To Panoptix or not to Panoptix that is the question?
Posted , 11 users are following.
I am scheduled to have the Clareon Panoptix implanted next Tue.
I have been researching for a few months now and honestly it is very hard to decide on a lens since you want the first choice to be the right one.
My story starts first part of this year when I noticed that my vision is my left eye was to me improving. I had to switch to an older pair of readers and my as my new RX (2 months old) was just too much power. But soon I noticed this cloudiness when I walked at night and then some halos around lights. So I go the eye Dr and she says you have a cataract. She says it is fast moving and I should see their surgeon. So I do and what a complete disaster, that day I waited 2 hours past my appt, nothing worked well as in the equipment they had network issues half the machines needed to be rebooted what a mess took forever. Then I get to see the surgeon he is looking at the results of the testing, confirms I have a cataract, discussed the option but seems very unsure about the readings from the machines as they don’t match up with some of the manual readings for my astigmatism. So, he makes this comment when deciding what to do “well I guess I have to go with what she wrote here it should be right” What red light alert is this guy joking , no he is not. I decided no way am I using this place and said thanks see you later.
Then I start to think about it my reading vision has been slowing improving over the past 2 years. Then I read that this is a classic symptom of a cataract. So, IMO this place has missed the onset of my cataract for the past 2 years. Further I think hmm this visit for checkup was a different Dr and she picked up on the cataract right away. So yea other Dr I have been seeing has been missing it, so this place is a place to stay away from.
I find a new surgeon on the first visit unlike the other place he only wants to see me for a consult. I think maybe they are just making more visits to make more money, but he has a good rep as this time I did my research. Turns out he seems very knowledgeable does his evaluation confirms the cataract in the left eye and it should come out soon and that I have one starting in the right eye that in his opinion can be done when it gets worse or whenever I am ready and lets me know the options. Totally no pressure says he is here to answer my questions, but I need to make my own educated decision on what to do. He says eye surgery has risks no matter what even if everything goes well. This is your eyesight you need to think about it and make a decision you can live with. He says no rush think about it do some research we can talk on your next appt. So, I go back for the next appt we get all the testing done, it goes all well, everything works as it should, we get all the needed test, very professional, and makes me feel like they know what they are doing. See the doc he says to give him a min to look things over to see what lenses are optional for me based on all the testing. He then says based on the testing you can get any lens you want and goes over all the options. I ask lots of question he answers just like he should on all the lens and is spot on with what can happen with each one. I tell him I have had good vision all my life and only in the past 10 years needed readers. I really want the best vision possible all ranges and I prefer to not have to use glasses if possible. He says you can do the EDOF Vivity or the Panoptix and goes over each one. I says really don’t want to depend on readers for cell phone use or to read a label in a store but not sure if I like the trade off with the possible side effect of the Panoptix. He says I can answer all the questions you have but I cannot tell you what lens you should pick only you can make that decision. I tell him I am undecided I don’t know. He says listen we have all the types of lens in stock for your RX give me one to pencil in and you have up to the time I start the surgery to change our mind. I say ok give me the Panoptix he says ok just let me know if you change your mind or if I an answer any questions you think of as this is a decision you should be willing to live with for the rest of your life.
So I am scheduled for surgery next Tuesday.
Even after reading negative posts here, I am on the fence but still leaning towards the Panoptix especially since I have confirmed no matter what I pick it will be the new clarion a lens.
Here are some of my thoughts.
I currently have halos and starburst at night, and I can drive no issue, if I am not thinking about them, I forget they are there. But they are mainly in my left eye and right eye very little so brain is maybe tuning out.
I do work on small close-up tasks at times and I sweat a lot so glasses are a pain and sometimes can fall off when hands are full. So no glasses sounds really nice like it was 10 years ago.
Most of the workday I am on a computer where I do where readers but again if I get up to walk somewhere I must take them off to see distance, yup a pain.
