Case #34: Man in his 60s from Suginami (right eye: trifocal intraocular lens PanOptix; left eye: ActiveFocus)

He first visited us more than a year earlier for cataract consultation because both far and near were hard to see. At that time the cataracts were still mild and could be managed with glasses, so we did not recommend surgery and monitored him; this time he returned because things had become even harder to see and it had begun to affect his work, driving. He had hyperopic eyes with strong presbyopia, and cortical cataracts had progressed with reduced corrected vision, so we judged surgery to be indicated. He wished for surgery with multifocal lenses using advanced medical care insurance, but as a professional driver, the effect of light spreading at night on his driving was a concern, so we recommended surgery with ActiveFocus, which seems to have the fewest halos and glare among lenses covered by advanced medical care. He said the latest trifocal multifocal lens, PanOptix, was also hard to give up, but in theory more focal points mean more halos and glare, so it may not suit professional drivers who drive at night. With his understanding of this, as a safety measure we went into surgery with the plan of first operating on the left eye with ActiveFocus and, if halos and glare did not bother him, using PanOptix in the right eye.
After left eye surgery, he said near vision was a little uncertain, but halos and glare did not particularly bother him even when driving at night and did not affect his driving, so the right eye was operated on with PanOptix. As a result, the right eye with PanOptix had good vision at both distances, 1.5p distance / 1.2p near, and he was very satisfied. The left eye with ActiveFocus is also good at 1.2 distance / 0.9 near; the difference in near vision is probably due to the difference in the lenses' adds = 0.75 D (PanOptix +3.25 D, ActiveFocus +2.5 D). As for the feared halos and glare, looking with one eye at a time, he said PanOptix did have somewhat more than ActiveFocus (especially halos), but not enough to affect his driving.
PanOptix is at present the only trifocal multifocal lens certified for advanced medical care. Its theoretical focal distances are distance, 60 cm and 40 cm, but in actual measurements there is almost no dip in vision between the foci. The only concern is halos and glare, which are said to be almost the same as the bifocal ReSTOR, so it is on the low side among trifocal lenses. Its release in Japan is scheduled for the end of October, but our clinic is certified as an early-use facility, so it is already available under advanced medical care. It seems suited to people who rarely drive at night and want to reduce their use of glasses as much as possible, so if you are interested, please feel free to consult us.