The Alcon PanOptix IOL (Trifocal IOL)

The Acrysof IQ PanOptix intraocular lens is the first and only trifocal IOL available for use in the United States. The lens was approved by the FDA in 2019 for use during cataract surgery and refractive lens exchange (RLE).

The PanOptix is clinically shown to deliver an exceptional combination of near, intermediate and distance vision while significantly reducing the need for glasses after surgery. Studies show high patient satisfaction with more than 99% of PanOptix patients saying they would choose the same lens again.¹ 

Trifocal Lenses and the PanOptix IOL

Several types of IOLS are available in the market. The most affordable option are monofocal IOLs as they are covered by insurance for cataract surgery. These lenses provide one clear point of vision, which can be set for near or distance vision. While they are a great option for many people, they cannot offer any sort of spectacle independence or customization. To achieve greater visual freedom, lifestyle lenses (also known as premium IOLs) are available. The trifocal IOL is one of those lens options.

What is a Trifocal IOL?

A trifocal IOL has 3 focusing points. This lens has a diffractive design to split incoming light into three focal points, not unlike trifocal glasses. The lens allocates 25% of light to near vision, 25% to intermediate vision and 50% to distance vision.

The intermediate focal point is optimized for common tasks such as using digital devices. It is typically set at around 60 cm (24,6”). The near focal point is set at approximately 40 cm (15,74”), and the distance focal point is set at infinity. Before this lens, “multifocal” IOLs were only bifocal, providing good vision for near and distance, but no intermediate focus.

The PanOptix IOL

The PanOptix trifocal IOL is one such lens. This particular model has a unique mechanism that no other lens in the market can offer, and has been implanted in millions of eyes worldwide.

The PanOptix Trifocal Lens is only 13 mm in diameter.² It is made from a hydrophobic acrylic material (which is biocompatible with the human eye) and 26 diffractive rings that allow the IOL to focus at different distances.⁵ Although there are a few trifocal IOL models available around the world, the PanOptix Trifocal IOL is the only one of its kind in the US market.

PanOptix Trifocal IOL FDA Approval

The FDA’s approval was based on a pivotal clinical study conducted at 12 investigational sites across the U.S. This study involved 243 patients who were implanted with either the PanOptix lens or a monofocal control lens. The results demonstrated that the PanOptix lens provided enhanced visual outcomes across near, intermediate, and distance vision compared to the control.

The study reported high patient satisfaction, with over 99% of participants indicating they would choose the PanOptix lens again. While visual disturbances like glare, halos, and starbursts were noted (and deemed more pronounced compared to monofocal lenses), less than 5% of patients rated these symptoms as significantly bothersome after six months.

Alcon, the manufacturer of the PanOptix, has a long-standing history of innovation and expertise in the field of IOLs. The company holds more than 60% of the global market and 80% of the United States market for multifocal lens implants.³. 

PanOptix Trifocal IOL vs Other Lenses

While trifocal IOLs are one of the best options available for patients undergoing cataract surgery or RLE, other visual needs, preferences, budget, and health concerns warrant choosing a different lens.

Other premium lens options include:

• Extended Depth of Focus (EDOF) IOLs
• Accommodating IOLs
• Light Adjustable Lenses

EDOF and Accommodating IOLs provide a similar range of vision as the multifocal lens, but using different technology. Light adjustable lenses (LALs), are a customizable version of monofocal lenses, and the only type of IOL you can adjust after surgery. Just like the PanOptix, these options are more expensive than traditional monofocal lenses, which provide extremely clear vision but at just one pre-set distance.

Before settling on an IOL, you should discuss your options with a specialized surgeon to ensure you are making the best choice.

Type of Lens	Number of Vision Ranges	Materials	Pros	Cons
PanOptix Trifocal Lenses (Multifocal IOL)	Three (Near, Intermediate, Far)	Hydrophilic Acrylic	Improves all ranges of vision, reduces the need for glasses	Higher cost, potential for halos and glare
Monofocal IOLs	One (Set for Near, Intermediate, or Far)	Various	Simplest, most cost-effective solution	Only one range of clear vision, glasses needed for other distances
EDOF IOLs	One Expanded Focal Range (Near to Distance)	Various	Provides an extended depth of focus across the visual range	Less contrast sensitivity, hard to read in dim lighting
Accommodative IOLs	Varies (can change shape)	Various	Can move or change shape inside the eye, offering more natural vision dynamics	Can be more expensive, not as widely used
Toric IOLs	One (Set for Near, Intermediate, or Fa	Various	For those with astigmatism as well as cataracts	Only one range of clear vision, glasses needed for other distances

