The PanOptix Lens. What do we do when patients don't like it? Replacing a PanOptix with a Symfony.
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- Опубликовано: 2 окт 2024
- (Disclosure: I have no financial interest in any of the products in this video)
The Panoptix lens is a presbyopia-correcting lens implant that successfully corrects vision at all distances - far, mid and near - enabling patients to see with minimal to no reliance on glasses.
It works well in 99+% of patients in our experience thus far. Since no lens implant is perfect and without side effects, there are patients who may not like the quality or quantity of vision with the Panoptix.
We present a case of lens exchange (IOL exchange) where we removed the panoptix lens and replaced it with a symfony lens. The patient did not like the vision with the Panoptix but was satisfied with the vision of the symfony lens. He preferred the optical quality of vision with the symfony lens more than the panoptix lens.
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I just had the PanOptix implanted over the last 2 weeks in both eyes (Feb 2024). I have the exact same problems he had. If I get mine replaced, I will just go to the basic IOL and wear glasses and be done with it. I wore glasses for 50 years before cataracts and having crisp clear vision at ALL distances with progressive lenses was much better that 'close' to 20/20 but with blurriness and shadowing and only 3 focal points. I will wait but I think I made a $6,600.00 mistake buying a lens I was sold to me like buying a used car, all the positives and skimming over all the negatives. I will give it a few more weeks but so far I am unhappy with the lens and the crappy vision without glasses is NOT worth it. I will take basic IOL and glasses ANY day. The basic IOL is free with my insurance by the way and so are my glasses each year. PS, Just hope you are one of the lucky ones that gets the right power in the IOL too, it is really just a best guess at the power you need to correct your vision so that is why you just get 'close' to 20/20 with a few getting lucky and hitting the jackpot with 20/20 and great vission.
Probably the best, most trustworthy eye specialist currently broadcasting
Thank you so very much for your skills and willingness to share your experience and experiences
Thankyou Shannon. Its nice that you are not only showing the success stories.
Two months is not enough time to make decision on a lens exchange. I bet with time, this man would have been just fine with the original lens. Just my opinion, from my experience.
Funny you say this. I would worry this guy is just a nit pick
Valid point.
Is there an update with this patient and the symphony lens? I’m over a year into both eyes receiving panoptix and am more bothered by my poor vision every day. Same exact side effects as this guy. Maybe worse.
I agree...I'd love to know if Rob is happy with his new Symphony lens today...Could you share that Dr. Shannon?
Dr Wong, Is it medically possible to replace all existing new gen Multifocal IOLs and replace them with newer, enhanced ones? Any constraints to consider here? For instance, post a cataract surgery, can the Synergy or PanOptix lens be removed and replaced with a newer generation IOL in 5-10 years down the road?
And how do you see the progress of next gen IOLs? Any breakthroughs expected in terms of material, better vision with less aberration, or low light vision issues etc.?
Thanks
Where is your clinic located
I had pan optics implanted in both eyes early this year (2020) just prior to the COVID-19 pandemic. I also experienced the tunnel effect and the shadows at the periphery of both eyes. It was disturbing to say the very least. I had been fully advised of this possible side effect as well as halos around lights.
Over about 6-months my mind became accustomed to the peripheral anomaly and now I can’t distinguish it even if I tried. The halos though, they are worse than I could have imagined! I mean I thought I had a clue - I didn’t. They are real and basically make driving at night more of a chore than it’s worth.
Having said all of that, I would make the same choices again, even knowing what I know now. I see great through near, intermediate, and far distance. My advice to anyone considering total lens replacement, any corrective procedure really, is that there a trade offs to be considered. You have to really think about where you are prior to any procedure, and what you can accept if the worst of the possible side effect manifest.
By chance, has the halos gotten any better since this last post? I just had the panoptix trifocal put in 1 eye and it's great except for the horrible halos from headlights at night, and effects of dim light situations. I' ve "somewhat thought" about getting a different lens in the other eye thar let's in more light and has reduced halo effects. Any additional information that I could use to make a more informed decision would be great. Thanks
😉 in
I had Panoptix IOLs and find them awful. If I am not wearing a hat with a brim, I get so much refractive error that I can't really see. I can be indoors, and light coming in from a window is enough to mess up my vision. The loss of contrast is always an issue, even when I wear polarized sunglasses and a baseball cap.
Hello, did any of your side effects get better?
My mom just got Acrysof IQ Panoptix lenses, and 2 months post surgery she can not still differentiate objects from the background well. Her closed vision got better in comparison to before the surgery but now distance vision got worse. Can someone please help us, anyone experiencing the same?😞
This was fascinating. I wish I had as good vision that the patient had prior to surgery. I would not have gone through with the surgery. I have the panoptics and LOVE my outcome. I am glad it appears the patient's problem was solved.
How bad are the halos at night and are there any other side effects of PanOptix
@@chloenkitty
I have no halos.
Great Doctor Shannon...really great with the sharing of the real case .Thank you very much.
Can you make a video regarding neuroadapting to a panoptix lens and timeframes for that to happen?
Thank you for putting this video together. I found it very informative as I contemplate whether to move forward with lens replacement surgery. Thank you, again.
Hi my name is Brenda Miller and I had the PanOptix Lens put in August 2021. The very first day after My eye sight is so bad, glare, circles, letters framed. .y doctor said it would get better so he did the seconded one. Well nether one is better. In fact everything is worse now 1,6,2023. But my doctor said there was nothing I could do about them that if I tried to have surgery again I could be blind. Can you give me some other advice? The thoughts of this for the rest for my life like this makes me sick if at 71 years old now. Brenda
Thank you for this video Dr. Wong. I just had my cataract surgeries last month with Symfony implants. I had watched your videos and initially asked my surgeon in Brasilia if I would be a candidate for the Panoptix lenses. Due to my glaucoma I was not.