If I have to pick just one concern it would be lack of contrast for night vision. I do notice the left eye has some lack of contrast with the cataract already and I manage. What I don’t want is to have total loss of contrast at night.
As for brain adaptions I think I will do well as right now I have effectively mono vision and really don’t need any glasses. Reason is left eye sees quite clear at 12 inches and right still sees ok at a distance so everything seems in focus for the most part, it is what I would call functional. But I can see both eyes especially the left getting worse as time goes by.
I have read many bad posts here and not so many positive ones. I found this site by searching for Panoptix reviews to see what was out there. I was looking for post by real people and not some sponsored study. I realize that people do have issues real issues but also that most people who have no issues don’t post anywhere.
Anyways thoughts opinions?
0 likes, 84 replies
007Bond
Posted
Ok evening is here vision clearing some but still blurry better over the day but not where it needs to be.
I went out on a drive in the dark. With both eyes open everything looks great so much better than having a cataract in my left eye. I don’t notice any visual disturbances no halos no starburst contrast is good much better than the cataract.
Remember the right eye is the natural lens with almost no cataract. So what happens if I close my right eye??? Some noticeable halos some starburst but much less then I was experiencing already with the left cataract. Right eye open all gone so the brain clearly puts the best visual picture forward.
Let’s say I had both eyes with the Panoptixs could I live with what I am seeing today just in the left eye? Absolutely the issues with the halos and starburst are minimal and I am only 30 hours post op and I am deliberately looking for them. In time I would think they just go unnoticed, but I could live with it as-is.
Left to right contrast is the same on dim roads I can see shadows/shades of gray in the darkness as I would expect I would see them.
Moon and stars look as they should however with the Panoptix eye they are a brighter white no yellow hue. I have always preferred daylight higher kelvin lights as I feel I can see better especially when working on small projects so to me this is a good thing.
Besides the lack of focus at all ranges I don’t have any complaints. At 30 hours post op not sure I can expect things to be fully clear and in focus, only time will tell. I do feel things are improving as time passes so positive thinking…
007Bond
Posted
Ok am is here 44 hours post op.
Foreign body feelings most of the night and this am but to be expected, am drops seem to have helped.
Vision is clearer today over yesterday. It is not fully what I expect as all distances are fuzzy around the edges. So we are not where we need to be but I feel it is evenly fuzzy from up close to infinity.
My eyes together today are very functionally usable, distance is good as right eye carries the load still and this laptop is much better then yesterday very functional with the Panoptix left eye carrying the close up visual load. I can see my Apple watch ok at 12 inches, cell phone ok a bit farther, and laptop ok farther yet. Again, they are not 100% clear or what I really want but it is usable vision without any glasses @ 40 hours post op.
Some odd flickers at times to the left of the left eye more so when around brighter light sources. Still have my monitors dimed down and shades cutting outside light as still seems sensitive. As noted Panoptix is more brighter white where right eye is more yellow tinted not noticeable with both eyes open seems blended then.
Fingers crossed that all distances dial in to full clarity over the upcoming days/weeks.
007Bond
Posted
69 hours post op
-Still foreign body feeling most all the time.
-Vision is clearer at all distances today. I feel the drops are somewhat interfering with things but not sure. I know if I blink a few times, it seems much clearer for a time.
-Today if I blink a few times, I can read the small print on the Rx drop bottle at about a footish. It is not 100% crisp maybe let’s say 85% but reasonably impressive given the size of the print.
-Same goes for most all other distances 90% for reading a book it’s not crisp but can be read.
-Computer is clearer today again not 100% but very usable.
-Going outside license plates can be read at distance again not 100% but can easily be read.
-Some trees are changing colors and look the same as right eye with my natural len.
-Things at a great distance are as good as my far sighted right today again I would say 90%.
-I still feel contrast is as good as my right eye I can see shades of gray in the dark as good as I would expect to see them.
I know this site is filled with mostly people having issues. I am very thankful that so far things are going well for me. Am I 100% satisfied? No not yet, but for just under 3 days post op I am feeling very positive.
