Hi! I had my measurements for cataract surgery done in November 2018. I left my contacts out for two weeks...15 days for good measure...and endured the extensive measuring by a highly rated surgeon I plan to use in the Philadelphia area. I say endured bc the bright lights for a few of the tests were honestly painful. I have very light sensitive eyes and my pupils dilate very easy. I put off surgery for a few reasons - and upcoming vacation, then the surgeon had a change in schedule that didn't fit mine, and then in August I decided to wait for Panoptix, Now my LE is getting pretty cloudy and I'm trying to get the nerve to do the surgery. My surgeon said the measurements from 2018 are still good and I don't need to re-do them. Anyone know? Is there a benefit to do them again? My vision hasn't changed other than the cataracts. BTW - my glasses script is -9.0. Contacts -7.5. Thanks in advance for your expert opinions :)
My surgeon said the measurements were good for a year. I did my second eye 5 months after the first and kind of insisted we measure again…he complied, and said the measurements were exactly the same.
H’mmm I would have measurements taken again if it were me. Measure twice cut once is good advice for more than cutting more than wood. Surgery cannot be undone and exchange is last resort.
Personally I would take your surgeons word for it, but most important thing is that you feel safe, so if you feel insecure, you should ask for new measurements.
If you look at it the other way around, the measurements should hopefully last for a lifetime.
If measurements change within one or two years, we all would need to have our iols replaced every two years. And thankfully we don´t 
I think Danish_Viking’s logic is good. We are into these lenses for a lifetime so a month here and there is nothing. I would suggest that your much more important decision is whether or not to go with a multifocal lens. I am convinced they are definitely a compromise solution, and not everyone is tolerant of compromise vision. My thoughts would be to expend efforts on making sure you are fully aware of the compromises associated with multifocal lenses and whether or not you will be satisfied with them.
Yes - I agree. I honestly don’t know what all the “tests” were, but from what I understand, adults shouldn’t change. But the fact that he said they are good for about two years had me wondering. Thanks for your advice.
I agree. I’m still conflicted with that decision. I’ve basically had poor vision since a teen so at 47 it is very appealing to be glasses/contacts free for the most part. That being said, I don’t mind readers for reading, but would love to be glasses free for computer use and distance. Right now I’m leaning towards panoptix and my dr thinks i will do well with the lens.
I do have some concerns over possible side affects - mostly halos and night driving as i have three young (ish) chlildren. But I do already see halos or starbursts around lights at night now…and those super bright headlights are blinding. So I can’t imagine it could get worse.
I’m also worried about light sensitivity in general. I’m already pretty light sensitive and I hear everything is brighter when the cataracts are removed.
It is indeed a hard decision to make. But seems most are happy with their outcomes either way.
if you don’t mind glasses for reading perhaps look into a mini monovision strategy with monofocal lenses. These have the least amount of halo and glare. On eye will be targeted for best distance and the other for intermediate (computer distance). You could also get more range f you went with a monofocal for best corrected distance in your dominant eye and go with a trifocal in the non dominant eye. The monofocal would help reduce the incidence of halos.
Yes people are generally pleased with outcomes no matter which lens they choose but of you tend to be a person others find very particular you may be bothered by the halos and glare. Certain personality traits do better at compromise than others
Hi I had my surgery in both eyes about 7 weeks ago and only got measured the once. My left eye is spot on with 20:20 vision and my right is about+.25. However, the eyes are still settling and I have been told to allow 3-6 months.The lenses I chose correct in increments of .5 so i guess you could say you would not need to have another measurement but everyone is individual. This is a life changing procedure and if you feel that it would put your mind at rest, then in my opinion, you should get it done again. Believe me, having no regrets will help with healing process.
Best of luck!
Hi Crista:)
They take a lot of measurements, many of which are only about the physical eye characteristics - size, shape, length, etc. Maybe these are the most important for the surgeon when calculating the power of your IOL before surgery, not sure. But your prescription would most likely be different after a year of increasing cataract growth. Perhaps your surgeon could better explain to you his/her opinion that it doesn’t matter.