Now one moth after my surgeries( two days apart), I am very satisfied with the results. I do need reading glasses sometimes ( long reading sessions) but other than that am very satisfied.
Your previous videos describing the comparison of the two types of lenses were very helpful and I am very grateful to have received this information prior to my surgeries.
Thank you very much
Gerry Dunphy
Florianópolis,
Brasil
Nearly three months ago I received bilateral Panoptix lenses. My complaint is the same as this gentleman. There are days I want to rip them out. My surgeon and second opinion MD don’t understand as I see 20/20 according to exam. Reading and quality are no the same. Everything glows. No edges to anything. I can’t see detail either even with readers.A surgeon I work with laughs at me saying he places these lenses weekly and his parents never complain.
According to my exam after implants, I see 20/20. Everything has the glow and you are right. If I look at something long enough, I can make it out but looking down the road and then to my dash, it would be dangerous to look as long as I would need to to determine my speed.
As a 72-year-old who never wore glasses until readers, I have wanted the total lens replacement for a few years as distance vision diminished. I did consult locally but did not go through with the surgery mostly because of the $11k price tag. But the variables of the outcome is very disturbing (maybe unless unlimited funds are available for corrections). I tried progressive lens glasses. First the peripheral vision area blur drove me nuts. Then I noticed while driving, I could actually see the speed limit sign better without looking through the glasses. So the difficulty of correct vision after surgery is scary. Still I would like to see without glasses. So Dr. Wong's video and explanation is of great interest as well as the experiences of those who post your comments. Thank you.
I would not be undergoing this surgery if I had good vision with glasses. I’m moving forward at just 62 years old bc my cataracts are severe enough that even with my glasses I cannot see, everything is blurry and the world is dark. I have also lost depth perception particularly at night. Good luck!
How do we know there wasn’t a fault with the panoptix lens?
OMG I am sobbing!.. .I have the SAME symptoms but my Dr keeps telling me my eye is perfect and he is declaring it a success (except the posterior capsule folding over and he said I needed yag to correct it - it didnt help the "glow" in that eye at all)... driving at night with all the lights glowing makes driving in a city near impossible... but now that i have had YAG I am guessing swapping out for a symphony is no longer an option... wish I saw this earlier this month... :(
How long ago was the lens exchange ?
@@jasong728 I had the lens placed June 29,20... then tag 10-16
I'm seeing a specialist this week. In a situation like above, who pays for the second surgery?
Dr Wong, I have the exact symptoms this patient does can you help me please.
Robert
Had the PanOptix implant approximately 2 months ago. I dearly love being able to be glasses-free and reading is a pleasure. Distance vision is good as well. I can relate to this gentleman's tunnel effect, but that has passed. The only issue I have is with the halos at night. I see about 3-4 halo rings around every light. One reader explained the halos as 'disco-balls'.....exactly. I'm hoping some of this will alleviate over time, but there's been no change to date. Vision is great, halo effect is sometimes problematic in nighttime situations.
Are the halos so bad that I should consider getting Vivity instead of PanOptix? If I understand correctly your vision is better with PanOptix but u get halos at night. Do you get the halos also watching TV or do they just come with headlights when you are driving at night? Are there any other side effects or any other reason to not get PanOptix in your opinion? Thank u
@@chloenkitty Headlights, street lights, traffic signals, bright stars, tail lights LED lights, but not all light bulbs. The farther away the more halos...sometimes 3-4 on each light. This has been the whole drawback to the procedure. I'm being honest
I had PanOptix in both eyes after cataract surgery 18 months ago. I see beautifully during the day and I can read the tiniest text. However, that all changes at night. I can still see, but I'll never be able to drive at night again. Every light, including the moon and all I see are bright concentric rings. The closer car headlights get the worse it gets. I cannot judge distance at all because of it. I'm going to try anti reflective glasses and see if that at least helps. If not, I'm going to have to consider having them removed and go to just the mono vision lenses, which I should have done to begin with. As far as watching TV or looking at the Internet, if there's a black background with white text, I see a halo around the text. I can live with that, but not that I can no longer drive at night. It cost me $2000 per eye which would have been worth it if weren't for the fact that I can no longer drive at night. I'm kind of a prisoner to these lenses now. I would not recommend them period.
I'm coming to this thread 1 year later. Did you get them removed? @@cindeenelson5114
Sounds like a great doctor and a great patient. Really nice when it all comes together.
I have the PanOptix in both eyes. I hate them. Vision is worse than before this IOL.
I'm having the same issue-- had my panoptix put in 3 weeks ago-- when I'm in the car- the dashboard etc. are crystal clear-- but anything past about 30 ft. out- is BLURRED.. SOMETIMES i can use the artificial tears and it's good for about 2 minutes.. then blurs again--- I am finding that smaller letters on the computer are also blurred up close-- but only the small ones.. I'm willing to wait a good while-- but I thought it would be crystal clear all over by now..
David, I'm curious how you eyes did a year later? I had Panoptix implanted two weeks ago on left with the same symptoms you experienced. Would love your update and feedback! Thank you! Deb
@@debrawilliams2221 Well, after over a year- it's BETTER. I think my brain is beginning to pick out the better views more often. I was told THAT was the issue-- not the lens. I still have days where I'm blurry- I go to the store with my SIS- I don't drive that much- and everything is blurry.. Here in the house usually everything is fine. VARIETY of viewpoint is important. I don't get out much because of OTHER health issues- so my brain can't adjust to far and near and back and forth-- which it NEEDS to.. MOST of the time it's clear at all distances though-- and is slowly improving. BUT- keep in mind, I have OTHER health issues as I've sais.. Good luck to you. OH- I can't read much wthiout a VERY bright light on the page, but it I DO have a bright light- it's clear as can be!!! Same thing when I'm out and about- if the sun is BRIGHT- I can see very clearly. This lens just cuts out a lot of light..
