The Clearview 3 Multifocal Lens. First Impressions. Less Halos than PanOptix? Shannon Wong, MD.
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- Опубликовано: 1 окт 2024
- The ClearView 3 Multifocal lens implant is a lens implant that enables patients to see far, mid and near without glasses and while providing great vision at night with minimal halos around lights at night.
We present our first case using the ClearView 3 multifocal lens implant in a patient who was seeing great with his PanOptix lens implants but was bothered by halos around lights at night seen with the panoptix lenses.
We performed intraocular lens exchange - removed his panoptix lens from his right eye - and placed a Clearview 3 multifocal lens into his right eye.
One day after surgery, his far/mid and near vision were comparable to the range of vision with the panoptix. Importantly he did not perceive halos around lights through the Clearview 3 lens implant.
Financial disclosure: I have no financial interest in the products or lens implants discussed in this video.
Thank you to our patient for allowing us to share his experience.
0:01. Introduction
0:52 Patient experience with PanOptix lenses in both eyes. Great vision with halos at night. BEFORE having intraocular lens exchange with the Clearview 3 Lens for his right eye only.
4:10 Intraocular lens exchange procedure to remove the panoptix and place the Clearview 3
7:12 Patient experience AFTER having intraocular lens exchange. First impressions with the Clearview 3 lens
13:13. Conclusions
It would be interesting to get impressions of the “quality” of vision at night or under dim lighting. Not just whether Halos or Starbursts appear, but whether the distribution of light under darker conditions allows good quality vision when compared to a standard lens.
Wow..please do more on the Clearview 3 lens soon..❤❤
Would love to know the follow up on this case. How was his night driving? Were the concentric circles less noticeable with the ClearView lens in the right eye? Did he decide to leave the PanOptic lens in the left eye or do a lens exchange for the ClearView? I’m 5 months in from having PanOptics lenses. Daytime vision is great, but the concentric circles are very troublesome when driving at night. Maybe this would be a good fix.
Can you make same sort of sketch to show how do you see at night? how big are circles?
thank you for doing this! would really love to hear how he responds to night driving after a week. i'm considering this exact lens right now and would find this additional information invaluable. thanks again for posting this
FANTASTIC! You make me cry with joy, Dr. Wong! There IS hope in gaining my independence back & reducing my fear of driving at night. My cataract surgery left me worse than how I saw before. I will ask my Dr. about these lenses. Educating us, educates others. Bless you for taking this time to teach.
I had cataract surgeries about 7 weeks ago for both eyes and had Vivity Toric lens (for astigmatism & previous lasik). I can see everything (distance, intermediate & near) crystal clear and no halos or starbursts at night. I now see 20/20 on left eye and between 20/20 - 20/25 for the right eye. Not sure why my doctor didn't use Clearview but overall, I'm very happy with my new vision.
Because clearview is not available in toric.
Great video. Always informative. I'm in my late 40s and dealing with the crappy loss of near vision. Personally I'm hoping and waiting for those accommodative IOLs. Hoping that they'll be a real option in a few years, like FluidVision or Juvene. Crossing my fingers.
I am not quite 58 years old and one year ago I had my first eye surgery for cataracts. 10 months ago I had my second eye surgery. These new lenses were not available and I opted for the panoptix. I do see halos while driving at night, but to be honest they are much less intrusive than the halos that I saw with my cataracts. The halos are only around certain point sources such as LEDs. When I first had the surgery it was very pronounced and quite wild to see these halos. I was quite nervous because it was so bad. Within a few months after both surgeries were complete, The halos lessened substantially. When I drive at night, which is very common for me, there is a slight notice of halos and if I really look for them I notice them more, but they do not stand out like they used to. At first I thought I was getting used to them but my memory is pretty good, they have toned down substantially as my eyes healed. Right now it is 3:00 a.m. and I am sitting in a dark room with a very small light behind me. I can see much better than I had expected with just a slight loss of contrast. When I am tired it is hard to focus correctly, but that is mainly because I am tired. It took several months before my brain really learned how to focus on something, and even now a year later if I am having an issue focusing I just force myself to be precise in what I'm looking at. That may sound strange but then I remember that these are not natural eyes and I am not 20 years old anymore. Many people who are in my situation that are friends of mine are very nervous about the halos, and all I can say is that while they are there, they are less intrusive than the halos I had while trying to drive at night with cataracts. I no longer have to look away while driving which I had to do prior to the surgeries. Normal light and even dim light vision is very good to outstanding and I can see very well at all