Are there things I don’t like so far, visual disturbances, things that are not like your natural lens? The answer is yes.
-At times I feel there is some dark crescent in the left very edge. It seems to come and go I cannot notice it on demand. It will be there for a second and gone. It kinda makes me want to rub my eye but I don’t dare. It is something I think in time will just be gone or ignored.
-I still get some flashing of light or fluttering more to the left edge at times but improving.
-Looking at lights there is some difference when compared to the right natural lens. Depends on the angle, distance, type, can have minor star nothing crazy or bothersome just if you really compare there is a difference.
-Finally found an odd one not sure what it is related to. If I look at my Nest thermostat with the Panoptix and I really look I can see a shadow of the number to the right lower about 5 o’clock very faint. The farther I move away the more the shadow moves away the closer I get the closer it gets to the real numbers and at about 12 inches it’s gone. Not sure the leds are behind the glass like mirror. It seems like the leds do reflect off the front glass kinda like an infinity mirror works. However, my right eye cannot see this at all. Again, I have to really go out of my way to notice this and it cannot be seen with both eyes open. If I had the Panoptix in both eyes I can imagine I would be able to notice it all the time. As we know there will be tradeoffs no manmade lens is going the replace the real lens 100%.
I still need to let things settle in an heal as noted things are not 100% and I have not been out and about much, nor have I done everything that I normally do. I have not tried, been, or done everything in both light and dark. So only time will tell if more things crop up that I don't like.
Overall, currently things are on a path that is much better than having the cataract in my left eye, and vision is reasonable at all ranges. I have not worn my glasses since the surgery, as of today I could live without them at any distance. Again, stressing for sure my vision is not 100% razor crisp like it would be if you had a perfect pair of glasses or vision. But it is very usable at all distances and comfortable enough to not need glasses. I am still on the antibiotic drops, the steroid drops, the anti-inflammatory drops, and for today (last day) the pressure drops. So, lots of drops going in here and the steroid drops and the anti-inflammatory drops are for 30 days. So, there is no way for me to make any final calls until things settle in after all these drops are over.
RonAKA 007Bond
Posted
The scratchy feeling is normal for a few days. I used two kinds of drops, Durazol and Vigamox, and I've forgotten which, but one of them had a bit of a sting to it when you put the drop in. However I don't recall them affecting my vision for more than a minute or two after putting them in. The dark crescent effect is probably negative dysphotopsia and caused by a shadow from the edge of the lens.
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The second image effect sounds similar to what I have from residual astigmatism, but in my case it is distance independent. I see it at all distances. I suspect your issue is from the multifocal image effect of the lens that is providing an out of focus second image at a certain range of distances. The hope would be that you would learn to ignore that over time.
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But, all in all it sounds like you have had a good outcome. The lens outcome should start to be stable in about 3 weeks, and be fully accurate in 6 weeks. It takes some time for the eye to recover from the trauma of the surgery.
007Bond RonAKA
Posted
Thanks Ron.
Yea not sure if it is the drops the one does sting for a few. I more feel my eye does not feel clean you know you cannot wash it or touch it. Kinda feel the eye lashes have junk on them I feel like just cleaning the eye would help but not going to touch it. Maybe some presentive free eye drops used more like a wash not sure maybe I will call the Dr and ask.
As for the image in the thermostat yea I was thinking like you said it has to do with the astigmatism correction. I think if the thermostat was bigger, it would keep going off to the edge as I back up, but it does become one close up very odd. I know he said the astigmatism measured 1.75 and he corrected it with a 1.5 I believe since it is only available in half steps. I just went to look at every display in the house. On the Google home display also led behind glass (not a mirror glass) if I really look like intently this is there but so faint I almost missed it. So it seems to be related to the led being located behind a reflective surface. I don’t think it will come into play very often. I cannot see this on the microwave display or any other appliance display, alarm, clock, for that matter. But still I have not looked at every display in my life or around so who knows. If it is related to residual astigmatism, I imagine not much can be done at this point. Not sure if this can be considered a miscalculation or just a fact that you are never going to get it 100%. At this time it’s very insignificant so far.
