I just got the PanOptix in my second eye!

Eye care
1

I just had my second Panoptix installed yesterday (right eye, left eye was done exactly 6 months ago).

I just came back from my post op exam the doctor said everything looks good, but the pressure is very high. He gave me a pill to take at the office and some drops for the next few days otherwise he said everything else is spot on. I had the same high pressure with my left eye but that time he only gave me the drops for a few days not the pill.

I have a lengthy post here from my left eye surgery six months ago and it was quite a rocky road. At first like many I was on the fence as to which lens I should get. I was between an extended depth of focus and the Panoptix. I wound up settling on the Panoptix and initially had a lot of regret.

Like many people who post here I had halos starburst what I would say combine as spider webs. And I also had an afterglow around letters on my cell phone and computer basically anything with a backlit display. I also had not great vision at any distance so initially things were quite disappointing. After some time, I realized a lot of my problem was dry eyes so after a few weeks just taking preservative free eye drops improve things quite a lot. I also realize that the drops that I was taking for the 30 days after the surgery we’re also adding to the poor vision. Approximately two weeks after I stopped all drops and continued the lubricating drops there was quite a dramatic improvement in overall vision.

However, I was still experiencing some of the common side effects associated with an optic lens. And also, my vision was not razor sharp at any real distance, but I could see at all distances well. I would probably say between 90 and 95%. I had my vision tested at about four months and it came in at 20/25 though as noted things were still not razor sharp but improved.

A few weeks ago, it was time to decide what to do with the second eye so I had another eye exam as well as getting the right eye remeasured to ensure that the readings from six months ago were still accurate. At that time the left eye was coming in at 20/20 and I can say that all distances where what I would term as 100%. So, it really does take at least for me six months for your vision to adjust to a lens like the Panoptix. You may ask do I still experience some of the side effects I would say yes, they’re there but I just don’t notice them. Do I see Halos starbursts and spider webs yes if I want to, but I don’t notice them anymore and they don’t affect my vision quality. I would say with the lens like the Panoptix neuroadaptation is mandatory and some people will do better than others adapting. For me having clear vision from approximately 12 inches to Infinity without glasses is really a great advantage but it didn’t happen overnight.

A few people have private messaged me asking about night driving and glare. I personally don’t have any issue driving at night and I don’t have any issue with glare anymore. For my job I do drive long distances of several 100 miles at times day and night mostly on Interstate highways. I also don’t have any problems with contrast. Also, I’ve had my natural lens in my right eye for six months with the Panoptix in the left eye as a comparison. I am convinced that my current vision is better than my natural eyes have been at least for the past several years in this area. I’ve said this many times there is no lens that’s ever going to replace your natural lens that you were born with. No matter which one you pick there are going to be some side effects or anomalies that you will have to adapt to or learn to live with. You just must decide which ones you think you can adapt to and or live with for the rest of your life.

Today is just 24 hours after surgery and my right eye is still considerably dilated, and things are still blurry and hazy. But I think with the knowledge that I learned the first time around with the left eye things are going to go a little smoother with the right eye. I will be using the lubricating drops as needed for comfort. I also now realize that I cannot expect results for at least a few weeks after stopping the drops. I’m going to go with the assumption that neural adaptation should be much quicker for the right eye since the brain is already adjusted for the left eye.

Unfortunately, most people find this forum because they’re having problems certainly that’s how I initially found this forum. I think we all can agree that people that are completely happy just go about their day-to-day life and don’t seek out some forum to post happy thoughts.

Of course, I still must heal from the surgery and see how things settle out. But I’m not expecting any issues directly related to the Panoptix. As we know there are many risks with any surgery and many things can go wrong no matter which lens you pick. I do know that the vision in my right eye is better than the vision was in my left eye the day after surgery. I think it has a lot to do with the learning experience from the previous surgery.

I’ll keep things updated from time to time.