distances. I am absolutely thrilled with being able to see probably as well as I did in my mid-thirties. I am better than 20/20 at all distances in good light and I am amazed at the fine details I can see close up. He is correct that I have reached for readers a few times when working on extremely intricate projects. My job requires excellent vision and I do not use glasses at all. I am a printer and need to be able to see very fine dots which I can do without glasses. The very fine precision that I am talking about is doing very fine trigger work on a gun or very precise changes in metal work which require me being able to see extremely small changes in surface area. I am sorry that this is so long and I am not saying that the panoptics are better than the clear view three. What I am saying is that over a period of a year my eyes are still adjusting and getting better everyday and I am amazed at the change in my vision. My cataracts had degraded my vision to the point where I didn't realize how poor my vision really was. With the surgery I am amazed at the colors and contrast that I can see in good light and I am OK with the slightly reduced contrast in low light. I have no problems getting up in the middle of the night to go to the bathroom in darkness. I enjoy hunting and target shooting and have not been able to use iron sites in almost 20 years and now I have no problems with iron sites. For at least 15 years golfing has been a challenge because I really couldn't see the ball well when I addressed it and after I hit it I could never see it if there were clouds in the sky or if it landed in an area with perhaps some leaves on the ground. I can see all of that again with no issues. Watching TV is much sharper and crisper than it has been in the long time and reading is crystal clear. The only issue are the halos at certain lights at night, and again they are not nearly as pronounced as they were in the weeks and first few months after both surgeries were complete. I believe that My eyes and brain needed to adjust so that I could see better. First of all the healing process takes longer than just 24 hours. It takes several months before everything is completely to where it is going to stay. Secondly I believe that your brain needs to relearn how to see when using this type of lens. I have to learn to look directly at something whereas before something could be off to the side and it would still be visibly sharp. Now you need to focus on a spot. My peripheral vision is still good but to be able to see clearly I think you need to be laser focused on what you are looking at and then your brain will make it happen. I know this sounds strange but that has been working for me and I can't believe how well I can see with the pan optics lenses. I hope this helps at least a few of you and I hope that All of you can have the miracle of vision improvement that I have had!
If the Clearview 3s aren't trifocals how is the mid range vision say looking at a computer monitor just beyond arms' length? Thank you for your reply
Q: For those patients with a very poor prescription and some astigmatism, would the LAL likely be a better option?
Thank you for this video Dr Wong. This is interesting indeed, given the notable reduction of the night time halos.
Looking forward to more client experiences for this IOL.
So wonderful to learn alot with your great videos, Dr.Wong! Luckily, 'till now, haven't have many problems with my patients implanted with the Panoptix (neither the Vivity ones) - maybe due to alot of preoperative chairtime, maybe due to a lower n comparing to yours, maybe for avoiding to implant the Panoptix in patients so attentive to small details, like this one fom your video and also maybe for not being so open for patient's smallest complaints about their lenses... Even so, looking ahead to have the Clear 3 lenses in Brazil. All my best! Dan
Is there any contrast loss with Clearview 3?
It is quite interesting, but is the Clearview 3 not exactly the same as the since many years available Teleon Lentis Mplus segmented design principle? The Lentis MPlus is also available in toric. I a a bit surprised to see that there are so many similarities between the really old Teleon Lentis Mplus segmented design. So are there any advantages in the Clearview 3 vs the Lentis MPlus or is this just the same from another company?
Remember the Clearview 3 is "old" too. Launched in 2012, in the US it is new since 2022. The SBL-3 which is the original name has been around for a decade
Are those good if you have astigmatism?
Wish my biggest complaint was 20/20 vision ❄
I have a Vivity Toric lens in my left eye. Can the Clearview 3 correct for an astigmatism? Looking for options for my right eye that will ensure good near vision.
Have Vivity last year. Not happy with it. Cost?
I currently wear glasses and require spherical & cylinder correction. Watching these videos convinces me that when my time comes for cataract surgery and choosing a replacement lens, I'll choose a lens that corrects only the sphere for distance and wear glasses to correct the cylinder and anything remaining. I don't mind wearing glasses and it's imperative that I be able to drive comfortably at night.
Very educational and inspirational as always, Dr. Wong!! Thank you for the video!!
Was he a myop or a hipermetrop before putting the panoptix?
I heard myops do worse eith trifocals lens than hipermetrops
Would love input on night driving from patients who have this lens.