Negative dysphotopsia I guess I should just hope it goes away as I don’t see any other good options. At this point it seems to come and go, and we are only a few days out so too close to call at this time. But from my understanding this can happen with any IOL after surgery.
Thanks again for your reply
RonAKA 007Bond
Posted
You will know more once you get a refraction test after the eye has settled down. I think it is rare that astigmatism is fully corrected. The steps in cylinder power available to the surgeon are large as you say, and as I understand it they do not like to over correct astigmatism. That could be the reason for using the 1.5 D. My optometrist says that "flipping" the astigmatism can be very disruptive to your vision. My understanding of flipping is when the negative areas of astigmatism become positive areas. I guess your brain gets used to one way and may react badly to it being flipped.
jimluck RonAKA
Posted
That was the explanation the optometrist gave me as to why my vision was so bad (worse than without glasses) the first time she put scleral contacts on me. I had to be led by the hand to walk and guided to a chair to sit. I was functionally blind. It was a trial pair of contacts, so they did not have my prescription in them, but they automatically take away all corneal astigmatism even with no prescription, leaving the lenticular astigmatism revealed. She said the axis of my lenticular astigmatism is very different from that of the corneal astigmatism, so my brain rebelled and could not make sense of the signals it was receiving, even though the lenticular astigmatism is a very much lower cylinder power. Once she did an over-refraction and corrected for the lenticular astigmatism with a cylinder lens on the right axis, then I could see through the trial frame. Weird experience!
007Bond
Posted
Ok we are at 92 hours post op.
Today is really about the same as yesterday I don’t see or feel there is any noticeable difference.
Went on a long walk last night and night vision is quite good IMO. No contrast issues Panopticx when compared to right eye natural lens is the same. With some lights I would say more so with bright artificial example LED, streetlights, there is some difference with starburst compared to natural lens but very minor I must want to notice it. Now I have not been in a NYC traffic jam with hundreds of LED brake lights in front of me so time will tell on that one. But general life no issues. Again, when I look at the sky it looks as it should.
With both eyes open watching TV is very nice. I now see what 4K is supposed to look like. Remember I am comparing my new vision with the previous cataract vision. Actually I cannot remember the last time I could see this level of clarity, color, or vibrancy.
I decided to look for an online vision test chart and found and printed one. I had my wife place it on the wall and measure off the recommended 10 ft. I covered my left (Panoptix) eye and could only read to 20/50 with my uncorrected natural lens right eye. Covering my right eye, I could very easily read to 20/32 line, the 20/25 line I got them all right but I have to admit to myself they were not razor sharp. As for the 20/20 line I got 1 wrong, and they were in no way sharp or clear, I was struggling for the results I achieved of 1 wrong with the 20/20 line.
Is this good for 4 days after surgery? I am not sure if this is good or bad at this point. Should I be expecting better results by now? No noticeable difference today over yesterday so is this it, hopefully and probably not, only time will tell.
With both eyes open vision is acceptable for life near to far but I do very much expect a higher level of clarity in the end. At this time, I have not reached the point of vision or clarity I wanted to achieve but we are only 4 days post op so maybe this is ok for now. Really, I guess the only true test is when I go back for the 2 week follow up and they test my refraction. Then we will know if they hit the mark or not.
I still have a decent level of forging object sensation, so I am guessing there is still some remaining irritation, inflammation or something not fully healed.
greg59 007Bond
Posted
The steroid drops tend to dry my eye and make it hard to unfold my eyelids in the morning. They probably also cause the stinging. The stinging got worse and lasted longer over time as the eye healed. My drops contained a steroid and bromfenac (NSAID) which contains an acid that allows the medication to penetrate the cornea. It was fine for the first few days when there were plenty of tears but after the eye got dry, those drops became painful. Keeping my eyes lubricated with OTC eye drops helps. I put them in about 5 minutes before putting in the prescribed drops.