I tend to agree with SueAn - measure twice, cut once.
In my own case, I had the two eyes done 4 months apart, using a plan similar to what SueAn mentioned - monofocal IOL in dominant LE set for best distance and Symfony EDOF IOL in non-dominant RE for slightly less distance. Ended up with perfect results - perfect distance and near and intermediate. so grateful!
I did the monofocal IOL with an excellent surgeon nearby, but because he wasn’t on board with my plan (older guy, very old school), I went with a somewhat younger surgeon with lots of Symfony experience for the other eye. The 2nd surgeon definitely took the measurements over again with his own staff.
Your insurance should cover the measurements again if it’s been over a year.
Best wishes in your process!
Wow - and your eyes can adjust to one monofocal and one symphony EDOF?
I was inclined to go with Panoptix as the latest and greatest but am afraid of the tradeoff with night vision and glare.
My regular eye dr. does cataract surgery but she does not use alcon panoptix. She wants me to have her do the surgery and get monofocal (either mono or mini monovision scenario) or the multifocal brand she uses - which may be the tecnis (can’t recall as it’s been some time since I discussed with her). She also does not do the laser assisted surgery and discourages me from spending the money. But I have the money set aside.
The top surgeon I met with used restore when i met with him, now he uses panoptix. So he said I am a good candidate for Panoptix but of course informed me of the potential side effects. He is also an hour away and we haven’t discussed other options beside just monofocal.
Yes I am very confused. I’m getting more comfortable with the idea of surgery but not more comfortable picking a lens.
Maybe I’ll get another opinion!
There are so many options and configurations, and it seems if you ask six eye specialists you will get six different opinions.
You should not have any concerns about the surgery. It is easier and less uncomfortable than getting your teeth cleaned with the ultrasonic scaler, a root canal, or having a colonoscopy.
Mini monovision is certainly an option but if you are going to get trifocals then do it with both eyes. Doing a mix will still result in some glare/starbursts.
Like you, I experienced halos and starbursts with my cataracts, and they are no worse/better now with the PanOptix trifocals installed. I was prepared for this compromise as I did not want glasses, maybe an irrational view after wearing glasses for 50 years. I might still have needed reading glasses with mini monovision so did not select that option.
If you are prepared to use readers then premium lenses adjusted in both eyes for distance is an excellent option.
My surgery was with the laser assisted procedure, as recommended by optometrist, even with the additional costs. He felt that it lower the potential for retinal detachment from the phaco procedure.
One study you may want to read is the following. You should find it with a google search and there is a full pdf report on it available. I found the Discussion part of the study report non technical enough to reasonably understand it. I think it gives a pretty good idea of the pros and cons of the common options:
- Full monofocal distance correction both eyes with reading glasses essential for reading
- Mini Monovision with potential requirement for glasses to see small print, or driving at night
- Multifocal IOL’s - Almost certainly with some compromises to vision for reading in lower light and at night driving
One thing to consider is that the first two solutions have issues that are pretty much resolved with glasses in certain situations. The multifocal solution most likely includes some compromises that are not resolved with glasses. In any case here is the name of the article you could look at:
Pseudophakic mini-monovision: high patient satisfaction, reduced spectacle dependence, and low cost
The significant attraction of Alternative #1 that Ron identified is the combination with progressives glasses which will allow for the correction of any astigmatism and minor refractive errors, i.e., use glasses all the time.
I am coming up to my 6 month checkup after implant of trifocal IOLs and will need to discuss if some corrections should be done for my minor astigmatism of 0.25 and 0.75.
Chris - Are you in the US?
Can you tell me your experience with panoptix?
or is there a thread i can read if you already covered that?
Hi Christa, I am in Ontario, Canada.