I wear a +250 reader would i still be a candidate for this lens?
I mean +2.50
Hello Dr. Wong, Thank you so much for your informative videos!! You mention near the end of the video to your patient that both the Panoptix and Clear view lenses have their strengths and weaknesses. I know that the weakness with the Panoptix is night time halos. Could you please tell me what is the weakness with the Clarview lens? Thank you
Oil change takes longer... Amazing technology..
Is cost to replace lens same as new installation? What if the guy didn't like Clearview, would you install PanOptix again?
Thank you, it would be VERY helpful if you could make your patient pick out some glare-photos and tell us how the glare/smearing at night looks.
It is hard for me to read small and darker letters/sentences but whenever, I did the reading charts in my doctor's clinic my vision seems okay to him.20/20.He told me to to use the reading glass.
Would you comment on this please?
Thanks
Great information, and the halos at night is what puts me off IOLs but, Just wondering why a patient wouldn’t have the LAL surgery?
Reading vision with the LAL is weaker than reading vision with clearview 3.
I believe the LAL is essentially a monofocal...
Assuming I meet the physical requirements do you think you could recommend or possibly consider this lens for someone like me who has had a retinal detachment? I’m 38 with -9 myopic.
Getting Clearview 3 lens IOL x2 from Dr Wong in 2 days!!! Very excited. I'm a service technician doing a lot of close work. Not happy with glasses. I'm 65 and have minimal cataracts in both eyes. Using +3.75 readers for several years, slowly getting worse from 40 yo before that. Low astigmatism, 3mm pupils. No other issues.
How did it go? Any follow up? I'm considering this lens too but concerned about night driving and/or type of glare or whatnot from the design of the SBL3. Do you notice any visual "artifacts" (ie positive or negative dysphotopsias)? Thank you
@@johndoe-ep7qk I don't think you need to worry. I'm seeing some "angel wing" flares on bright lights at night and longer, thin ones from the bifocal design. But nothing substantial or to be anxious over in driving. It's really very good at night for me. Also I'm ecstatic at both the near/far performance. Especially when I have significant cataract along with 20/150 vision! Now I am seeing 20/20 near/far! What a delight!!
@@mdmorell how is your intermediate vision? 25 - 30 " ?
@@dat7hrfa 20/20
So when a patient is unhappy with a result, and it is an elective out of pocket surgery, they are paying for a full complete additional surgery and lens? Possibly but 20k to have two replaced?
I wonder how much does these cost?
❤Amazeing Science. Hard to believe we have the machines to manufacture and design these in 2023-2024. What is the cost versus mono focals? Do you have any patients from northern California?
Hello, Dr. Wong. What is the difference between ClearView and lentis mf30?
I know you like to say no lens in perfect but with better than 20 20 vision and no Halos what would be the down side to these new ClearView 3 lens? They sound pretty perfect to me
Not everyone is a candidate for the clearview 3. 3 criteria must be met by the patient: 1) pupil size 2.75 mm or larger in normal lighting, 2) low degree of astigmatism, 3) prescription of the eye cannot be too nearsighted due to limited power range of the clearview lenses available.
@@ShannonWongMDwhat’s the max prescription for nearsighted
This is very interesting! I’ve recently undergone cataract surgery in my dominant eye with a standard IOL. Unfortunately there was a refraction error and I’m only seeing 20/70. 😢 Previously I wore contact lenses one set for distance and the other a multi focal which suited me very well. While I’m sorting out what my options are for the dominant eye might this might be an option for the non-dominant eye?
Is this suitable for someone who had the panoptix and yag in both eyes a year ago?
It would be difficult to place a Clearview 3 after yag capsulotomy.
Thanks to you and your patient. These videos teaches me on what to expect on RLE from a first hand experience
I had the Crystal Lens put in each eye about 3 years ago and have not been able to achieve good close up vision without reading glasses. Is the Clearview lens one that could replace at least one eye? I have a lazy left eye so i wouldn't change that one. Is it too late to make the change?
I’m curious how your eyesight has been after you replaced just one of your lens.
Thank You.. I Need To Get Those..
3 months post op with panoptix and still dry eyes
Using eye drops frequently
Will this get better?
Wow
Impressive
Did u reopen ur original primary wound for this case?
I would imagine it’s hard to reopen 10 months later.. I’m guessing you made a new wound.
Also- I’ve heard the Clearview needs a slightly larger wound..