Great video. Very interesting. I have the panoptix in both eyes. Saw the shadow for first couple days but it went away. Still see the shadow around letters on screen with high contrast but not as bad as the example picture you showed. In bright light the vision is perfect. Not so hot in dim lighting. It's not perfect but I'm glasses free for first time in my life so happy
Thanks for the interesting and well-made video. I think that what happened here is that the patient's expectations are bumping up against the limit of what cataract surgery technology can provide. Perhaps deferring surgery until a significant cataract was present would have made him more accepting of side-effects (most of which will go away with time).
I have about 4-5 patients with panoptix (1 in 150 implants) that are unhappy with their visual quality. Most had more visually significant cataracts than this patient. Additionally, I found with symfony, there is a 1:300 chance of visual intolerance with that IOL. No lens is perfect.
@@ShannonWongMD I appreciate the statistics - that information is hard to come by. Nice job on the IOL exchange.
So if he had worse vision he would accept his new bad vision. Fun
You are amazing!!! Kudos to you for working so hard to achieve patient satisfaction!!!
I'm not a doctor. I am certified HVAC Service Technician, passionate certified motorcycle mechanic and motorcyclist.
The most important, #1 thru #5 advice i have is to find the best available surgeon you can possibly visit for a consultation. Do your homework and don't rush this step.
#6 Don't rely on people's online posts, reviews ,post surgery, it will only mess up your mind if you are looking for answers. Reach out to your surgeon and your personal eye doctor.
Well said. I agree completely.
My neighbour had her eye lens done and it cost her $20,000 I have never heard of Islands costing $10,000 per eye. My neighbour said that it wasn't a good lens and asked if it could be replaced and the woman said no it can't be and so sheer she was left with two eyes that we're not that good and $20,000 later. And after the operation the woman doctor said that she had eye stigma and my neighbour said it would have been nice if he had told me that I had that problem
the same doctor operated on my friend's eyes and she couldn't get them replaced and at night she had problems with headlights which she never had problems with before however she has glaucoma and she got the government paid lenses.
The same woman doctor said that she couldn't have her lenses replaced and that she was stuck with them the rest of her life and I thought I had watched a video before and you had replace this one woman's eye lens?
If that is the case then why would this woman opthamologist that my neighbour and my friend had say that you can't replace once they're in they have to stay in.
I don't think that is a good ophthalmologist to tell you the truth however I don't know and that's why I'm asking you.
Is there a certain length of time that has to go by before The Lens can be replaced.
And if you have a stigma or if you have glaucoma will that make any difference both of these women are over 60 but under 75
I've watched most of your videos including your own surgery and have been really impressed with your honesty and detailed explanations. I was hoping for my cataract lens choice that I could use the pan optics. I have .bad astigmatism and an epiretinal membrane problem in my right eye so the dr thinks the astigmatism lens would be best for me in both eyes for a far distance. I'll have to check with him again but he said I should see clearly from far to close but will need to use cheaters for small print. I haven't heard any dr on the tube mention how distance is affected with a toric lens if it's not a multifocal lens. maybe after the lens corrects astigmatism my eyes would just have a good vision by themselves, I don't know. I don't mind using cheaters for small print but wouldn't want to put them on and off to see anything in close range. Any thoughts?
there in a wonderful new lens called the alcon vivity which can address the astigmatism, give a fair amount of intermediate and near vision, and can be a match for some patients with epiretinal membranes. ask your eye doctor if its right for you.
Just did both eyes 5 days apart. 1.5 and 2 weeks ago. So far I absolutely hate them. Making me very depressed but I realize I have to give them a couple months. I hope they improve otherwise I want then out and exchanged for something else.
Hi, did the vision get better?
Hi, what did you hate about them? Did you get them replaced?
I've had my panoptix lens for over 2 months now and can't see shit!!! My close vision is remarkably better-- I can read my computer close up- things around my room here are clear-- NORMALLY-- other days can't see this either--- but from the front of my car on out-- all blurred.. can't read street signs until they are within 30 ft. of the car--- too damn late for directions if I'm going where I haven't been before. I'm seeing "ghosting" some too- like what this guy calls a "glow"... when i go back to my Doc to get checked- the "charts' etc. show PERFECT-- but I CAN"T SEE... NOTHING is clear.. not even in front of my car-- Everybody I talked to- had GREAT vision in a few days after the surgery-- mine has been 2 months and STILL not clear.. at all.. it's like I got a close lens only...
ADVICE??? My doc wants to treat it with lasik- and I have retina specialst working on the LEFT eye that was injured- and he said DO NOT do the lasik on the "good" one.. because it would screw up the good vision I DO have.
HELP????
Just got my right eye done almost 2 weeks ago and left eye a week ago with panoptic. I know I just go them but so far I hate them. I will give it more healing time but so far not impressed at all.
Kirk, how did things go w/your Panoptix? I had it done on my left eye 2 weeks ago - everything >15" is blurry and hazy. I can't see my computer screen without leaning into it and street signs, bikers, billboards are all blurry! I'm so disappointed!
Just got a Panoptix implanted two days ago and absolutely love the outcome so far. I get the next one done in a little under two weeks and can't wait.
