If we assume the patient had myopic LASIK, the corneal wavefront will show positive spherical aberration, the higher the LASIK correction the higher the spherical aberration. High SA is not our friend, it robs the eye of contrast. In general the Panoptix, which has negative spherical aberration, does not have enough to compensate for the positive SA of the cornea. This, along with some other optical design issues, renders the Panoptix a suboptimal choice in post myopic LASIK eyes. I completely agree with Shannon that the Odyssey, and it’s sophisticated optics and better material, is likely a better choose for these patients
Amazing, this is very helpful to know! Thank you for sharing. I recall, Dr. Hamilton told me a similar pt experience where the Panoptix was switched out to Odyssey and resulted in significant improvement for the patient. So far I have only offered Panoptix to LAL, but it is great to have another option! Truly, thank you both for sharing!
Stayed in Austin for a week, had lense replacement surgery on both eyes, I was almost blind..went with panoptix lense, expensive, but Wouldn't change a thing...I can answer questions if someone is thinking about it.. absolutely YES, I see like a hawk
I have a similar question. Is it fair to say that for patients that can tolerate at least some monovision, the LAL (or LAL+) would be able to provide the same range as the Odyssey, but with better quality?
Nice video. I am currently using contacts with modified monovision (toric monovision in left and multifocal in right) to treat my presbyopia and myopia. It is giving me good range of vision (I test 20/20 in near and far), but I find myself straining especially in the near vision (similar to how the man from this case is describing). I have decided to have lens exchange surgery. My doctor offers both lenses, but he recommended panoptix. This video is making me want to inquire more about the odyssey. It might be a better fit for me.
Your videos are so good and educational, you are doing a lot for the community…I would have loved to see his topography for a brief second just to better understand why he might be dissatisfied….thank you for all you are sharing
What I have found is that about 2% of people are going to be dissatisfied with their vision with the multifocal or EDOF lens that they first receive. Therefore, at scale we will need to have options to perform intraocular lens exchange for this population. This patient's topography was perfect.
@ShannonWongMD Thank you for the videos! I had LASIK about 22 years ago. I now need cataract surgery. Which cataract lenses are best for people with previous LASIK surgery?
7:38 i wouldnt expect to see identical satisfaction rates (98%/98%/98%) across the board for three IOLs that are so different. it makes me wonder if there are errors in how how the data is being collected or reported
I have a minor astigmatism in both eyes. Is there a toric version of the odyssey lens? Is it better to use a non toric lens and correct the astigmatism with lasik (or does that even make sense)?
@@ShannonWongMD I’m looking at having cataract surgery in the next couple months. I wanted the Vivity iol but my doctor refuses to consider that because I have some 4th nerve palsy in my left eye. I have some astigmatism in my right eye, so he wants to use a toric lens there. Would the odyssey lens be a possibility for me? I wore contact lenses for 40 years and didn’t have a problem in day to day activities as a professional pilot with the 4th nerve palsy, so I thought that experience might carry over to IOL . But the doctor refuses to consider anything other than a mono iol in both eyes for some reason.
Hi doctor, I would like to know what was the R.E.Q of the #Panoptix that the patient had, and also to know what was the Target that you ment to get and what was the actually Target after 2 month? Thanks
I had an IOL for distance placed on my eyes during cataract surgery. I will now have a second lens inserted on top of it to be able to see near and mid range. Could you please elaborate on this option.
Nice technique! I can think of a couple cases I could have used that. Did u consider the SBL3 ? Injecting that lens into a bag with an open PC would be challenging for sure.
@@ShannonWongMDПроплатили за рекламу? Сначала рекламировали паноптикс,люди его по вашей рекламе установили ,теперь Одиссей . Дальше что будете рекламировать? Паноптикс теперь удалять и ставить Одиссей?
I have a Restor multifocal toric IOL in my right eye since June 2017 and I am not satisfied with the quality of distance vision, and I am especially not satisfied with the near vision, can it be replaced with Odyssey IOL?
"It depends." You would need an examination with the surgeon who performs intraocular lens exchanges. Obtain the preoperative biometry measurements and the lens implant information for the exact implant placed into your eye. It is possible but depends on your exam and a discussion between you and your surgeon.
I got the Synergy put in back in 2021. I experienced PVD in one eye and now I can't see distance. I was hoping to see if I could get the Oddysey as a replacement but the doctor says it's not worth the risk.
Consider looking for a physician that performs YAG laser vitreolysis if it is a PVD blocking your central vision. Consider a second opinion to assess the reasons you can't see at distance as the Synergy lens has a 20/20 distance visual potential and you should be able to get near or to that point in most healthy eyes with touch up following it or optimization of the visual pathway with other treatments.
All lenses currently available in the US can and will have a 20-50% chance of needing yag capsulotomy after implantation due to posterior capsule opacification.
@@ShannonWongMD Thanks for the response. I know your data may be limited for the odyssey lens, but what % of your patients receive yag due to pco for the panoptix lens?