If you did make a new wound, did u make it in the same area as the original or did you have to scoot it over to completely avoid it?
Thx for sharing! 🙏
Reopened OG primary incision. 2.8 mm. No need to widen.
keep us up to date with the clear view lens very helpful
What is the intermediate vision like with these, is it as good, or better than "normal" trifocal lenses?
I’m curious why you didn’t use the vivity lens.
Vivity generally does not provide enough near vision compared to the panoptix and it seems like the clearview as well.
I am less and less enthused with the Vivity lens. There are better alternatives: Light adjustable lens, and likely Clearview 3.
@@ShannonWongMD Is Clearview suitable for people with astigmatism?
I’m a 70 year old retiree and I’ve never had cataract surgery. I’m thinking about my options for lens replacement and I want the best available.
I’ve been waiting for the technology to advance to at least this level.
How should I go about making arrangements to have this done?
Thank you.🙏
Contact your ophthalmologist.
@@ShannonWongMD👍
Does patient has to pay again for the lenses exchange if he has issues with his current lenses
Within our practice, if we place a lens implant and the patient is intolerant of the vision with the original lens implant then we will exchange the original implant for a different lens implant at no additional charge to the patient in most situations.
What do you know about the new Tecnis Odyssey lens?
Started using the Odyssey lens 2 wks ago. Will learn how well it works over the next 2 months.
Scheduled for Sx in 10 days. If I remember correctly, Dr. suggested Symphony in dominant eye with ZLB00 in non dominant eye two weeks later ostensibly achieving a combined broader range of near/intermediate acuity. Currently OD -0.5 sphere -0.5 Cyl 065 Axis and OS -0.75 Sphere -0.5 Cyl 085 Axis My readers have a +2.00 add in both eyes.
Obviously would prefer to minimize the potential for glare or halos with multifocal IOLs.
Can you give an opinion if I should discuss the Clearview 3 with the Dr. before it is too late or is it too early to determine how the Clearview 3 is behaving.
I realize new lenses will always be developed but would hate to miss an opportunity for what might appear a game changer regarding halos and glare.
if your doctor suggested symfony, change the doctor. run!!
@@aniketnavalkar5974 can you explain your experience and expertise?
Obviously I want what is best and can only rely on the Dr's suggestions.
@@juicer52 I got Symfony in 2018. I was 41 at the time. It is outdated technology. I got no near or intermediate vision with it. Worst was huge ring around light at night. Not the concentric rings of light, those are manageable, but huge ring of light of lens edge. Also the vision was never sharp. Last year I got it exchanged for Clareon PanOptix from Dr. Safran. Five years of misery was over. If you are going to get an iol with rings then get a trifocal. Good luck!!
Is there a cost difference between these two IOL's ? I got a price quote from my ophthalmologist of $ 3395 per lens for the Panoptic Trifocal lens. She only uses the Alcon Panoptic for high end lens cataract surgery.
Pricing for elective surgery varies from surgeon to surgeon/practice to practice.
@@ShannonWongMD Thank you. I understand that costs will vary due to many factors but my question is the actual cost of these two lense brands. Are they different ?
Roughly equivalent costs.
How was his mid-distance vision?
Hello doctor, did the patient came back to exchange the lens on the other eye, do you have any updates?
As always thank you very much for your videos.
He kept panoptix in his left and Clearview right. Happy with the combo.
@@ShannonWongMD thank you so much for your response, I don't have cataract but being 47 yr old the near vision is getting worst, I heard a out LAL plus of extended depth of focus coming out soon so I'm just waiting to see those reviews and make my mind before seeing you.
If you ever have a chance to share your opinion on that I'll be great full.
Also would you have picked Clearview vs your own iol?
Does he have blue light filter in the Panoptix@@ShannonWongMD
Are there such lenses in toric options?
Did he leave it with 1 PanOptic and 1 ClearView or did he change out the other PanOptic?
He is happy with clearview 3 in one eye and Panoptix in the other eye.
Was the panoptix lens yellow or clear? Since the Clearview 3 is clear, it is interesting to know if it is ok to mix yellow tinted iol and clear. I would assume it is ok. @@ShannonWongMD
Is it the same lentis mplus?
Does it come in a toric version?
No.
Are you accepting new patients?
yes he is - I'm one of them
Yes. But only for patients interested in having cornea or lens based surgery.
Is this a new technology lense? I have postpone my surgery with the Panoptic due to the halos effect.
👍👏🎖🙋♂️