007Bond greg59
Posted
Yes the one steroid does burn and it is doing it more agree with you on that.
I just went and got the preservative free drops and used them seems to help thanks.
RonAKA 007Bond
Posted
I think you are doing fine for 4 days post op. Visual acuity will likely continue to improve. It is a good sign that you are not seeing huge halos and spiderwebs. That is the common negative issue with the PanOpix, along with poorer than expected near vision.
007Bond RonAKA
Posted
Thanks Ron for the words you are probably right things should improve even more.
The spider webs, contrast, and halos and all those things listed were really a big concern for me and thankfully it does not seem to be a problem at all. I also read about some people saying there were some distances that go out of focus past the computer and then come back. I can look at an object close and slowly back up and I cannot notice any change in its focus or clarity. I cannot perceive any change as I guess I am going from one ring to the next from close to far. I somehow thought since there are rings like steps there would be or could be some noticeable change but there is not. The drops seem to make things more comfortable but vision is about the same we will see how things go over the next few days and weeks.
I will be very happy if I can get to a bit more clearer focus and things sharpen up more.
007Bond
Posted
I did not post an update yesterday since no noticeable change from Sat to Sun.
I can say the lubricating eye drops have made things much more comfortable and have significantly reduced the forging body feelings.
Today post op 6 days at this point and as noted not much change from 4 days out. Everything from near to far is ok but just not very sharp or what I would say totally in focus. With my printed eye chart, it is the same I really cannot read the 20/20 line clear (I make mistakes) and the 20/25 line is not really totally clear but fully readable if I try.
Remember slight cataract in right eye not noticeable to me but Dr can see it beginning. Right eye is farsighted (needs +2.5 readers at this point). So, with both eyes in general I can see close to far reasonably well without any glasses. Is the computer, cell phone, distance in prefect clarity, no it is not. Can I manage to generally read everything, yes. Am I where I had hoped to be getting this lens, no not yet. I probably could have got here with most any EDOF lens so still wanting more from the Panoptix at this time. Admittedly just under a week post op so there is time for things to settle in.
My Panoptix left eye is not my dominate eye the right is, I have noticed a few post that people had some various clarity issues until they got the second eye done. Not sure if that was in 2 weeks like is traditional or later. Since my right eye is not that bad, I am in no rush to get anything done to it. Really, I don’t see a medical reason to get it done until it starts to cause visual issues I can notice. So, my plan was to continue as is with only one IOL for now.
I still do notice something off to the left under certain lighting conditions. More so when in a bright environment or light is to the left. Not sure I would call it a dark crescent maybe sometimes. But I think I want to say it is more of a blurry light source to the left. It really does not take anything away from my forward vision, but it is annoying at times.
I do feel my vision is fluctuating throughout the day. sometimes I do notice more clarity in the left eye other times it’s not as crisp as I describe above. Left eye did have astigmatism so they did need to hit two points to get this on target.
I did go out for a drive yesterday during the day no glasses both eyes open. My experience is the same as not driving. Dash LCD looks the same as my laptop, I can make out license plates, I can see distant road signs, but I think or at least expected to seem them better at a greater distance then I currently do. So overall ok but we are not up to the clarity I had hoped for yet.
So, I am not on the hook line and sinker for Panoptix yet.
I did go out again for an after dark walk no issues with halos, starburst, or contrast. You ask do you see halos or starburst at all. Well, yes there is some difference between my left Panoptix and my right natural lens. Do I think it’s a problem, is it going to bother me? I would say no, at least not from what I have experienced so far. What will a NYC traffic jam look like, what will a Christmas tree look like? I don’t know yet, so the jury is still out on several situations in this department.