Are the halos bad? It’s the only things making me undecided between Vivity and panoptix
I noticed them at first, but after awhile, they become less noticeable. You get used to them to the point where they are not a problem. At least that is the way with me.
@@bobunger66 hi and God bless you, how is your progress now, and would you recommend the surgery for someone and can you tell me the side effects from it please and the pluses and the minuses of having it
No way.... love to hear more.
Thank you for all your videos.
I received the Panoptix
Sept 2 Right
Sept 9 Left
From 20/40 to 20/20
Experience similar symptoms.
Need bright lights to read.
Morning fuzzy viewing on phone.
Peripheral not as good as before ... bumping head.
There are more floaters and shadows.
About 3 months ago, I had a Panoptix put in my left eye, and a Vivity put in my right. The Vivity is giving me GREAT distance vision, however there is a huge ghostly floater that is quite annoying. I suppose that floater can be removed. The Panoptix is not giving me good distance nor near vision, and has some annoying floaters as well. I get better distance AND NEAR vision with the vivity lens! Should I expect the eye surgeon to replace my Panoptix lens? Is it possible he put the wrong prescription in? This doctor is supposed to be the best eye surgeon in Florida, but I am not convinced of that. Also, everytime I step foot in his office, I get hit with a $45 co-pay even though I am only coming in for follow ups of the $10,000 ($2000 paid my insurance) for my premium lenses. Is it a big deal to replace a Panoptix lens? or is he probably going to tweak it with PRK? He claims he already did "polish" my eyes with PRK, but I was still concious with the "sunshine" anexthetic, and there was so laser treatment done, nor was there any post surgical pain for 3 days which is typical of PRK. I have my next appointment with him in about 3 weeks. I got billed for the refraction done on my eyes AFTER having the $10,000 in surgery done! He also has a little shop in his office which sells non-prescription sunglasses. The CHEAPEST pair he sells is $200! I am surprised that there is not a $10 charge to use the elevator and $20 charge to use the toilet!
I think that I understand the topic of the video but I am unsure as to why he needed a replacement lens in the first place. He couldn't see his golf ball and it was very important to him to be able to. Would glasses have helped or did he have cataracts?
Right?!? All this for seeing the golf ball better. Perhaps Rx glasses would’ve done it?
Thank yu mr Wong what country are yu.u made me feel like I have a chance to save my eye sight .i have a caratch surgery to do on Wednesday 21april an I am scared dead .i have the Caracas on the left eye an because of coved my operation in Montreal is delayed. Sir yu give me hope. I feel like my eyes is getting worst .i could hardly see I the left eye like some thing has came up .the left eye is very blutty.. May God help me with this carat have ..blessing Doctor thank yo patsy
I had Panoptix placed two weeks apart October 2019 for narrow angle glaucoma treatment at age 48. I had very clear mid and distance vision but needed reading glasses for up close. The two weeks I had one panoptix and my natural lens was super weird. After getting second one placed I had post- capsular opacification and had to get that laser corrected. I also had worsening of my dry eye inflammation. 3 months post surgery I was prescribed Restasis which helped so so much.
It took a little while to get adapted. My up close vision was good right away but the rest took awhile. A year later I see quite well and am happy I can see so well up close for my work.
The only downside I notice is at dusk my vision seems blurry. Also when driving at night I wear glasses as my vision gets a little fuzzy and I see car light halos.
So while my night vision is diminished, I am happy to gain up close clear vision my mid distance and distance vision seems comparable to before. I did take me awhile to adapt. Some delay I believe was due to inflammation so if you have dry eyes, I would think it best to pre- treat for that.
I am thankful that this lens became available just around the same time I needed to have surgery for the NA glaucoma.
I will also add that I had weird flashing when waking up for the first few weeks. That went away.
@@emmawang431 kaleidoscope rainbow flashing?
At the beginning of your surgical video, there is clearly an abnormality of the anterior rhexis edge on the right side of the screen. It appears the optic portion of the lens may be prolapsed anterior to the rhexis or possibly the rhexis is adhered somehow to the edge of the lens optic. The haptics are clearly in the bag but there is something abnormal about that rhexis edge. I wonder if the lens was slightly torqued anterior/posterior and this was the cause of your patient's visual symptoms. After you exchange for the ZXT, the rhexis is perfectly circular.
Astute observation.
I was going to ask the same thing. Love your videos! -Lloyd (ophthalmologist in SoCal).
7-4-23 today. I had PanOptix lenses implanted 12-1-22 and 12-15-22. I am extremely dissatisfied with these lenses, both eyes water frequently, are blurry often and Driving at night due to the glow is impossible. I also feel the Phantom Eyeglass Syndrome almost constantly and I realize that has nothing to do with the lenses but it is disturbing. I will revisit the optical surgery center in November 2023 for a consultation to replace these lenses. The wait is because I am a snowbird and am North for 6 months.
I do not think I needed cataract surgery at the time but I took the chance to get away from bi-focal. I wish I had never done the surgery. My vision is worse and I experience vision symptoms every day.
I do not trust the optical surgery center but I am stuck with them as they did promise to replace the PanOptix IOL’s no cost.
Question is what replacement lenses should I consider? I don’t mind readers but I want my distance and intermediate vision that I had with prescription glasses.
I so understand. Just had mine 2 weeks ago and I hate it!!
any possibility of defective lens? i have Symfony implant with 3’ blur zone not correctable with glasses. with +2.0 glasses lense i have vision range of 24-27 inches... rest is blurry. +3.25=1”@10”visibility range, rest blurry. cannot see anything in hands, feet or stairs with implant eye. thinking to wait for fda approval of Triumf lens. decided not to replace with Panoptix now. wondering if Symfony failure results of mismeasurement or defective lens? overcorrected? lovely telescopic view of stars... cannot read any print with symfony eye... postponing 2nd eye for technology evolution... advice please? maybe i come to find Dr.Wong for iol replacement? depth perception, Symfony right eye thinks everything twice as close as natural left eye...