@@JasonSesler If you receive a lens implant (panoptix or any other lens implant), expect a 1/3 to 1/2 chance of needing YAG capsulotomy in your lifetime.
@@ShannonWongMD That is what I am facing because my vision is so blurry in my right eye after almost 1 1/2 months since surgery. Please tell me you've seen success!!
Surprised you did the YAG Capsulotomy in a patient with Panoptix who is 20/20 and unhappy…would have been much easier exchange without the YAG. Panoptix in general is not good enough in post LASIK eyes, especially in younger patients who still have native lens to compare it with. I would caution other surgeons to not do YAG so quickly in these patients and move towards the exchange earlier. When a patient sees 20/20 and is unhappy, don’t YAG! While the IOLX turned out well, there is too high a risk of an outcome the patient would be unsatisfied with or, worse, a disaster.
Rex, Great points! Actually I have had good success with Panoptix in post myopic Lasik patients (but not in post hyperopic Lasik patients). Your points are valid. Prior to doing his yag capsulotomy, I made sure that his anterior capsulorhexis was 5.0 mm or less (which I found out it was probably too small...closer to 4.25-4.5 mm) and knew that I could do IOLX post yag capsulotomy prior to pushing the "fire" button on the YAG laser. I have now done a good number of IOLX post yag and feel comfortable and safe doing so. This case was "a challenge" due to his small rhexis which turned-out to be a good teaching point.
If we assume the patient had myopic LASIK, the corneal wavefront will show positive spherical aberration, the higher the LASIK correction the higher the spherical aberration. High SA is not our friend, it robs the eye of contrast. In general the Panoptix, which has negative spherical aberration, does not have enough to compensate for the positive SA of the cornea. This, along with some other optical design issues, renders the Panoptix a suboptimal choice in post myopic LASIK eyes. I completely agree with Shannon that the Odyssey, and it’s sophisticated optics and better material, is likely a better choose for these patients
Thank you Rex! Great points!
Amazing, this is very helpful to know! Thank you for sharing. I recall, Dr. Hamilton told me a similar pt experience where the Panoptix was switched out to Odyssey and resulted in significant improvement for the patient. So far I have only offered Panoptix to LAL, but it is great to have another option! Truly, thank you both for sharing!
Did that pt also have a h/o lasik? Bc if it is this might be a great choice over vivity for post lasik pts
Stayed in Austin for a week, had lense replacement surgery on both eyes, I was almost blind..went with panoptix lense, expensive, but Wouldn't change a thing...I can answer questions if someone is thinking about it.. absolutely YES, I see like a hawk
Very informative video as always. Is there any comparison between the LAL and Odyssey lenses?
LAL has a role. th-cam.com/video/Fv9j1xVxy-M/w-d-xo.html
I have a similar question. Is it fair to say that for patients that can tolerate at least some monovision, the LAL (or LAL+) would be able to provide the same range as the Odyssey, but with better quality?
Nice video. I am currently using contacts with modified monovision (toric monovision in left and multifocal in right) to treat my presbyopia and myopia. It is giving me good range of vision (I test 20/20 in near and far), but I find myself straining especially in the near vision (similar to how the man from this case is describing). I have decided to have lens exchange surgery. My doctor offers both lenses, but he recommended panoptix. This video is making me want to inquire more about the odyssey. It might be a better fit for me.
Your videos are so good and educational, you are doing a lot for the community…I would have loved to see his topography for a brief second just to better understand why he might be dissatisfied….thank you for all you are sharing
What I have found is that about 2% of people are going to be dissatisfied with their vision with the multifocal or EDOF lens that they first receive. Therefore, at scale we will need to have options to perform intraocular lens exchange for this population. This patient's topography was perfect.
@ShannonWongMD Thank you for the videos! I had LASIK about 22 years ago. I now need cataract surgery. Which cataract lenses are best for people with previous LASIK surgery?
7:38 i wouldnt expect to see identical satisfaction rates (98%/98%/98%) across the board for three IOLs that are so different. it makes me wonder if there are errors in how how the data is being collected or reported
I have a minor astigmatism in both eyes. Is there a toric version of the odyssey lens? Is it better to use a non toric lens and correct the astigmatism with lasik (or does that even make sense)?
There is a toric or astigmatism-correcting version of the odyssey.
@@ShannonWongMD
I’m looking at having cataract surgery in the next couple months. I wanted the Vivity iol but my doctor refuses to consider that because I have some 4th nerve palsy in my left eye. I have some astigmatism in my right eye, so he wants to use a toric lens there.
Would the odyssey lens be a possibility for me? I wore contact lenses for 40 years and didn’t have a problem in day to day activities as a professional pilot with the 4th nerve palsy, so I thought that experience might carry over to IOL . But the doctor refuses to consider anything other than a mono iol in both eyes for some reason.