PanOptix Trifocal IOL vs EDOF IOLs

Extended Depth of Focus IOLs are premium IOLs that offer a wide range of clear vision using a technology different from trifocal lenses. Instead of creating multiple focal points, EDOF IOLs manipulate light to create one elongated focal point that goes from near to distance vision. That is, they create an extended depth of focus.

EDOF IOLs provide similar results to the PanOptix Trifocal IOL, although performance depends on the model.

PanOptix Trifocal IOL vs Symfony EDOF IOL

THe Symfony IOL is manufactured by Johnson & Johnson, another leading player in the eye care industry. While both the PanOptix and the Symfony provide great visual outcomes, each lens tends to perform better at a specific range. These lenses have been around for several years now, and studies comparing the two have shown that:

• If you prioritize clear near vision for reading or using your phone, the PanOptix lens may be better for you.
• If you spend a lot of time using computers or tablets and need clearer intermediate vision, the Symfony lens could be more suitable.
• If you have an active lifestyle and want to minimize the need for glasses, the PanOptix lens may provide more spectacle independence.

PanOptix Trifocal IOL vs Vivity IOL

Another EDOF IOL option is the AcrySof IQ Vivity IOL, which is Alcon’s own EDOF model. Both lenses are popular and have high satisfaction rates, but the reasons vary. 

The Vivity IOL has a significantly better profile regarding glare and halos compared to the PanOptix lens. Approximately 85% of Vivity patients report little to no glare or halos, while only 69% of PanOptix patients report the same. This makes the Vivity lens a favorable option for those concerned about visual disturbances, especially in dim lighting.

While both lenses can reduce the need for glasses and provide a wide range of clear vision, The PanOptix IOL generally offers higher rates of spectacle independence compared to the Vivity.

PanOptix Trifocal IOL vs Monofocal IOL

Monofocal IOLs provide excellent vision for a single point of focus. The PanOptix trifocal lens, by contrast, provides good vision at all distances. However, there may be a compromise. Vision may not be as sharp as the one provided by a monofocal lens.

As mentioned earlier, the PanOptix IOL has 26 diffractive rings, which allow the lens to focus at all distances. However, these diffractive rings are associated with more glare and less visual sharpness than monofocal lens implants.

Vision will still be very clear, but it’s important to understand that no lens can achieve the same visual clarity and broad vision range of young, healthy eyes.

Panoptix IOL vs Accommodating IOL

Accommodation refers to the eye’s ability to focus on objects at close range. The natural lens inside the eye alters its shape to allow objects at different ranges to come into focus. 

As we start aging, typically in our 40s, we lose a significant ability to focus on objects at close range, a condition known as presbyopia. Most people eventually require reading glasses as a result. Accommodating IOLs are special lenses that mimic our eye’s ability to adapt and focus on nearby objects. They are similar to monofocal IOLs in that there are no diffractive rings that may distort the vision. Instead, they have a special mechanism that moves in response to the ciliary muscles’ contractions the way the natural lens would.

Accommodating IOLs provide similar or even superior clarity for distance and intermediate vision compared to multifocal IOLs, although near vision won’t be as clear.  However, accommodating lenses need the ciliary muscles and the zonules (the fibers that hold the lens of the eye in place) to be in good shape to work properly. Otherwise, the functionality of the lens will diminish. With the PanOptix trifocal lens, this is not a concern.

PanOptix Trifocal IOL vs Light Adjustable Lens

LALs are designed as monofocal lenses, meaning they typically provide clear vision at one distance (either near or far). However, the focal point can be adjusted after surgery, providing a lot of flexibility in achieving optimal vision for specific tasks. A wider range of vision can be achieved by performing monovision cataract surgery, where each lens is adjusted for a different distance.

The light adjustable lens is a great option for people who want customizable vision results. The lens is adjusted after surgery with a series of light treatments. You can decide the ideal power of the lens together with your surgeon, and then lock-in the lens at your preferred distance. The main caveat is that you very likely won’t achieve full spectacle independence with this lens. Although monovision is an option to expand vision range, not everyone adapts well to it.