Has anyone tried antiglare glasses to reduce the concentric circles glare seen on all lights at night. I'm so frustrated with these lenses that I could cry. I wasn't told beforehand that I may not be able to ever drive at night again. Halos and glare are one thing, but seeing all these circles and not being able to judge distance because of it is quite another.
Just two months? Doesn't it sometimes take longer? I'm 53 and got Panoptix in both eyes on 2-20 and 2-27, so it'll be two months soon. My intermediate vision is blurry still as is my near vision. My doctor attributes this to dry eye and to be patient. So far I'm not happy with the lenses. Before the surgery I could read up close just fine, but long distance and intermediate was terrible. Now my intermediate is terrible and I nothing is sharp.
Wow! I thought lens implants were permanent once placed. You can replace them? Omg.
Believed it to be a 6 mo window. Not the case anymore? Also what about approaching double cats, post and anterior? Thanks
I got PanOptix in Dallas 3 weeks ago. Had to pay $8400 for these lenses. I HAD great far vision, and now I cannot see road signs, I can't read the isle signs in grocery stores, and my night vision is horrific. Luckily, I don't have a job.. because my vision is so screwed, I wouldn't be able to work. My doctors did NOT warn me about this, and I got in my car to drive at night, and I COULD NOT DRIVE! I just had to drop my night classes I was taking, because my vision is so bad, and shows zero improvement over 3 weeks. Just being in a car at night makes me sick, because I see 5 distinct rings around any source of light!! It's like being under water. And then my doctor at the eye surgery place, plus my referring optometrist blame my problems on DRY EYE and have me on 4x daily three different eye drops. It is NOT improving. I am so unhappy with this whole thing.
Should a doctor be chatting up a person in the operating room (for advice about their own lens exchange, the entire surgery) while he's vacuuming out and implanting the lens? I wanted to say something so bad, but was afraid to move for fear of wrecking the surgery. I had the Panoptix and my vision past 12 inches is TERRIBLE. All I know is I can't talk and concentrate on a job and do it correctly.
Could've there been a microscopic fault with the PanOptix Lens? Cause this Patient said He could feel this Lens. Where as He couldn't feel the Symfony Lens.
Maybe a microscopic fault could've been the reason for the crescent shadow and the problem with the glowing shadow letters that happened? Or maybe the Lens was microscopically just a litter thicker in width?
It's a pity You had to cut it in two to remove it. It's a pity it couldn't have somehow folded it like it was originally ( I suppose or assumed here) when it was placed in the eye. And then removed from the eye. And then for the Lens to be carefully examined to see if there was a microscopic fault......☮️⚛️👀🌏
this is why you are not an eye doctor :)
Is the Panoptix toric lens this patient first had implanted the same as the Panoptix multifocal lens? That's what I'm trying to decide on....I do NOT want to see glare and halos as I do right now. I'm thinking readers might not be so bad as long as my overall vision is crisp. Thank you for this informative video!
I have a question. When you are cutting the PanOptix lens with the micro-sissors, I observed a small amount of the PanOptix [@4:24) detach from and remain on the surface of the lens. After you remove the PanOptix lens, you can see remnants of the lens remaining on the surface. Then the Symfony Toric lens placed over it. Should that tiny remnant have been removed before placing the Symfony lens over it?
That dr seems kind and caring/honest!
The patient man seems super honest and 100% reasonable. He seems stylish and pretty believable. I respect his honesty and clarity
He seems very honest
I hate the pan optic lenses , Dr said my eye was trying to reject it and formed something the Dr. lazered off. I was told the pan optic lens can’t be removed!!!!
I am unhappy with pan optic, I will be there in January to discuss replacement, rachel barrett 10 13 1955
I am waiting for the Vivity iol to become available and will be looking forward to your commentary on it. Many thanks for your detailed yet patient-oriented presentations!
Alcon announced availability of the Vivity earlier in 2021 and FDA approved last year. I got a PanOptix IOL implanted in 2020, but have daytime postiive dysphotopsia which is bothersome. Wondering if the EDOF non-diffractive properties of this lens is better than the way the PanOptix splits light. "Neuroadaptation" -- no thanks.
At 3:59 in the video, the right edge of the lens optic appears to be out of the capsular bag as evidenced by the distorted capsulorrhexis. If this is correct, the patient may have developed IOL tilt with some mild decantation which could lead to his symptoms. I agree that this is highly a panoptix issue, however the etiology of his complaints is a bit muddy with the position of this IOL. Am I correct about the IOL position?
Hi Dr. Wong, Interesting topics. I'm just curious to know what was the Angle Kappa for this patient?
Dr. Wong, what is your take on Crystalens? I had cataract in one eye and got toric monofocal distance five years ago. The other one was fine and near vision. Now got cataract on the other. My initial plan was to get monofical toric for near to create mono vision as I was living on monovision until this cataract showed up. But now thinking panoptix tirofocal may be better! I do need near vision correction as I don’t like to wear glasses for reading . Any advise! Thanks
Why did he get lens replacement when he only wanted vision correction which is lasik??
I am a bit surprised that the chosen remediation to the problem was to implant a Symfony lens rather than a monofocal lens. I would think that if a patient could not tolerate the side effects of a multifocal lens the solution would be to go with the simplest solution.