Hi doctor,
I would like to know what was the R.E.Q of the #Panoptix that the patient had, and also to know what was the Target that you ment to get and what was the actually Target after 2 month?
Thanks
Nice outcome. Considering ROC for your IOL, what changes were made with IOL power calculation?
I use this link to calculate the bag vs sulcus power adjustment - doctor-hill.com/iol-power-calculations/bag-vs-sulcus/
I had an IOL for distance placed on my eyes during cataract surgery. I will now have a second lens inserted on top of it to be able to see near and mid range. Could you please elaborate on this option.
When will the RayOne Galaxy lens come to the US? Any thoughts on this lens?
Mr Wong. What’s your view on PureSee IOL? I’m in UK this lens is now available but I’m not comfortable trying new product
I have no experience with the puresee.
Great video and outcome! Can you explain why you planned on ROC? Thank you!
He is post YAG capsulotomy. Didn't think that placing an odyssey single piece acrylic IOL in an open bag would age well.
Nice technique! I can think of a couple cases I could have used that. Did u consider the SBL3 ? Injecting that lens into a bag with an open PC would be challenging for sure.
I don't think placing a clearview 3/SBL3 into an open bag would age well.
Appreciate your videos!
🙏
Is there any reason why you might recommend panoptix over odyssey?
Currently, I cannot think of one.
@@ShannonWongMDПроплатили за рекламу? Сначала рекламировали паноптикс,люди его по вашей рекламе установили ,теперь Одиссей . Дальше что будете рекламировать? Паноптикс теперь удалять и ставить Одиссей?
Are the haptics inside the capsular bag, or behind the anterior/posterior capsule?
In reverse optic capture, the haptics are "inside the bag" or posterior to the anterior capsular rim.
How do you stay calm in such a situation ???
I have a Restor multifocal toric IOL in my right eye since June 2017 and I am not satisfied with the quality of distance vision, and I am especially not satisfied with the near vision, can it be replaced with Odyssey IOL?
"It depends." You would need an examination with the surgeon who performs intraocular lens exchanges. Obtain the preoperative biometry measurements and the lens implant information for the exact implant placed into your eye. It is possible but depends on your exam and a discussion between you and your surgeon.
@@ShannonWongMD thanks a lot
Great video! Well done! 👏🏼 💪🏼
Thank you Omar!
I got the Synergy put in back in 2021. I experienced PVD in one eye and now I can't see distance. I was hoping to see if I could get the Oddysey as a replacement but the doctor says it's not worth the risk.
Consider looking for a physician that performs YAG laser vitreolysis if it is a PVD blocking your central vision. Consider a second opinion to assess the reasons you can't see at distance as the Synergy lens has a 20/20 distance visual potential and you should be able to get near or to that point in most healthy eyes with touch up following it or optimization of the visual pathway with other treatments.
I read that lens material can effect the risk of PCO after a RLE surgery. Does either of these lenses present a lower risk of PCO based on that?
All lenses currently available in the US can and will have a 20-50% chance of needing yag capsulotomy after implantation due to posterior capsule opacification.
@@ShannonWongMD Thanks for the response. I know your data may be limited for the odyssey lens, but what % of your patients receive yag due to pco for the panoptix lens?
@@JasonSesler If you receive a lens implant (panoptix or any other lens implant), expect a 1/3 to 1/2 chance of needing YAG capsulotomy in your lifetime.
@@ShannonWongMD That's a bit discouraging, but thanks for the transparency.
Do you ever do a piggyback surgery where you put in a second lens on top of another IOL?
Yes.
@@ShannonWongMD That is what I am facing because my vision is so blurry in my right eye after almost 1 1/2 months since surgery. Please tell me you've seen success!!
How did his iris heal after so much manipulation during surgery?
His iris appears completely normal.
Surprised you did the YAG Capsulotomy in a patient with Panoptix who is 20/20 and unhappy…would have been much easier exchange without the YAG. Panoptix in general is not good enough in post LASIK eyes, especially in younger patients who still have native lens to compare it with. I would caution other surgeons to not do YAG so quickly in these patients and move towards the exchange earlier. When a patient sees 20/20 and is unhappy, don’t YAG! While the IOLX turned out well, there is too high a risk of an outcome the patient would be unsatisfied with or, worse, a disaster.
Rex, Great points! Actually I have had good success with Panoptix in post myopic Lasik patients (but not in post hyperopic Lasik patients). Your points are valid. Prior to doing his yag capsulotomy, I made sure that his anterior capsulorhexis was 5.0 mm or less (which I found out it was probably too small...closer to 4.25-4.5 mm) and knew that I could do IOLX post yag capsulotomy prior to pushing the "fire" button on the YAG laser. I have now done a good number of IOLX post yag and feel comfortable and safe doing so. This case was "a challenge" due to his small rhexis which turned-out to be a good teaching point.
I wonder what lens will you like best in another 6 months?
There are many great lenses. None are perfect. Each has flaws.