So far, I have not noticed any sweet spots. I have seen other post from people with a Panoptix that say they notice some distances are sharper than others. For me I can look at something slowly back away it’s the same no change. Granted it’s not fully in focus at this time so not sure this is a valid test.
Still waiting for the Panoptix to deliver me the promised as advertised land. What I have today is ok, but I did not go for this to be just ok at all ranges. I did at the least expect more clarity than what I have today. Lucky we are only 6 days out so there is still time for Panoptix to deliver.
007Bond
Posted
Ok here we are 7 days post op really no change to report.
I would say I am learning some things though as the days progress. The lack of full clarity I more and more think it is partially related to what I am going to call ghosting.
This ghosting seems to be highly related to the colors used. For example, I notice that black letters on a white background are clearer than white letters on a black background. This could be related to the 26 rings of the Panoptix lens and very well be very subtle faint other images from other rings.
Today I decided to take the left lens out of my Rx glasses so that my left eye with the Panoptix is as-is and the right eye is corrected. This provides very clear vision with both eyes open. But if I cover the right eye things go back to not crisp with the left eye for any distance.
Honestly, I don’t know if I should be wearing my glasses like this so that the right eye is corrected or if it is better to just go without them like I have been doing. I want to give the Panoptix the best chance of me adjusting as soon as possible. But no idea what would make that happen faster.
I think I am going to just have to wait till my 2-week follow-up to see where the lens falls on the refraction test. You know did they get my Rx correct and this is just going to take some time to settle in or did they miss the mark. I sure hope they did not miss the mark, or something like that as the options would not be the best. I also have the toric so another mixer in the equation.
I read so much on that Dr’s YouTube about the Panoptix where he constantly says the Panoptix is at max clarity in 1-7 days. He even interviewed a few of his staff and patents all said the same, average 2 days they see like Steve Austin (you must be older to know who this was).
Today is the last day for the antibiotic drop but still 3 weeks left to the steroid and anti-inflammatory both seem to burn after putting in.
Anyways that’s where I am today.
007Bond
Edited
Ok we are at 8 days post op.
I think maybe just a little bit today is slightly crisper. However, could be in part to me learning how this iol works.
As noted, I noticed that black text on a white background was sharper than white text on a black background. I noticed that lighting has something to do with it too. If I take a book outside in the sun the text is much clearer and sharper, then it is inside the house. A white piece of paper with black print next to a computer monitor with the same size print and white background with the same black print is easier to read. So going around I notice that anything with an illuminated background is not as clear. Another example my laptop keyboard has the keys illuminated. If I am viewing the keys in a dim room, they are not clear they are fuzzy around the letters but if I don’t move and simply brighten up the room light the fuzz slowly goes away and once the room light is more than the keys backlight, they are clearer.
I want to point out how much the artificial tears have helped as noted by greg59. I would go so far as to say that IMO if I had started to use the OTC eye lubrication eye drops from day one my recovery would have not only been much more comfortable, but I am betting the foreign body and scratchy feelings would have been gone days sooner if it bothered me at all. Maybe I would have even been to where I am today at day 8 by day 4 or 5. The Dr office the surgery center everyone gave me this crazy detailed instruction sheet that never mentions OTC eye drops for comfort or for the inevitable dry eyes. For anyone having cataract surgery I highly recommend using them from day one you won’t regret it.
Today I am still going around with no glasses so that means my right eye is uncorrected for computer and close vision. Still not sure if this is the correct approach or if I should be wearing my reading glasses with the left lens removed so that my right eye is corrected. I guess I was hoping for mono vision for now not sure if that is the right thing with this type of IOL.
I found a very interesting thread on the Panoptix for anyone who is considering one. https://patient.info/forums/discuss/panoptix-did-you-adjust-to-them-or-explant-were-you-happy-with-results-if-exchanging--779997
I think some of what swm1970 is describing is very close to what I am experiencing. “Shadows/blobs/offset gray images around text, especially light text on dark backgrounds.” “A double edge, ghost edge, faint transparent projection of the outlines of every object I Iook at up close. Everything looks slightly out of focus and nothing has sharp, clear edges.”. This sounds similar to what I am seeing not exactly but everyone describes things a bit differently.