The symfony seems to have been the solution that worked for the patient. I realize that most ophthalmologists would have chosen a monofocal. Hence, I thought this case presentation was illuminating.
@@ShannonWongMD Yes, great example, great sharing.
Is he still unhappy? Did the blur subside?
Dr Wong can you give us an update in 2021 about the difference between the vivity lens versus the panoptixs lens
Vivity gives good far and mid-range vision with minimal night halo. The weakness of vivify is that patients will need glasses to read. Panoptix gives good far, mid-range and near vision without glasses but is associated with a night time halo around points of light. The strength of the panoptix is minimal to no reliance on glasses. The weakness of the panoptix is the night halo. The strength of the vivity is good far vision, decent mid-range vision with minimal night halo. The weakness of vivify is weak reading vision that will necessitate reading glasses.
@@ShannonWongMD excellent presentation. thank you for this clarity. in 2021 I am considering cataract surgery. I am 81 do not wear glasses either for reading or driving and have some mild astigmatism. I have some trouble reading traffic signs as there is double images. I want to be able to see clearly at all distances without glasses. I have some flares around light images at night that is tolerable. Would Panoptixs or vividity be the better best lense.
Is it wise to set a Symfony lens at -.5 in order to read better? Would it affect stereovision or contrast if the other eye was at Plano?
Interesting. I have Symfony IOLs in both eyes, and I see what this patient was describing, with regard to ghosting text , but in my case it happens with light text on a dark background. With dark text on a light background, as his illustration showed, it is not noticeable, to me. It is more noticeable in my left eye, which is the first eye that I had done (approx 3 months ago), with my right eye about 2 months ago. Not sure if it improves, over time.
Hi God bless you I was just wondering how your progress is, and are the symptoms better, and would you recommend the surgery for anyone
@@jesuschristfollower6251 I still see the ghosting, but it's not a big deal. As to recommending the surgery, with this particular IOL (symfony), it really depends on the person. I'm very happy with it, for reading, mid and distance vision. I'm not thrilled with the night vision. I see halos around any reasonably bright light under dark conditions. I also see a series of concentric rings around smaller light sources. When driving, for example, it's very noticeable from traffic lights and tail lights. I think it seems to be worse with red lights. I find that mildly annoying, but tolerable. I'm an amateur astronomer, but mainly enjoy astrophotography. If I were a visually oriented astronomer, I would definitely not recommend this particular solution, as I see halos around stars, and a bright moon appears to have significant glare. The night vision issues are definitely something you need to be aware of before making the decision.
Can you tell me why I have so many floaters after my cataract surgery?
1. Shocked that the negative dysphotopsia disappeared. He is lucky it seems.
2. When will Synergy be available?
3. I see the highlighting around the letters with my Symfony.
Synergy is not yet available in the US
Can you share some experience on monofocal lens and how it compare to PanOptix.
For example Tecnis J&J Eyhance and AcrySof™ IQ Vivity™
I'm surprised by all who all have been quoting price per eye as 3k or less. Here in Seattle two of the big well known companies K2 and one other charge 6k per eye Panoptix and 7.5k per eye for LAL. Was thinking Panoptix but all the issues with halos has me rethinking this. Maybe stick with glasses for a few more years and wait for next round of technology.
Weird... The PanOptix IOL is what I'm set to get... also in July ...and my name is Rob ...and I'm 55. I also have a low astigmatism... (I don't play golf or wear a neck gaiter though) Should I be paranoid?
My right eye bothers me endlessly after my panoptix surgery. Causing serious anxiety, non stop discomfort and my vision is not clear at all. Left eye 20/20. Rt eye 20/45
Tears and burning at evening times. I feel this surgery was possibly my worst decisions of my 55 years of life. So depressing. 😥
Hi Tracy, I feel the same way at this point. It is very depressing. If mine don't improve I will get hem replaced for sure. Really my quality of life just sank, I'd rather have my glasses back.
Makes me nervous to move forward reading this. Would you two perhaps have preferred the monofocal w readers and no complications w lights/halos? I am trying to consider it all and don’t want glasses but more so don’t want it to go sideways.
@@lisao1186 Perhaps you would consider monofocal lens w/monovision. I'm having my Panoptix explanted and opting for that.
I have a panoptix in my left eye I can sometimes feel something in my eye morning light I get a spray of dots floating in my eye. It happens sometimes when I’m in sunlight or on my tablet…. I’m not happy for the up charge I had to pay and I still need readers (Dr said I wouldn’t need glasses that why I did the up graded lens!) I don’t really want to go back to the dr who did the surgery but I probably have to…..it’s been 5 weeks nothing’s changed
My biggest problem is floaters getting worse but it would be this way witj any lens. It is like constant clouds. I guess i just expected the vision had with contacts pre cataracts.now it feels like i have contacts in all the time but clouds all the time.☹
Floaters suck. Most people develop floaters over our lifetimes.
@@ShannonWongMD I also had floaters before, and still after the Panoptix lens. I was told that they can use a laser in a couple of months to remove the floaters. In your experience is this successful?
At 341 if you pause, you can see the pantopix partially in the bag and inferiorly from 3 to 8 o'clock outside overlapping the rhexis. This probably created a very slight lens tilt and may have contributed to the dysphotopia and his visual symptoms. Given that it was early in the post-op course, the bag contracture had not begun, else the lens over time might have shifted superiorly. Was there any consideration to just popping the optic back into the bag, or reverse optic capture to reduce the dysphotopsia. Given that he didn't he didn't like the vision OD ("it didn't feel right" ([I don't like the panoptix]) I can understand explanting it and replacing with a different lens technology.
