Cataract Surgery--Did You Get Light Adjusting Lenses or Premium Trifocals Lenses?

[Qs Laptop]

I've had one cataract surgery consultation and I've got two more scheduled. My goal is to ditch wearing glasses forever.

From what I've learned the best way to get rid of glasses forever is to get a premium trifocal interocular lens implanted. Some of the brand names are Johnson & Johnson's Tecnis Odyssey lens, Alcon's PanOptix lens, and Basch & Lomb's Envista Envy lens.

Another option is the light adjustable lens (LAL) pioneered by RxSight, though success rate of never wearing glasses is not as high as with trifocal lenses.

If you have had cataract surgery, or lens replacement surgery, and you've gotten the Odyssey lens, the PanOptix lens, or the Envista Envy lens I'd like to hear about your experience and your review of how your eyesight is after surgery.

I'd also like to hear from those that got light adjustable lenses (LAL).

Both premium trifocal lenses and light adjustable lenses require out-of-pocket payments above and beyond the Medicare paid benefit amount.

I DO NOT want to hear about the standard monofocal lens that is used to correct vision at a specific distance, usually distance. People that get this lens are fully covered by Medicare and they typically need glasses to see intermediate and close up.

Some get the standard lenses and set one lens for distance vision and one lens for close up. This is called monovision and the person that gets this set up relies on their brain adapting to the mismatched lenses. This is of some interest to me as the light adjustable lens set up is somewhat similar to this setup.

 

[5Miler]

I had cataract surgery in both eyes in Nov 2025 with the J&J Odyssey toric lenses placed in both eyes. As you know, these are the trifocal premium lenses from J&J.

I don't think I was the typical case as my eyes were pretty bad off. I was about 1.5 and 2.0 diopters farsighted with 4.0 diopters of astigmatism in both eyes prior to the surgery. I also had irregular astigmatism in both eyes greatly resolved with a superficial keratectomy on each eye prior to the cataract surgery. Those took 8 weeks to fully heal prior to surgery.

Prior to the cataract surgery I couldn't read any line on an eye chart without glasses, not even the huge top line. As a result I wore glasses from the minute I woke up until I went to bed for about 60 years. When traveling I would have to go into a hotel shower with my glasses on prior to using it so I could identify which dispenser had soap and which had shampoo.

Since the cataract surgery I have been glasses free. The only exception has been whenever I use one program on my laptop to log my dives after scuba diving. For some reason whoever wrote that program made the font very small and {control +} won't enlarge it so I bought a $3 pair of readers on Amazon I have only used for that purpose.

My eyes have been corrected to 20/30 and 20/40 for distance and for close up I can read just about anything with no problem except that stupid dive log program and the very smallest print on my prescription medicine bottles. Truly a life changing event for me. I would have been thrilled to achieve 20/20 in each eye but considering where I started from, this is great. I am glasses free.

The cost was about $4K per eye but money well spent in my opinion. The biggest downsides are halos around points of light mostly at night and a decrease in contrast in low light. The contrast issue only effects small print such as a menu in a low lit restaurant. The halos around lights were significant the first few weeks after the surgery. I went to Europe for the Christmas markets 6 days after my second surgery and got quite the light show there. That died down significantly so that today I rarely notice halos unless I think about them and even then they are pretty small so not really an issue. I understand this can vary by individual.

 

[Qs Laptop]

Thank you for a very comprehensive response. Exactly the kind of feedback I'm looking for.

I'm glad to hear things worked out great for you.

You've got 20/30 and 20/40 for distance vision. Are you satisfied with your distance vision? For example, can you read freeway signs at far distances? What about license plates on cars that are several cars lengths ahead?

Do you happen to know your near vision J chart rating?

 

[Mulligan]

My vision sagged to 20/50 and I was used to 20/20 until late 40s. Too young for Medicare to foot the bill, I had lens replacement surgery a few months back. I had the PanOptix put in my non dominant eye, and a distance only lens in the dominant eye. I now see 20/12.5 vision. I do not need glasses to read with now. Before surgery, I would wear transitional glasses, readers, and script sunglasses basically needed a man purse for these things. Now I need nothing…
That being said, this was what Doc called a “compromise” surgery. I like to golf and see distance and like to drive at night. This setup mitigates the “night time haloing” which I have no problem with at all.
He told me my eyes were perfect candidates for the surgery and was certain I could get the 20/12.5 vision but couldnt guarantee I might need to use low powered readers for extended reading. I dont need them which is great. Every option one decided from carries its plusses and minusses depending on what your featured outcome is….And also what condition your eyes are in and the skill level of the eye surgeon.
BTW…The eyes “work together”. My brain doesnt know which eye has the multi focal and which has the distance. I have to physically put a hand over each eye to really notice the difference. The distance eye only can read but its a bit blurry being its meant for distance. Mid range for like tv watching I dont see a real difference as they are both very clear. Long distance say leaves on a tree a 100 yards away, the distance eye is real sharp and the multi is a little less sharp. But as I mentioned they blend together so no difference is noted.