2

It seems that you have adapted well to the PanOptix vision, and I wish you well with your second eye. I understand that elevated pressure after cataract surgery is fairly common just as a result of the trauma of the incision etc. However, I believe it can also be aggravated by the corticosteroid drops used after surgery to reduce inflammation. Surgeons seem to be all over the map on their eye drop routine after surgery. The surgeon I had seems to be on the side of minimizing the steroid drops and that a particular one, Durezol, may be more effective at a lower dose. It costs extra and if you use it, then the prescription is one drop per day for 3 weeks. If you go for the generic prednisone, then the use is three times a day for 3 weeks or until the bottle runs out. I went with the Durezol so I don’t know if the prednisone bottle actually runs out or not… I think I would discontinue it after 3 weeks if it had not run out.

3

Thanks Ron, Yes seems my outcome is adaptation, seemingly doesn’t work out for everyone. Doctors do seem to be all over the charts with drops. A coworker had her eyes done and it was what they called dropless cataract surgery. Apparently during the surgery, they inject the eye with time release medication, and you don’t have to take any drops at all. She seemed to like that but suffered quite severely from dry eye and they told her not to use any lubricating drops and power threw it, which I thought was very strange. I have the antibiotic for 7 days 4X the steroid for 30 days 4X and the anti-inflammatory for 30 days 1X all of which were started two days prior to surgery as my protocol.

4

What worried me was that if the higher pressure does not go away one can be left with glaucoma.

5

Currently at six days post op.

In general, I think things are progressing for the right eye about the same as they did for my left eye six months ago.

There are some differences, with the left eye I was noticing some negative dysphotopsia right away. So far with the right eye I have not noticed anything like that at all. Generally, with my left eye at six months I only notice it occasionally and it’s not exactly a dark Crescent more like a visual anomaly off to the left. Thankfully so far this is not present at all with the right eye.

I was in a store over the weekend with very bright LED lights that when I first got my left eye done I noticed flickering. I am now noticing this with the right eye, this seems to have mostly gone away in the left eye. Quite honestly, I think it really depends on the particular type of light, some seem to be more prone to this than others. For example, I think that bright LED lights tend to be more of a problem then traditional incandescent light for flickering.

The right eye that was just done is similarly experiencing the same ghosting and lack of general focus at any given distance. However, with both eyes open everything is just fine it’s only when I cover the left eye do I notice this.

Since I’m using the lubricating drops in between the regular drops with this eye things are progressing much more comfortably. I’m not having anywhere near as much foreign body sensation or irritations as I did with the left eye before starting the lubricating drops.

I’m surprised to discover that neuroadaptation between the left and right eye seems to be completely independent. When I first got the Panoptix six months ago in the left eye I noticed the standard halos and starburst better described as spider webs that most people experience. Over the course of time I have learned to ignore them with the left eye and I see very well day and night. However, just having the right eye done six months after the left eye I did some testing of my eyes independently looking at the same light source. Currently the right eye notices the spider webs like the left eye did initially 6 months ago where the left eye has learned to ignore this now. Oh and as for looking at things like this computer monitor the right eye used independently the letters are ghosted like they were originally with my left eye. But as noted the left eye sees this text completely normally now and it has learned to ignore the ghosting. At this point I’m not sure if the right eye will learn any quicker with the previous experience from the left. Normally people get one eye done and then the other eye within a week or two so they’re probably not noticing what I’m noticing. Anyway, my expectation is that the right eye will learn to ignore these the same as the left eye has already learned.

For some reason my two week follow up is at 3 weeks post op. I think the doctor just didn’t have any appointments available for the two-week time. So I still have another two weeks to see the doctor after the initial day after visit.

That’s my update for now.

6

OK we are 9 days post op.

I would say starting with day 7 the right eye was approaching 90%+. By day 8 which was yesterday I’d say we were at 95%+. My left eye which was done several months ago I would say is at 100% and tested out at 20/20 on my last visit. I printed a home vision test that you do from 10 feet away and the right eye comes in at 20/25 and I can get half of the ones on the 20/20 line. For sure the right eye is dialing in and adapting much faster than the left eye did several months ago.

The only thing probably holding back the last 5% is a slight amount of neuroadaptation still necessary. Specifically, a very small amount of the ghosting around letters and the spider webs seen at night. At the current rate I’d say probably another few days and we should be at 100%.

I know this forum doesn’t have many positive posts most people are here because they’re having problems and generally not satisfied with whatever IOL they have currently. And I see many threads that just go dead because probably people had issues came here posted but they cleared up and they just never come back to update. For sure I was initially here for questions concerns and some initial problems that I was having. But I’m very happy that the Panoptix has worked out so far very well for me.