I didn't initially scroll through the comments, but other folks noticed the non bag placement as well.
But does that mean the patient pays for multiple procedures and lenses?
The post-op symphony interview with the patient was the day after the replacement surgery. I would love to know the patients impression after about 3 months with it. Does anybody know the answer to that?
Secondary cataracts (opacity of the posterior capsule of the lens) sooner or later develop in almost all patients who have undergone lens removal.
A piece of plastic in the eye is a SPLINTER not in the ass
Interesting! Plase let us know what made you decide replacing a difractive lenses with another difractive lenses, because of glare?
I had a Panoptix lens placed in my left eye 6 days ago. I can see the glow around letters on my phone and computer. It looks like a 50% transparent 2 pixel outer stroke. I hope this goes away soon. I can see text on my phone okay even with this glow when I use both eyes. Using just the eye with the new lens I can’t focus on my phone or computer. Will this improve when both eyes have new lenses? (I am scheduled to have a Panoptix placed in my right eye next week.)
I had LASIK in 2003, and will say that the halos around lights at night with the Panoptix lens are much better than the starbursts I had with LASIK. I have not had my right lens put in yet so I have a side-by-side comparison. I expected to still have the starbursts along with the new halos, but I do not see the starbursts in the eye with the new lens.
Your videos are great. Thank you!
I had lasik 2004, and panoptix both eyes same day, Aug 19 2020. Flowing day my vision was 20/20, after 2 weeks vision 20/8 but i had glows around letters, vision was still foggy and I had shadow moon crest like on one side of my eye, After 8 wks foggy vision gone, moon crest is pretty much gone I may notice a bit shadow once in while, but massively improved. You have to give the lens exchange time for your brain to adapt.
This adaptation varies for everyone. 1 month to 8 months...just depends on each humans brain.
Hi PryorGuy, I hope you are doing well. Have you got better?
I am also not happy with the vision of the Panoptix multifocal toric intraocular lens on my left eye, I have negative dysphotopia after surgery and only 20/50 vision at far distance 17 months after implantation, what can be done with my eye?
I just went to have my consultation and the doctor suggested either PanOptix or Vivity. He said PanOptix would make my vision totally clear and I would not have to wear readers at all but the only downfall would be halos at night. He said I would not have the halos at night with Vivity but that my close-up vision would not be as perfect and I would still have to wear readers for something very close or very small. I’m trying to decide between the two of them and of course I wish the PanOptix did not have that halo side effect because then it would be perfect. Has anyone had to choose between the two of these and if so which did you choose and did you have any regrets? Are the halos that bad that I should not get PanOptix and for those who got vivity, do you still have to wear reading glasses
What did you decide? I'm am now in the same situation.
I chose the PanOptic. Very unhappy. I’ve been doing a lot of research on lenses, not that I didn’t before, but I have found a lot of conflicting information in the submitted FDA clinical trials and how that information is relayed to patients. There were between 40 and 50% of people who got the PanOptic lenses had disturbances. That’s a lot different then the way the sales pitch is stated. Granted, it’s not lying but it is deceptive. I wouldn’t choose them again. My only choice is to go through the whole process again to the tune of $5000 for the second time!
@@lindamorgan8219 I would not choose Panoptix for ALL the reasons stated in these comments. I appreciate the backgrounder from @ricristow9040. Would love to see that, where did you locate as I"ve been unable to?
What scissors do you use to cut iol?
I wish I had never done implants. Possibly the worst decision of my 56 years of life. 😢
Maybe a defective lens or it not seating properly. The "double vision" suggests two vocal points.
What is your experience with this lens post macula off retinal detachment with symptoms of retinal displacement
How long is too long to wait to have IOL removed and replaced?
Over my career, I have found that almost all lens implants can be removed. Replacement with various implants is the tricky part.
@@ShannonWongMD thanks for the info.
If you gave bilateral cataract that is a 3 , I am 60 years old, have worn glasses for year. I am very farsighted and have to wear progressives and I want to near wear glasses age. I have issues driving at night from glare of car lights... oh and I have mild fuchs and severe dry eye syndrome
Now I know you can dx somone over the internet but do you feel somone like me would be generally a candidate for cataract with lens exchange.
FYI my commerical insurance is no pa required for cataract surgery.
I sit for 8 plus hours day in front of 3 computer screens
Thanks for the video, Dr. Wong. Do you have any experience or insight with the Vivity lens?
Not yet.
My left eye is worse than his, at 16 inch distance i cannot make out a letter on a keyboard :-( wonder if a symfonic would change that i have the restor lens and absolutely hate it, well assuming its the lens!!
The Panoptix seemed to be halfway captured in the anterior capsule, can it decenter the IOL ? Can it be the reason of his disconfort?
MINE is just the opposite-- my was distant issues- not close-- although neither was good..
Hi, please help me
My mom just got Acrysof IQ panoptix lense in May, 2023. Two months post surgery she can not still differentiate objects from the background. Her distance vision got worse in comparison to before the surgery. She needed reading glasses before, now she sees okay from the close, but distance vision got worse. Will it get better? Anyone having the same problem?
This is my exact response to the Panoptix. I had it done on my left eye 2 weeks ago - everything >15" is blurry and hazy. I can't see my computer screen without leaning into it and street signs, bikers, billboards are all blurry! I'm so disappointed! How's you mom now? My surgeon is suggesting I remove Pan and replace with a monofocol/monovision lens (left eye near/right eye distance).
