The IOL Redefining Full Range Vision

As Assoc Prof Bala reflects on his early experience with Alcon’s latest generation trifocal technology, his verdict is overwhelmingly positive. The IOL, he said, is delivering meaningful improvements in near and intermediate vision, spectacle independence, and overall patient satisfaction – particularly when compared with earlier trifocal technologies.

“I started using it at the end of last year,” he said. “My impression is it’s actually a far better lens than the previous version.”

For Assoc Prof Bala, the most significant improvement has been the strengthening of near and intermediate vision without compromising distance outcomes.

According to Alcon, Clareon PanOptix Pro is built on Enlighten NXT optical technology and features an optimised diffractive structure. Alcon said the IOL achieves 94% light utilisation and is designed to reduce light scatter while maintaining the optical characteristics surgeons valued in the previous PanOptix model.^1-3

Assoc Prof Bala believes these refinements are helping to address the changing visual demands of modern life, with patient lifestyles changing significantly over recent decades.

“People used to read books. Now hardly anybody goes to a bookstore,” he said. “Most people are spending all day using the phone, [using] the smartphone as a television… to read emails and all that.

“A lot of people who are in their 40s and 50s are currently in work environments where they don’t just use one screen,” he said.

He noted that while earlier trifocal technologies represented a major step forward from bifocal lenses to help this patient category, older IOL technology was often associated with glare, haloes, and a degree of intolerance if refractive targets were not achieved precisely.

… there’s a fullness of vision in the ‘arms-length to nearby’ vicinity. That’s a huge bonus

Upgraded Technology

Comparing the Clareon PanOptix Pro with its immediate predecessor, the Clareon PanOptix, Assoc Prof Bala nominated the biggest improvement as “intermediate while keeping near”.⁴

“On average, people used to get N6 to N8 for near and about an N10 for intermediate (that is the font size). At the moment, most of my patients are hitting N6 to N5 for near and N6 for intermediate. So, there’s a fullness of vision in the ‘arms-length to nearby’ vicinity. That’s a huge bonus.”

The patient doesn’t feel a loss of near to intermediate anymore; this continuous range was previously only felt in the pre-presbyopic age group.

And he said those intermediate and near results are being achieved without compromising distance, “and so because the distance vision is holding, we are able to fiddle with this lens a little bit more… so they get very good full range from far to near”.

“We are not affected so much by the vagaries of biometry as much. And it’s been a very popular lens.”

He said this broader range of functional vision was translating directly into greater independence for patients in their daily lives.

“The ideal [Clareon PanOptix Pro] patient at the moment is one whose ocular surface is good, whose tear film is good, whose retina is also good,” Assoc Prof Bala said.

… this broader range of functional vision was translating directly into greater independence for patients in their daily lives

The Optometrists’ Role

Assoc Prof Bala has also observed a shift in attitudes among optometrists, who he said are increasingly comfortable discussing premium IOL technologies and lifestyle-based visual solutions with patients.

He said optometrists were increasingly referring patients interested in reducing spectacle dependence for further discussion about available technologies and realistic outcomes. The modern optometrist recognises that they are the long-term eye health partner in the patient’s journey with or without glasses. They are no longer being paternalistic telling their patients what to do. They are listening to the patient’s lifestyle desires and engaging in frank discussion with their patients. This maintains trust.

“That openness from optometrists has really changed in the last 10, 15 years,” he said. “There is now less of a fear of these technologies.”

For optometrists managing patients after surgery, he emphasised the importance of allowing time to recover, while also maintaining realistic expectations around visual performance.

“People have to understand a trifocal lens is not a microscope,” he said.

He encouraged clinicians to tailor postoperative care and spectacle prescribing to each patient’s individual needs and activities, particularly for specialised visual tasks or night driving.

The Patient Experience

One of the more notable changes Assoc Prof Bala has observed with Clareon PanOptix Pro is the reduced impact of postoperative adaptation.⁴

“Adaptation is not a big issue anymore,” he said.

While some patients still notice rings or haloes around lights, he said these symptoms are generally tolerated well because of the gains in visual function. Additionally, most patients fully adapt within three months, with many returning to work within a week of surgery.

“They literally say that to me,” he explained. “‘I get a few rings, but it’s getting better’, and then ‘it’s now three months and I’m fine’.”

Patient feedback, he said, had been consistently enthusiastic.

“Oh, they say ‘I just can’t believe I didn’t do this earlier’,” he said.

He described patients experiencing rapid improvements in day-to-day functionality almost immediately after surgery.

Although monofocal, EDOF, and trifocal lenses all continue to play important roles in cataract and refractive surgery, Assoc Prof Bala believes the performance of newer full range trifocal technologies is influencing surgeon preferences.

“The forgiveness level of these lenses has picked up,” he said. “At the moment, at least 70% of my cases are trifocal.”

Ultimately, Assoc Prof Bala believes the technology has reached a level of maturity that is changing both patient expectations and surgeon confidence.

Asked for his key takeaway on the Clareon PanOptix Pro for both optometrists and ophthalmologists, his answer was straightforward.

“For range of vision – significantly increased range of vision and significantly increased range of freedom – it’s huge.

“It just outshines its predecessors,” Assoc Prof Bala said. “It just performs well.”