 

[Mulligan]

My vision sagged to 20/50 and I was used to 20/20 until late 40s. Too young for Medicare to foot the bill, I had lens replacement surgery a few months back. I had the PanOptix put in my non dominant eye, and a distance only lens in the dominant eye. I now see 20/12.5 vision. I do not need glasses to read with now. Before surgery, I would wear transitional glasses, readers, and script sunglasses basically needed a man purse for these things. Now I need nothing…
That being said, this was what Doc called a “compromise” surgery. I like to golf and see distance and like to drive at night. This setup mitigates the “night time haloing” which I have no problem with at all.
He told me my eyes were perfect candidates for the surgery and was certain I could get the 20/12.5 vision but couldnt guarantee I might need to use low powered readers for extended reading. I dont need them which is great. Every option one decided from carries its plusses and minusses depending on what your featured outcome is….And also what condition your eyes are in and the skill level of the eye surgeon.
BTW…The eyes “work together”. My brain doesnt know which eye has the multi focal and which has the distance. I have to physically put a hand over each eye to really notice the difference. The distance eye only can read but its a bit blurry being its meant for distance. Mid range for like tv watching I dont see a real difference as they are both very clear. Long distance say leaves on a tree a 100 yards away, the distance eye is real sharp and the multi is a little less sharp. But as I mentioned they blend together so no difference is noted.

Added note…I just checked. My non dominant eye had the Clareon PanOptix UV IOL, my dominant eye had the Rayner RayOne Aspheric US…My surgery set me back a little over $12k. Worth every penny to me based on my outcome. I recently did my 3 month follow up and tested to 20/12.5 vision.

 

[keppelbay]

Trifocals, along with laser correction of minor astigmatism.
Recovery was reasonably quick. I could see the next day, and see well after a couple of days.

The information going to your brain is different than with natural lenses and it takes a little while to get used to it. You get in-focus information at 3 different distances at the same time. The lenses are nested rings, so there are edge effects, as well as halos/sparklers from point sources in a dark background. I got used to these quickly and now rarely notice anything.

Low light vision is improved at all distances.

Near-range vision for reading is very good. I read comfortably, even relatively small print (eg small format paperbacks). No problem with low light for restaurant menus with small print etc. Anything involving close focus (manipulating small things, painting etc) is all fine.

Mid-range vision is good. No issues.

Long-distance: I notice a small decrease in visual acuity. I have no problem with distant road signs (also at night), but I do notice that resolution of detail at far distance is not as good as it was (this makes sense as you only get 1/3 of the information in focus at that distance). I find this an acceptable compromise for the much improved vision at other distances.

Glasses are a thing of the past (though it took a while to stop reaching for them).

 

[Texas Proud]

I need to find it but someone had put a video showing all the lens options out there and the J&J was not rated that high...

My sister got them and loves them... she can read really small print and see well at distance... the problem is night glare and halos... she does not go out that much at night so it does not bother her..

We both have the same Dr and she only used the J&J.. so I have decided to wait and see how the newer ones work... I want the best out there...

 

[Qs Laptop]

Trifocals, along with laser correction of minor astigmatism.

Glasses are a thing of the past (though it took a while to stop reaching for them).

Do you know which brand and model of trifocal lenses you got?

 

[AudiDudi]

Before, I was using bi-focals with a 3.25 for reading. When driving, I could not read a road sign at 45 mph as by the time I could read it, I was going by it. Forget license plates. I had the standard cataract surgery as paid for by Medicare. I paid an extra $2200 per eye for Femtolaser correction. I am now 20/20 right eye and about 20/30 left eye. I am typing this on my PC and not wearing glasses. I have a pair of 1.25 reading glasses that I can use if I want to. I see very little difference between the eyes when watching TV from about 9ft. Distance vision is great. I can easily read road signs and license plates. I'm OK with using glasses to read the fine print.

I can delete this if you dont find it helpful.

 

[Qs Laptop]

I need to find it but someone had put a video showing all the lens options out there and the J&J was not rated that high...

My sister got them and loves them... she can read really small print and see well at distance... the problem is night glare and halos... she does not go out that much at night so it does not bother her..