My Biggest regret. If you want to have this surgery, DON’T! Don’t fix what is not broken. Really, really, really, really consider everything before this surgery. Risks outweighs the benefits, so unless Grade 4 cataracts, it’s all just lip service. Time professional be more frank. Otherwise, stick to glasses. Wish someone told me this and wish I’d have listened to those who did! I was told it’s very, very low risks for complications…so low that it’s not worth worrying about them. This kind of “optimism” is dangerous.
I had the synergy lens implanted in both eyes 6 months ago. My right is now 20/25 but my left eye is 20/50. I feel like I am looking through a slightly watery lens in my left eye...the watery ness sometimes shifts slightly as if water is moving around under the lens.Vision in my left eye is blurry for all distances. I now have an irregular astigmatism in my left eye...did not have this before the surgery. My dr said he can do PRK surgery to improve the vision in my left eye. I am hoping this will make my left eye be 20/25 like my right eye because it feels uncomfortable to have different vision in each eye. What are your thoughts? Thanks in advance.
I use to go outside and LOVE looking around at the trees etc.- now it's all just - NOT good and I don't want to even go out.
Hello,I just had a lens replacement and my peripheral vision is not that great,will this go away?
Hey Dr... greetings...from india .i am 29 i had tecnis symphony in my left eye in 2016,i have some starbust experience in the night while drving..the starbusts cover lot of area around vehicles headlight,which makes dark objects unnoticeable sometimes..which i found very annoying.. my day vision is 6/6 with this eye..now i have to undergo right eye surgery...i want comfortable night vision along with intermediate vision..please suggest me the best option for IOL..
I got a Panoptix in my left eye. The vision is terrible. I get better near and far vision with the Vivity lens in my right eye. The near vision in both eyes is terrible, but worse with the Panoptix lens. I have considerable astigmatism in both eyes, and cloud like floaters. I was told that when the cataract surgery was done, he also did PRK to eliminate the astigmatism, however I know that he did not, because I have had PRK before... and that involves several days of PAIN. There was no pain after the cataract surgery. Now, despite signing a contract saying that after paying $4200 per eye for premium IOLs that would not require any additional out-of-pocket expenses within 1 year after the cataract surgery, they are now billing me $400 for having YAG "polishing" done - which they claim 100% of cataract patients eventually need (if 100% of cataract patents require the YAG LASTER treatment, WHY is it a separate charge?) Do the 3 rings of the Panooptix have custom prescriptions? Or is every Panoptix lens identical to every other Panoptix lens? What should I pursue to see NEAR? Frankly, my near vision was better BEFORE the cataract surgery! Incidentally, the ophthalmologist at the center I went to make a huge deal about how he uses a femto laser to perform the cataract surgery, however, I could feel the pressure of the blade making the incision in my eye. He did NOT use a femto LASER. Incidentally again.. I have been waiting for MONTHS to see the opthalmologist, They rescheduled me 4 times, and when they finally did see me, it was not the opthalmologist who did my surgery.. but his SON! I do not like having doctors switched on me without prior notification.
John...did you get an answer to this? "Do the 3 rings of the Panooptix have custom prescriptions? Or is every Panoptix lens identical to every other Panoptix lens?" I just had Panoptix implanted in left eye for near vision improvement) Right eye is scheduled for a few weeks from now)
Hi Dr.. I had cataract removed Jan 2019 .. then second one done July 2020thefirst one was /is fine but the latter one about 3 months ago is weeping .. is this normal .. the weeping is clear do I don't think there is any infection .. what do u think .... P. S . Still sentisive to light... Thank you so much . U havebeen a great help before my surgery . ♥️
I had PanOptix lenses done in late 2020 and immediately noticed that I was having clouding in my left eye. In early 2021 I had a vitrectomy to remove the floaters; this caused a major surgical infection which took more than 8 months to resolve. I am now left with residual astigmatism in my left eye and my vision went from 20/25 post op to 20/60 today. I am dealing with severe dry eye and elevated pressure; the drops for IOP are adding to the dry eye and irritation. Refraction of some sort is going to be necessary to bring my vision in my left eye to a clearer range. My ophthalmologist and retinologist are both reluctant to help and I am certainly troubled by that. I have two new doctors that will be evaluating because the current ones have lost their credibility with me. I need a solution and they are running scared. I have been a tennis player for more than 40 years; that may be ending because of this problem and I hate that. My distance vision is not clear and my up close vision is just as bad. Both eyes are not working together.
So, with having spent $3500 for each lens, I am now faced with having to wear glasses. This after the hard sell by my ophthalmologist that I was a 'good candidate'. I can't help but feel that they were pushing elective surgeries in the midst of a pandemic slowdown in their practice. I wish I had not agreed to the surgeries
Dr. Wong-Have you by any chance changed from the Bausch and Lomb Sofport to the Bausch and Lomb Envision for regular monfocal lenses? Thank you.
out of curiosity, since he only did the one eye to start, was this his dominant or non dominant eye?
Dr. Wong, you shared a video of another patient who has a similar bothersome visual experience with her Technic Symphony lens replacement. Could some people be more sensitive to perceiving the multiple rings of focus than other patients, regardless of the manufacturer? Or could this maybe be a quality control issue in the registration/focus point of the rings that occurs in a small percentage of lenses produced by both manufacturers?
hi doc. wong. i had my monofocal lens replacement last month. my left eye before 2000 grade but now is 300 but my doctor told me its lazy eye. my right eye previously had 1000 grade and now its 150 plus 100 astigmatism.. before the surgery, it was not explain to me that i cannot see better in front of me, i need to make a better distance just to read in my celfon or book. i thought i can have a better vision near me, sometimes i had a regret having monofocal lens surgery.
just want to ask if i can have a lasik surgery after this monofocal lens implant?. i just want to have a better vision near and far. 😥😥 I do i need to do?.