PanOptix after LASIK and PRK

More and more patients are coming to our office who have a visually significant cataract and have had LASIK or PRK in the past.

Newer intraocular implants (IOLs) used for cataract surgery attempt to allow patients to focus clearly in the distance, intermediate, and near without using glasses after cataract surgery. While none are 100% guaranteed to make a patient “glasses free all the time,” we are getting better results in the innovative implants (ie, PanOptix Trifocal and Symfony IOLs) even in patients who have had LASIK and PRK.

There are always risks but all surgeons have patients who cannot wear or tolerate glasses.
The below article shows many patients having good results with these newer implants. PanOptix thus far appears to be the best implant on the market for most patients who have no risk factors for extra haloes and glare. Patients who have had LASIK and PRK have an increased risk of halos and glare with these new implants but it appears from below, these issues may be less than expected.

January 28, 2020
1 min read

Patient satisfaction high with PanOptix trifocal IOL

Sheri Rowen
KOLOA, Hawaii — Patients who received the newly approved PanOptix trifocal lens reported high levels of satisfaction with the technology, according to a speaker here.
A data analysis of all PanOptix (Alcon) patients of two surgeons was completed using both objective and subjective measurements, Sheri Rowen, MD, said at Hawaiian Eye 2020. Patients, including post-LASIK patients, were examined for distance, near and intermediate vision and completed surveys regarding halos, glare, need for glasses, quality of vision and happiness.
In the post-LASIK population, which totaled 36% of the study, 79% had 20/30 vision or better at 1 week, with 95% 20/25 or better with correction.
At 1 to 3 months, 93% remained 20/40 or better and 85% were correctable to 20/25 or better.
In the monocular patient population, 72% were 20/20 or greater.
“The 1 to 3 months postop monocular uncorrected intermediate was really a wow factor,” Rowen said. “We had really good visual acuity results, so next we wanted to find out how the patients like it.”
In subjective patient surveys, 68.2% reported no halos or mild halos, with 30.8% reporting moderate to severe halos. Twenty-one percent reported using glasses for near tasks, while 79% reported no glasses use.
Fifty percent reported a 10-out-of-10 happiness level, with 86% marking a level between 8 and 10.
“So, what happened in that 8 to 10? There was a little contrast issue,” Rowen said. “They don’t perceive it being as perfect or sharp as they might like it. If someone says they’re foggy or hazy, that is where you’re going to have a low happiness score.”
The majority of patients did not experience halos, and those who did were mostly mild and non-debilitating. Ninety-five percent of patients reported they would have the same lens implanted again.
“Patients are pretty overjoyed with PanOptix trifocal IOL for function and quality of vision,” Rowen said. – by Rebecca L. Forand
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