Seeking feedback on EDoF lenses vis-a-vis monofocal (Eyhence)

So i received PanOptix Tri-focal) in my right eye Feb 5th and my left dominate eye Feb 26th. i can read the smallest print its amazing i also can see intermedite distances like my tv very well. when im indoors i absoluttley live these lenses for me. when i go outside day or night my vision seems to be distorted a little. i have halos during the day that i can handle but those night time ones are so big they take over the cars. so on that note im torn on what to do! i am active and own a salona nd need to drive at night. i heard that i have to give it time so i am. however, i have seen no change in either eye as of yet. My doctor did say he might first try ordering me glasses for driving. we will see!

Well, hopefully time will fix the large halos

I am in a similar position to you. One eye is more urgent, and the second will come later. I have come to the conclusion that this is not a single decision. It is actually a process. I have discounted all the multifocal/EDOF type lenses because like you, I am afraid of the night vision issues. But, that is only part of the decision making. Right now I am about 50-50 on going for both eyes with distance monovision or a monofocal solution. Here is my process plan:

1. First eye will be distance monofocal - AcrySof IQ Aspherical. I have discounted the "glistenings" issue as a minor concern. I like the idea of having blue light filtering, and I believe the AcrySof material is more resistant to PCO.
2. Will find out how accurate the correction was in the first eye. It cannot be assumed that what is targeted for correction is actually achieved. The power steps, unlike glasses are in 0.5 D steps, not 0.25 D. And they have to base correction on the topography of the cornea, not on vision tests. The usual target is -0.5 to 0.0 D, but that may not be what you get.
3. If the target is achieved and distance vision is really good, then I will then consider monovision using the second eye for near vision. However, I will test that first by using a few different under correction contact lenses in my second eye to see what I like or if I like the idea.
4. If the target in the first eye is not achieved, then I will most likely go for distance again in the second eye, and resolve to use prescriptions glasses to correct the residual error.
5. And either way, I strongly suspect I will end up with progressive prescription glasses that I can use for the best vision up close and for distance at night.

My suggestion is to consider it as a plan, rather than a single decision on this lens or that lens.

You may have seen it already, but a surgeon, Shannon Wong, MD, has published a youtube video comparing the Symfony and PanOptix IOLs. It has been a while since I watched it, but overall I think it is pretty good. I did take note of a few items though.

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He puts some time into being critical of the PanOptix, due to the potential for "glistening". I really think that is a minor issue, and has been largely addressed with improved quality control.

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He also claims that the light transmission of the PanOptix is less than that of the Symfony. He does not give the reason, which is that the PanOptix has some blue light filtering while the Symfony does not. The PanOptix gives a more natural light distribution. The Symfony gives more light overall, but it does that by transmitting blue light that the retina in a normal eye does not see.

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He also glosses over the issues of artifacts especially at night for halos, glare, and flaring of lights. If you google this link you should find the youtube video.

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Symfony vs Panoptix. Which is the BEST Lens for Cataract and Laser Lens Replacement Surgery? Shannon Wong

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I consulted with a good friend that had both eyes done with PanOptix lenses almost a year ago. Her feedback was that if she had it to do over again she would not have done it, and would have gone for monofocal lenses instead. She finds the artifacts at night too bad to drive safely. She does a lot of sewing and close work, and finds she needs reading glasses for any conditions other than in bright full sunlight. When I had my pre-op appointment, my surgeon said that there are multifocal/EDOF lenses available, but he considers it not ethical for him to recommend them, because he would not put them in his own eyes. That sealed the deal for me. He has access to both the Symfony and PanOptix IOLs, but essentially will not use them.

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That is kind of the process that got me to where I am now. I will do monofocal distance for the first eye, and will consider monofocal closer for the second eye, i.e. monovision, if the first eye has a good distance outcome.

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You should also be aware that even monofocal lenses are not totally free from artifacts. They also can have what is called dysphotopsias. They just tend to be lower in severity than in a multifocal or EDOF.

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This said, I am not disputing the reports of good success with these lenses. Everyone's priority to be glasses free is different, and everyone's tolerance for artifacts is different too. They are a solution, but not for everyone...

I wanted to say I am at an early stage of cataract. But on 2nd thought it’s more accurate to say am at the door of a threshold.

Let me explain.

Cataract is an ailment that develops rather slowly, imperceptibly & unnoticeably, like many other chronic diseases/ailments such as cancers, cardiovascular diseases, Alzheimer's disease, Parkinson's disease, diabetes, kidney failure, arthritis, rheumatisms, Osteoporosis, benign prostatic hyperplasia... They do not attract any attention at their early stages as there are hardly any symptoms. A point will come when symptoms suddenly become palpable. This is what I call a threshold.

It was a day after Christmas last year that I suddenly noticed a very thin layer of ‘haze’ in front of my right eye. The ophthalmologist I went to see a few days later said I had cataract, at stage 1 to 2 on a scale of 10. No need to do anything as yet but to go back to see him again in 8 months time. I began to read up on the subject and to search for possibility remedies to evade surgery.

As a result of some personal experience I am a firm believer in natural/alternative therapies.

In late 1980’s in a routine checkup I was found to be a Hepatitis B carrier. I was told it couldn’t be cured and wld be with me for the rest of my life. I had to go for liver function tests every year to ensure things didn’t get out of hand. In a routine liver function test about 10 years ago it was found that the carrier was no longer there. I believe it was the result of health supplements that I took since late 1990’s when I began to be more health conscious. There were other incidents, too, that reinforced my faith in naturopathy.

What was interesting was that a few days later the ‘haze’ before the right eye disappeared. Then, about 2 to 3 days later it happened before the left eye. In the meantime, the N-Acetyl-Carnosine eye drop that I ordered arrived. I began to apply it. More than about a week later the ‘haze’ moved again from the left back to the right eye. It stayed there for about a week and then disappeared. To date, it never came back. It’s been 2 months since I started applying the eye drop. Not only does the ‘haze’ not come back I can feel that things that I see all appear to be clearer.

I will continue applying the eye drop and see what the ophthalmologist’s findings are in September when I see him again.

I hope at the end I don’t need a surgery.

Just to share.