Something that apat said is a great way to put it.
“A lot of the negatives I read about the PanOptix tend to be reported shortly after surgery. This in my opinion is simply too soon to judge. While I think it's wise to basically ignore all the marketing material, the outcome does rely heavily on neuroadaptation, and that takes time. You're genuinely rewiring your brain to use your eye(s) differently. Everything you see is a construct of your brain. Your eyes just provide raw messy input. Consider optical illusions: you can see things that aren't there, and not see things that are there. What you see is literally all in your head.”
I think this is a great way to put it I am glad I happened upon that thread.
While driving yesterday I do feel that road signs are not fully in focus as soon as they should be. Kinda hard to judge since I was driving with a cataract that caused that eye to be nearsighted. But just took another drive around the neighborhood with the right eye covered. Used my older car so it was a standard dash no LCD screen. Dash looks good as well as things inside the car. What I do feel is speed limit signs, for sale signs, campaign signs, stop signs, are just not fully in focus until I am close probably 25 feet ish. Everything farther is just not crisp and if I don’t know what it says like say a campaign sign or rando lawn sign I could not read it until it was closer. But if I take my drops bottle and hold it with the sun on it, I can read the smallest print no issues it really seems clear. Probably I am way overanalyzing things as normal and I should probably give eye testing a rest and just go about my day.
Still whether this is a miss on the Dr not getting the power right or me and neuroadaptation we are not going to know until the checkup next week.
I hope for anyone considering a Panoptix or similar someday finds this information helpful in their journey to IOL selection.
Have a great day all.
RonAKA 007Bond
Posted
Light levels become more significant with an IOL. We get a deeper depth of focus when the pupil constricts due to the pinhole effect. I also find reading white text on a black background to be more difficult. I suspect the pupil opens up with the black background, and closes down with a white background.
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The surgeon I had suggested that it is fine to use any glasses you have if it improves vision, during the period between eyes. And of course wait at least 6 weeks before getting a prescription for glasses.
greg59 007Bond
Posted
Steroid drops and/or NSAIDs can sometimes cause blurry / ghosted vision. As you wean off these drops you might see fewer ghosts. Check your vision just before you put another steroid drop in, the ghosts might be less noticeable if the last drop has worn off.
Astigmatism is another possible cause, especially if you had a lot going into the surgery. Surgery can also induce astigmatism but surgeons typically account for this and plan the procedures to avoid residual astigmatism. If you had limbal relaxing incisions, they often only eliminate about half of the astigmatism. So if you start with more than -1.5D of corneal astigmatism, you will frequently end up with less but noticeable astigmatism (ghosts next to letters, etc.)
007Bond greg59
Posted
I will check more in the morning when I have not had the drops all night.
I did have astigmatism 1.75 not sure about the – or + and the Dr said he would use a 1.5 correction since they were not available in .25 steps only .5 steps. I was just out at night the ghost image is more to 5 o’clock and the closer I get the closer the ghost image is until they are one and then I see clearer when merged. So very far over say 25 feet + I see it once I get to less than 25 and they are one its gone and as noted things are more clear.
007Bond greg59
Posted
So, I did not put the drops in right away today. I really don’t see any difference in the ghost the one that concerns me is the one that is at 5 o’clock, makes me worry the toric lens is not in the proper place. I feel if this is the case that would be the reason nothing is really crisp.
So I did do some more investigation last night driving around. Finally, I figured out how to see the spiderwebs. If I am looking at a traffic light and I intently stare at it really fixated on it out comes the spiderweb. Truly crazy looking just like a spiderweb. Lucky for me if I stop my intense look and go back to just viewing the whole picture it fades away. Now this makes me think if I get another Panoptix or any IOL with rings would this become more of an issue. I could see that if you could not tune this out of your mind it would be an issue at night. So, I do think there are people that have a very valid issue with this especially if you have both eyes with a ring IOL. I am very glad that I am in no rush to have the second eye done and have time to really make an educated decision.
