not a problem. The artifacts are distracting, but I assume I will get used to them over time, and I'm ok with the trade off, at least so far.
Sue.An2 DavidBEsq
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Just finished reading this thread. For some out reason I was getting any notifications from the Cataract group for over a week. I had to rejoin it and now hoping notifications ate back on.
Seems like I missed a lot!!!!
Congrats on a successful surgery DavidBEsq. I am pretty certain if those trifocals were available when I had my surgeries I'd have gone for them. I am curious as to why we all get different results. Is really shape of the eye (size)? If only we could test drive them so to speak I could really compare. Guess it'll have to remain in the curious bin!
Did your surgeon say why he didn't provide an eye shield after surgery? I thought that was standard to avoid bumping or rubbing your eye during sleep.
Anyways very pleased for your results.
JesseH DavidBEsq
Posted
Had the toric Panoptix inserted in my right eye 5 days ago I am concerned that my vision is still a bit blurry Also have been experiencing glare and halos to the point where I am even thinking about lens replacement with monofocal IOL if no improvement My left eye is scheduled for lens replacement in two weeks and hopefully some positive changes by then.
Deb03 JesseH
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I would recommend postponing your LE if you aren't sure about your RE. Hopefully things will improve for you. Are you scheduled for a follow-up appointment soon?
JesseH Deb03
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My one week appointment is day after tomorrow so will have a better understanding once I see the doctor again.
Nick_W1 DavidBEsq
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I just had toric PanOptix implanted in both eyes this morning.
So far, my left eye is pin sharp. My right eye is slightly blurry.
Getting used to the near vision seems to be going well (I did wear multifocal contact lenses for many years).
This morning, after I got home, I had double/tripple vision close up - perfect at distance.
Now, (7:00pm) I can see to type on my iPad, no tripple vision anymore. The only problem is the slight blurryness in my right eye.
I have my follow up tomorrow morning, we'll see what they say about the blurryness in my right eye - hopefully its something that will clear up with time. My left eye is absolutely perfect, so if we can duplicate that it would be the best outcome.
I have seen a few halos but I'm not too concerned about them. We'll see how it goes over the next month.
8 hours after surgery on both eyes, and doing well so far...
Guest Nick_W1
Posted
Nice to hear, no doubt you have a great result.
It is normal with blurry vision for hours or days, you simply have a better result than normal on your best eye, your blurry eye is actually the normal one this close to surgery.
I have one toric trifocal as well (and one toric edof) I am a big fan of the trifocal, I am sure your blurry eye will become clear, and you soon will enjoy your new vision 😃
Nick_W1 Guest
Posted
Had my follow up today, and my left eye results do seem unusual, everyone else still has blurry vision.
I am reassured that my right eye will catch up with my left in the next few days.
I did opt to use the femptosecond laser option for my surgery, I don't know if that is a factor in my good results (so far).
No pain, itchiness or anything. My eyes do look bad (from the outside), red and somewhat bloodshot. But they look great from the inside.
I have been very happy with the results. I have never seen so well!
Guest Nick_W1
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I have no doubt things will turn out fine for you.
It takes about 6 weeks for your eyes to heal after surgery, in this period you will experience your vision to change from day to day, some days are better than others, but it is normal.
And when eyes are fully healed, it will stabilize.
The halos and stuff will also change when your brain learn to use the images from the new lenses, in fact these visual side effects can change the next year from now.
I am 4 month after surgery, I can see the side effects are getting smaller all the time, side effects are much less now than they were the first weeks after surgery.
Sue.An2 Nick_W1
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Glad to hear about your results. Things often improve as weeks go by.Everyone is affected differently by the drops too and better vision comes when those are done too. Be patient with it. Glad one eye seems to be perfect - great when that happens. I have that with RE. Wish LE was as good. However with both eyes open brain chooses the better view!