While I was watching TV last night, I was very amazed at the level of clarity and the vibrance of the picture. Also the fact that while I’m sitting there watching TV I can look at my watch my cell phone or to the other room to a distant digital clock or anything within my viewing range and it’s clear and in focus. I was out for a drive last night and just this morning equally amazed at the clarity of my dashboard license plates road signs everything necessary to drive well near to far.

I would probably say the last time I could see this well at all distances without glasses was probably when I was in my 20s.

If I must nitpick and complain about something this is what I would currently say. And I don’t think all of them are directly related to a multifocal lens specifically the Panoptix.

Left eye (done 6+ months ago).

  1. Occasionally I still see something off to the left edge it’s not really a dark Crescent it’s just, I think some light is catching the edge of the lens. It’s definitely more noticeable in stores that have high intensity LED lighting. This sometimes gives me the false feeling that I have something in my eye.
  2. A very minor amount of spider webs on some forms of light in the evening. Again this seems to be more noticeable with high intensity LED lights. This in no way reduces my ability to drive or see nor does it really bother me in any way. Unless I’m thinking about it and specifically looking for it I’ve completely forgotten about it and it’s unnoticeable.
    Right eye (done a week ago)
  3. A very minor amount of spider webs on some forms of light in the evening. Again this seems to be more noticeable with high intensity LED lights. This in no way reduces my ability to drive or see nor does it really bother me in any way. Unless I’m thinking about it and specifically looking for it I’ve completely forgotten about it and it’s unnoticeable. Currently this is ever so slightly more than what I’m seeing on the left eye as I believe some additional neuroadaptation needs to happen.
  4. I still have some unusual sensation to the lower right, but the lubricating drops seem to help so it’s probably related to residual dry eye.

Both eyes for optimum clarity of smaller print you do need good lighting. I can still see menus in dimly lit restaurants however if the restaurant is extremely dimly lit with a smaller print it can be difficult. But I’ve been with friends that don’t have IOl’s who wear glasses and are also having difficulty. Just for reference those very small printed inserts that come with the eye drop prescriptions. If I’m near a window with good sunlight they’re razor sharp, if I have them under say a desk light, they’re razor sharp, if I take that to a room with just some general lighting it would be noticeably more difficult to read but not impossible. But there is some light loss with most any IOL. Admittedly more so with a multifocal but the fact is even if you have your natural lens as you get older less light is entering. So in my opinion by the time you’re my age the difference between the multifocal IOL and your natural lenses is probably the same or maybe better with the IOL so does it really matter anyway.

The drops are still a pain for the right eye, and I can’t wait till they’re done and of course the limited physical activity is another thing.

I know most posts on this forum are issues that people are having with the Panoptix. But I would say at this point I have to highly recommend the Panoptix. The ability to see clearly from 12 inches to Infinity with what I’m going to term very minor at this point unnoticeable side effects is highly advantageous. I know that the Panoptix is advertised for a near focal point of 16 inches plus, but I’ve measured it several times and it is very clear from 12 inches plus.

I know I could have gone with monovision or several different combinations but I’m thinking that there must be some advantage to having both eyes seeing with the full range of vision and clarity without glasses.

I still have the follow-up in a few weeks and then one more at the 5-6 month mark. But thankfully things are progressing very well so far.

I won’t disappear I will post future updates.

7

OK I just got back from my post-opt exam at three weeks after surgery for the right eye.

The doctor said everything is looking perfect, pressures are good in both eyes. He said I can resume all normal activities everything is healed well.

Looks like the right eye that was done seven months ago has settled in at what the doctor said was 20/20 plus. At three weeks the left eye is at 20/20 minus. So I asked him what exactly he meant. Basically, with the left eye I missed one letter to have 20/20 and with the right eye I read the 20/20 line perfectly and into the next smaller line. He says that 20/25 or better is considered a success and I would agree. So with both eyes open I can easily read the 20/20 line and most of the next smaller line.

My vision is clear at all distances from 12 inches onward. I’m very happy with the results and the PanOptix lenses.

The doctor said to come in for a follow up at one year unless I have any concerns in the meantime.