We both have the same Dr and she only used the J&J.. so I have decided to wait and see how the newer ones work... I want the best out there...

The J&J Odyssey is a bit of an older lens, relatively speaking. They are rated high but the newer ones like Panoptix and Envy rate higher. We're talking only a couple percentage points of difference in user satisfaction.

You are like me, I want to get the very best available. So far, according to the research I've done Envista Envy is best overall, with Panoptix right behind it. Envy has better near/intermediate vision and less haloing at night, whereas the Panoptix let's in a bit more light and a tad more contrast making it sharper for far distance viewing. It's a trade-off.

I'm drawn toward the light adjustable lenses because they can be fine tuned after installation to tweak your particular vision requirements. They don't have any haloing or starbursts around lights at night either. But, they are a monovision system and I'd hate to have them implanted and then not have my brain adapt to the different setting for distance and intermediate. However, they say that the adjustment process can get these dialed in so you won't need glasses.

There are a lot of YouTube videos out there...

 

[Qs Laptop]

Before, I was using bi-focals with a 3.25 for reading. When driving, I could not read a road sign at 45 mph as by the time I could read it, I was going by it. Forget license plates. I had the standard cataract surgery as paid for by Medicare. I paid an extra $2200 per eye for Femtolaser correction. I am now 20/20 right eye and about 20/30 left eye. I am typing this on my PC and not wearing glasses. I have a pair of 1.25 reading glasses that I can use if I want to. I see very little difference between the eyes when watching TV from about 9ft. Distance vision is great. I can easily read road signs and license plates. I'm OK with using glasses to read the fine print.

I can delete this if you dont find it helpful.

No need to delete it. More data is good. I was a little cranky when I originally posted earlier today.

 

[Qs Laptop]

BTW, I've gotten pricing from four different ophthalmologists here in the Minneapolis area.

Odyssey lens: $3,000 per eye

PanOptix: $3,790 and $3,900 per eys

Envy: $3,790, $3,900, and $5,900 per eye

LAL Lens: $4,800 plus up to 5 adjustment for $800 additional, $5,700 (all adjustments included, up to 5), and $7,200 (all adjustments included, up to 5).

 

[Qs Laptop]

Before, I was using bi-focals with a 3.25 for reading When driving, I could not read a road sign at 45 mph as by the time I could read it, I was going by it. Forget license plates.

You were basically blind!

 

[pb4uski]

I had both eyes done recently, the left eye on Feb 27 and the right eye on March 4. Like you, my objective was to eliminate glasses if possible but knowing that there was a possibility that I might need readers. I chose the RxSight light adjustable lenses.

I had my second and last lock-in a week ago.

I'm fairly happy with the result. I can go without glasses for distance and for most near work. For example, I'm typing this on my laptop in normal size font without glasses. I can also use my phone without glasses for most things but in order to do so I had to increase the font size on the display on my Android phone a couple notches. My android has 7 settings. When I had glasses I had it on 3. Now I have it on 5. I could read things on 3 or 4 but 5 is just more comfortable.

So I can pretty much go without glasses but using readers for small print is clearer and more comfortable. For example, if I use my readers for what I am typing now, it is definitely clearer and more comfortable than without readers, but without readers is very manageable.

So from my second eye to my final lock-in was 9 weeks and a couple days and they had told me 2-3 months when they did the pitch. I'll concede that it was a PITA to have to wear IR protective glasses that entire 9 weeks, but they do provide you with sunglasses and clear glasses with 1.5+ readers built into the bottom of the lens which makes it like a bifocal.

I'm avoiding using the readers as much as possible so my eyes and brain can reconnect and so far, so good.

I ended up needing 2 or 3 adjustments and 2 lock-ins. Mine was $9,070 total. Since I was quoted in 2025 they honored the 2025 prices... otherwise it would have been $9.870. I probably should have shopped around but I didn't bother.

ETA: My right eye is much better than my left eye... both before surgery and after. I can read this post with either left, right or both... left is a bit of a struggle, right is pretty easy, both is good. Interestingly, with 1.5+ readers, either left only, right only or both are all crystal clear with no noticable difference.

 

[Mulligan]

BTW, I've gotten pricing from four different ophthalmologists here in the Minneapolis area.

Odyssey lens: $3,000 per eye

PanOptix: $3,790 and $3,900 per eys

Envy: $3,790, $3,900, and $5,900 per eye

LAL Lens: $4,800 plus up to 5 adjustment for $800 additional, $5,700 (all adjustments included, up to 5), and $7,200 (all adjustments included, up to 5).

