Patients interested in reducing their need for glasses after surgery may benefit from improvements in Intraocular lens technology. Dr. Lee was one of the earliest surgeons to use both the PanOptix trifocal and Vivity extended depth of focus IOLs. When you come in for a preoperative consultation, Dr. Lee will assess your candidacy for these special lenses and will customize your surgical plan accordingly.
Our eye is like a camera that must constantly shift its focus from far to near and various distances in-between. There are four primary zones or distances that we need to be able to see.
- Far distance (road signs, distant animals, movie screens)
- Indoor distances (pictures on the wall, faces across the dinner table, TV 8 feet away)
- Arm’s length (dashboard, store shelves, stove, desktop computer, piano, bathroom mirror)
- Reading distance
The best system is what a young person has, a human lens that is constantly and automatically changing shape to adjust focus. This is like having an “auto-focus” camera where you just point the camera (or eye) at something and the focus is automatically and instantly adjusted. With age, we all lose this convenience and end up with a “manual” focus camera—we must manually change the focus. We do this either by switching between different pairs of eyeglasses for each distance that we need or by using bifocal, trifocal, or progressive (“no line bifocal”) eyeglasses. Progressive glasses allow us to see all four zones by looking through different parts of the spectacle lens as though we had 4 different pairs of glasses stacked one above the other.
With a single focus (monofocal) lens implant, you select which of the 4 zones you’d want to see optimally without any eyeglasses on.
PanOptix trifocal lens
The PanOptix trifocal lens implant is the newest generation multifocal lens implant and overall provides the most complete range of vision, designed to provide continuous focus across all 4 zones. This occurs naturally and automatically, without having to look through different parts of the artificial lens, unlike with wearing progressive or trifocal eyeglasses. The PanOptix is designed to be distance dominant, prioritizing having clear distance vision. Therefore, having good lighting is important to be able to read without eyeglasses. If the print is too small or the lighting is insufficient, you can always put on over-the-counter reading glasses to see better up close.
There may also be situations where very thin distance eyeglasses would boost your ability to see critical details in the far distance. For example, some patients have “glove compartment” eyeglasses for freeway driving at night. The PanOptix trifocal implant produces faint halos around a headlight at night as your pupil dilates. Patients typically report that they notice but can tolerate the halos while driving at night. They are rarely noticed during the daytime.
Vivity extended depth of focus lens
Extended focus lens implants fit between trifocal and monofocal lenses. They employ a completely different mechanism (increasing depth of focus) to reduce dependence on eyeglasses. For example, a photographer can photograph your face and have the background very blurred to create a portrait-like effect. Alternatively, the camera settings can be altered to have your face and the background simultaneously in clear focus, which is referred to as greater “depth of focus.”
The Vivity lens uses sophisticated optics to create more depth of focus than a single focus lens implant. By covering 3 out of the 4 zones, the Vivity lens is designed to provide continuous focus over a greater range of distances than a monofocal lens. For example, it is a good option for patients who want good natural focus without eyeglasses at outdoor and indoor distances and mid-range (zones 1, 2, & 3). Compared to a basic monofocal lens implant set for far distance (zone 1), patients with the Vivity lens have noticeably better mid-range vision at arm’s length (zone 3). They may be able to see large print without spectacles but should expect to use reading glasses for small print (zone 4). It is also possible to target zones 2, 3, & 4 with Vivity if you are willing to wear thin glasses for distance. These strategies can also be combined—unlike with traditional monovision, both eyes still work together as a team.
Multifocal lens implants, such as the PanOptix, are able to cover all 4 zones in one lens, but the tradeoff is that they create more rings around lights at night. Like single focus lens implants, Vivity does not produce these additional rings and halos at night.
Symfony extended depth of focus lens
The Symfony extended depth of focus lens also provides noticeably better mid-range vision at arm’s length (zone 3) compared to a monofocal lens. Again, there may be some ability to read larger print without spectacles, but you should still expect to use reading glasses for many near tasks, and certainly for small print. Naturally, there is some individual variability in the range of focus that each patient enjoys, depending on factors such as your age and the health of your retina.
The extended focus implant may produce faint starbursts around a headlight at night as your pupil dilates. Patients describe this as a radiating cobweb pattern that becomes less distracting over time. The majority of patients are not significantly bothered by this, but there is always some small risk that certain individuals may struggle to adapt to them.