So far as of today I don’t have 100% clear vision at any distance and really don’t know why. Sure, can I get threw my day as is, yea I can but I did not sign up for unclear but functional vision at all distances. Is it still in need of healing time, did the Dr get the power wrong, is the toric not in the right position. The ghost at 5 makes me think astigmatism issue. Unless this is related to the drops and once I stop them it goes away, or maybe eye pressure is still high and is distorting my eye, it is looking more like alignment or wrong power to me. But who knows I am just venting here.
Thanks for all your comments.
RonAKA 007Bond
Posted
The answers to most of your questions will be answered when you get a full vision test by an optometrist. You should wait at least 5 weeks before doing that. The test will tell you what your residual sphere error is, as well as the residual cylinder (astigmatism) error is.
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Keep in mind that if you get the desired near and intermediate vision with this eye, you could consider a basic monofocal or monofocal toric for the second eye. This could minimize the optical side effects like spiderwebs, but still give you a full range of vision.
007Bond RonAKA
Posted
RonAKA I think you are right on all accounts. I have the 2 weeks post op next week I assume they will do some vision test and give me some insight into where we are landing. Not sure if they plan for me to come again later like you suggest 5 weeks. I know nothing is scheduled at this time but sounds like a solid plan. I agree with you if I can get the left eye to have great near and computer, I can save $2600 and just get the distance IOL. That would put my right eye exactly where it is today, probably even better. Also, I would have the benefit of no worries of any potential side effects of the multifocal.
If my right eye was also bad and in need of immediate surgery today. Also, if my left eye was good near and intermediate and I had to pick a lens for my right eye right now today. I don’t think I would pick any multifocal. I would probably at the very most go for an EDOF iol and would strongly be considering the basic lens. It will depend on if the right really needs a toric or not. Since the toric is also not covered by ins if I must pay money out of pocket the EDOF could be the better value. But if no toric is needed then yea the covered basic would be the easy way to go.
What is slightly misleading and is the main thing making me worry is the online posts of people that are great sight regardless of IOL a day or up to 7 days post op. Makes me feel like man what is going on here with me so many posts (mostly on Youtube) with such good results.
I think the information provided by multifocal IOL’s is a bit misleading. To say some people may have halos or starburst is not really the full story. This is played down for sure I mean I don’t really have any issues as of today, but it very well could be the reason I am not seeing clearly. I am starting to think the EDOF is the safest bet over the MF and worst case you need some OTC readers sometimes. It is more correct to say most people will experience visual anomalies of some type with these lenses, some people will adapt to these, others may not, be forewarned.
RonAKA 007Bond
Edited
Your PanOptix likely has blue light filtering. If you want to match that in the other eye, you would likely have to go with the Alcon Vivity for an EDOF. I don't think blue light filtering or matching is a real deal breaker, and the Eyhance is an option too, although it likely will not be available with blue light filtering. Keep in mind the Vivity can have some optical side effect issues too, but much less likely than the PanOptix. But, if it were me, and you do achieve good reading and intermediate, I would just go with an Alcon Clareon monofocal. A monofocal always gives the best distance vision. And a monofocal does not drop off a cliff for vision as you get closer. It reduces gradually and most have very good intermediate vision down to the 18-36" range. Not sure if torics are available in the Clareon yet. You might have to go with an AcrySoft IQ Toric which will be the same material as your PanOptix.
RonAKA 007Bond
Edited
Oh, I forgot about the eye tests. I would not trust the refraction of an eye test at 2 weeks. It will give an indication, but changes are still likely to occur as the eye fully heals. I would trust the ones at 5 weeks. I don't think optometrists are likely to issue an eyeglass prescription at 2 weeks anyway, as you are most likely to come back complaining that it is no good if your eyes do change.