My surgery was done 5 months ago, right eye first and left eye two days later, both with PanOptix trifocal IOLs. Laser assisted surgery, IOL correction of -11.0D & -13.0D, and no astigmatism correction. A couple of days later RE was 20/25 and LE was 20/30. No change at the one month checkup and astigmatism was 1.0D in both eyes. At the two months checkup the astigmatism was back to pre surgery measurement of 0.25D & 0.75D. There was also some cloudiness observed by the optician and I was referred for YAG laser treatment. This was done 6 weeks later on both eyes. There were no floater observed after the procedure - unusual, but great. Two weeks after that both eyes were measured at 20/20.
The next checkup is at 7 months which coincides with my regular annual checkup. At that point I will have another discussion about possible correction of the minor astigmatism.
My near vision was good within a day of surgery, intermediate was reasonable, but distance was fuzzy. Driving at night after a week was OK but there were halos/glare from lights. The glare was/is not blinding.
Currently at night, in addition to the halos/glare there is a fine light beacon with the RE from bright lights, but none with the LE. I suspect that this is from the 0.75D astigmatism.
One interesting point: prior to surgery my LE required a stronger prescription, but the IOL Master worked its magic and predicted a lower correction. At one of the post op checkups my optician suggested that the LE was slightly under corrected, but it seems fine to me.
In summary I am a happy camper and my objectives have been met for not needing glasses for anything - after 50 years of glasses (but use sunglasses in bright daylight). My distance vision, in bright lighting conditions, is not as sharp as I would like, but acceptable. Maybe it is slightly better with sunglasses. I put this down to effects from the trifocals. Face clarity over 20-30’ is not as good as I would like, but acceptable. The lack of clarity may also be due to the trifocals, and/or minor astigmatism. There are are suggestions that additional neuroadaptation over time may help.
Hope this summary helps.
Yes, no problem adapting for me, but it’s actually the brain (and psyche) that does the adapting. Important point, tho - I did “micro” monovision (not full or mini), with only a half diopter (-0.5D) difference in the non-dominant eye. This is a VERY small difference between eyes. But it’s enough to give me crystal clarity for near vision with the Symfony.
I think full monovision is becoming less and less common, as it’s unnecessary to have any more than 1 diopter difference between eyes (=“mini”), for most people’s daily needs.
I had the surgery without laser in both cases with no problem. Both my surgeons had done tens of thousands of cataract surgeries, so I wasn’t worried.
Doctors tend to recommend the IOL which they are currently using most often. Restor is less common now. Each year there seem to be improvements to the technology with some new lens. So the only thing to be concerned about is how much experience the surgeon has with the latest IOL they recommend. This matters for measurement and power calculations, mainly. The surgery itself wouldn’t be much different no matter the lens implanted.
I understand your confusion over choosing the IOL and general course of action. In the end it comes down to recognizing your own daily habits and your preferences for when you would most like to be glasses-free, near/intermediate/distance or all of the above. Just take time researching and then reflect and feel your own inner desires. Then your research will kick in and you’ll know what to do. Best wishes for a perfect outcome!
I suspect the degree of monovision used is different when a multifocal lens is involved than when a monofocal lens is used.
Hi Ron:)
The degree of monovision for me was my choice, in consultation with my surgeon. We didn’t have any guarantee it would work out so spectacularly well, and he hadn’t tried this particular combo before. But he said he had done so many different combos for people he couldn’t keep track. So grateful he was available and we had such great success!
The common wisdom nowadays is that any difference between eyes greater than 2 Diopters is too hard for the brain/eyes to adapt to. “Mini” is considered >1 to 2 Diopters, I think. “Micro” is <1 Diopter difference, 1/2 diopter in my case.
Apparently many people who choose mini-monovision are ok with wearing glasses for one of the extremes (near of far) if needed after surgery. I wanted the best chance of needing no glasses at all. Luckily, that’s the result.
My concern with going that low is that I tried monovision with contacts at a 1.25 diopter difference. I could read, but it was far from perfect, and I definitely needed readers to see the small print on OTC drug labels (the stuff they really don’t want you to read!). I have recollections of taking drugs to the optical section of the pharmacy and using the readers to try and figure out what I was really buying… What the monovision at 1.25 was real good at was driving during the day. I could see the dash instruments perfectly and distance perfectly. Had no excuse for speeding!