People who struggled to adapt to monovision through contact lenses are unlikely to do better with monovision. In these cases, the Trifocal IOL is a better fit, as it allows both eyes to see clearly at all distances.

PanOptix Trifocal Toric IOL

People with astigmatism – a type of refractive error that causes blurred vision at all distances – will still need to wear glasses after cataract surgery or RLE unless they get a special type of astigmatism-correcting IOL. This happens because astigmatism is caused by the cornea or lens of the eye having an “uneven” shape. 

Eyeglasses and contacts for astigmatism have a particular curvature to compensate for this “unevenness”. In the case of IOLs, most models offer a “toric” alternative, which achieves the same type of vision correction as the “regular” model but also incorporates a unique shape that corrects astigmatism.

With a full range of clear vision and astigmatism correction, The PanOptix trifocal toric IOL allows patients great visual outcomes no matter if they had astigmatism, presbyopia (age related loss of near vision), nearsightedness or farsightedness prior to the surgery.

Pros & Cons of PanOptix Trifocal Lenses

Advantages of the PanOptix Trifocal IOL Lenses

• Improved vision at all distances
• Reduced need or no need for eyeglasses
• Great for patients that lead active lifestyles 
• Good option for people that cannot wear eyeglasses

Disadvantages of the PanOptix Trifocal IOL Lenses

• Halos and glare may be more likely than other IOL alternatives
• Higher cost than traditional monofocal lens implants
• Overall clarity may not be as sharp as other IOL alternatives
• May be unsuitable for patients with certain eye diseases

PanOptix Trifocal IOL Cost

Premium intraocular lenses like the PanOptix Trifocal IOL are not covered by insurance, so you will have to pay out of pocket. However, many patients find that the lenses are worth the cost. At NVISION, we offer payment plans to help patients finance their IOL of choice. Cataract surgery with PanOptix Trifocal lenses typically costs between $6,000 to $8,000, depending on the circumstances of the surgery, additional technology used and the facility involved.

PanOptix Trifocal Lens for Cataract Surgery and RLE

WIth the PanOptix IOL you can carry out all or most of your daily activities without the need of corrective eyewear.  If you are looking for a lens that performs great at all distances and has been proven to deliver outstanding results, then this could be the IOL for you.

Schedule an appointment to discuss your upcoming surgery and lens choice with one of our doctors at your closest NVISION Center.

PanOptix Trifocal IOL FAQs

Can you get a PanOptix IOL in one eye?

Absolutely. There might be a variety of reasons why patients may choose to get a PanOptix trifocal lens in one eye only. Some patients might have gotten a monofocal lens in one eye, and then decided they wanted more spectacle independence.  In other cases, a patient may have an eye disease in one eye that may prohibit a trifocal IOL in one of their eyes, but not both.

For these patients, a premium monovision or blended vision approach can be used. One eye will be set for distance vision with a monofocal lens. The other eye will receive a trifocal lens to allow for clear near and intermediate vision. Even if they only get a premium IOL in one eye, patients can still reap the benefits of this advanced technology.

What Trifocal IOLs are available in the U.S.A.?

The PanOptix Trifocal IOL was authorized for use in the United States (by the FDA) in 2019. It is still the only approved trifocal IOL in the United States. 

Are Trifocal IOLs considered the best for cataract surgery?

The best lens for your cataract surgery depends on many factors. Patients who have had LASIK, radial keratotomy, or eye conditions like glaucoma, macular degeneration, or an epiretinal membrane need special attention when choosing an IOL and should make a decision in collaboration with their surgeon. It’s also important to consider your vision goals, lifestyle, job, and hobbies while exploring your IOL options. Trifocal IOLs are a fantastic option for many people, but some patients might be better off with a different IOL.

Will I have Trouble Adjusting to a Trifocal IOL after Cataract Surgery?

Most patients need time to adjust to an IOL implant no matter what type of IOL. It is, after all, a major change made to your eyes and vision. Trifocal lenses might take more time to get used to for some patients due to the possibility of glare, halos, and alterations in how they see postoperatively. Significant visual improvement is generally noted within 3 months, though for some patients it might take up to 6.  By one year, most patients report stable vision, and satisfaction levels are typically high.

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