27 Nov PanOptix Lens
PanOptix lens (trifocal) vs Bifocal IOLs
The PanOptix lens can restore distance, intermediate and reading vision without glasses after cataract surgery. Losing our reading vision has always seemed to me to be one of life’s cruelest jokes. When we are young and can run far we can see up close. When we are old and can’t run far we can’t see up close.
Panoptix Lens vs Monofocal IOL
The PanOptix Lens has far intermediate and near vision in focus for most patients. A monofocal lens is a basic IOL that only has one distance in focus. Most patients choose to have far vision in focus, so these monofocal IOL patients need to wear glasses for intermediate vision and near vision.
As each new IOL comes to the U.S. we will be able to study the patient questionnaires from their various FDA studies to try to quantify these quirks. Interestingly, 99.2% of the patients in the PanOptix FDA trial indicated they would have the same lens implanted again.(See the table below)[2] To my knowledge this is the highest rate of satisfaction we have ever seen for a multivocus/EDOF lens! However, it is important to note that it also means that about 1 out of every hundred patients would not have the same lens implanted.
It is equally noteworthy that 95.3% of PanOptix pateints were either satisfied or very satisfied with their vison compared to 90.9% with the monofocal IOL. In addition, 3.2% of PanOptix patients were either very dissatisfied or dissatisfied compared to 2.7% with the monofocal IOL patients.
Patients have cataract surgery because they are not satisfied with their natural lenses that have turned into cataracts and made their vision cloudy. The vision through a man made lens is not perfect but usually much better than vision through a cataract lens.
Advanced Technology IOLs
Prior to cataract surgery patients treat their visual impairments with glasses. Progressive lenses are used to mitigate this prior to cataract surgery. Interestingly, at our optical, patient have the choice between bifocal or trifocal progressive lenses. 94% choose the more complete visual solution of a trifocal/progressive. This solution seems old fashioned to them and not elegant, but functional.
When it comes to modern cataract surgery with femtosecond lasers and “advanced technology lenses” patients anticipate trifocal vision as the bare minimum we have already trained them to expect. In the past, all we had were bifocal intraocular lens (IOL) options. When we told patients we could only offer a bifocal solution, they stared at us incredulously like we were backwards cavemen. They were expecting something more elegant, not less.
PanOptix Lens
Some patients have bifocal lifestyles so they find this option completely acceptable. For example, an individual that spends 10 hours per day on the computer and reads electronic books rather than paper books mostly needs distance and intermediate vision so a far/intermediate bifocal IOL would work great for them. Others mostly read paper books with very little computer time so a far/reading bifocal lens would work great for them. Many patients, however, spend equal time with computer and paper books and would prefer a trifocal IOL option like the PanOptix lens.
Trifocal Lens Options
Outside the United states there are multiple trifocal IOL options available like the AT-Lisa, Fine Vision, and the PanOptix. What happens when trifocal IOL lenses are introduced into the standard mix of bifocal/EDOF lenses that we currently have? The simple answer is that the trifocal lenses have tended to quickly become a preferred choice for a significant part of the market.
How Should I choose an IOL?
Start by asking your optometrist which ophthalmologist (eye surgeon) in your region has the best results and has the most experience with advanced technology IOLs like the PanOptix IOL. Often, these types of surgeons also do laser cataract surgery rather than just doing all of their surgeries by hand. Ask your friends who they would recommend as an ideal eye surgeon. You may be surprised to find that many of them have already had cataract surgery! Then meet with your eye surgeon, describe your lifestyle and your desires for your vision for the rest of your life, and ask which IOL would best fulfill your aspirations.
Gary Foster, MD is a Colorado/Wyoming based cataract and refractive surgeon. If you desire any further help, please contact us for a consultation.
[1] Cochener-Lamard, B. Refractive IOL Patterns are Evolving with the Times. Euro Times Supplement. June 2019. p. 2
[2] PanOptix product information p. 10
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