 

[Mulligan]

I know you will, but get the best doctor and make pricing secondary. Its not your toe nails its your eye balls! I paid a couple thousand more than some of the area doctors, but I knew this guy was the best and he did the most thorough in terms of understanding what I was getting into. If you want to get scared go on Reddit and read about some disaster stories…Or maybe not because I about chickened out, ha!

 

[Qs Laptop]

I know you will, but get the best doctor and make pricing secondary. Its not your toe nails its your eye balls! I paid a couple thousand more than some of the area doctors, but I knew this guy was the best and he did the most thorough in terms of understanding what I was getting into. If you want to get scared go on Reddit and read about some disaster stories…Or maybe not because I about chickened out, ha!

Totally agree. I emailed the local Bausch & Lomb rep and had him recommended some docs that implant Envista Envy's. I also did a lot of research and found a couple of places that do advanced research on trifocal lenses and do FDA first implants on the new stuff. Also, I check to see they have the latest and best equipment and of course look at the surgeons resumes.

My first consult was with my usual clinic network and I considered it a disaster. The tech that did my eyeball measurements was disinterested, looked annoyed when I asked questions. The surgeon came in and rushed through the consult frequently looking at his watch like he had somewhere else to be. He said he did about 30% of his surgeries with trifocals (too few for my liking) and only had the Odyssey lens available. He uses knife blades for the surgery, not lasers. He ended with "I do surgeries on Wednesdays, Thursdays, and Fridays--when would you like to get it done?" (takes pen out of breast pocket.) I couldn't get out of there fast enough!

 

[5Miler]

Thank you for a very comprehensive response. Exactly the kind of feedback I'm looking for.

I'm glad to hear things worked out great for you.

You've got 20/30 and 20/40 for distance vision. Are you satisfied with your distance vision? For example, can you read freeway signs at far distances? What about license plates on cars that are several cars lengths ahead?

Do you happen to know your near vision J chart rating?

Yes, I am satisfied with my distance vision even though it is not 20/20. I can now read license plates and road signs at distance which I could not do before cataract surgery. Freeway signs at distance are a snap. I always kept my GPS on in unfamiliar areas to know when my street was coming up. We do learn to adapt.

As far as the J scale for near vision, I never got a number but was told I can read newsprint size and smaller. In practice, I can comfortably read much smaller as I often read this forum on my iphone 13 mini at the default font size as I have never changed it. Prior to the surgery that just wouldn't happen much even with my progressive lens in my glasses with a 2.5 adder for near vision. Now I do it for long periods without concern.

I will say that I was a bit put off when I found out my surgeon used the Odyssey vs Pan Optics or Envy lenses. After doing a bit of research myself I concluded that there wasn't really that much difference and found youtube videos all over the map showing how some people see better with any combination of lenses. I decided the choice of surgeon was the most important aspect and went with that.

 

[badatmath]

It terrifies me to think of this as I have 3 very unique eye issues and corneal scarring . . . so I try not to.

I can't help but wonder what happens if you lose one eye due to accident or illness and you have one near/one far lens. Can they just give you glasses to fix the remaining eye? Is this even a thing? IDK.

 

[5Miler]

Also to add that my surgeon did use the laser for all incisions on both eyes probably due to the more complex nature of my case. The surgery itself was the proverbial nothing burger as both times it was over before I was sure it even started and both times I could see immediately afterwards although a bit blurry due to the dilation of my pupil. On both occasions I had surgery early morning at a hospital, immediately went with DGF to a local diner for breakfast and then on to my doctors office for an eye exam to confirm proper seating of the lenses. Never any pain or discomfort at all. The eye drop routine was tedious though as it lasted 4 weeks for each eye.

 

[5Miler]

It terrifies me to think of this as I have 3 very unique eye issues and corneal scarring . . . so I try not to.

I can't help but wonder what happens if you lose one eye due to accident or illness and you have one near/one far lens. Can they just give you glasses to fix the remaining eye? Is this even a thing? IDK.

Corneal scarring was what led to my irregular astigmatism and the need for the superficial keratectomy on both eyes. It is exactly the same procedure they use for PRK but do not do the laser eye correction afterwards.

And yes, you can be prescribed glasses after cataract surgery to correct many issues as is done when someone gets both eyes corrected for either near or far vision with mono lenses so they need glasses to see the other.

 

[oscar1]

With these advances in lens types and improved results (and ability to shed glasses) are people opting for the eye surgeries before cataract symptoms occur? Or is it still a wait until you know you need new lens's game?

 

[5Miler]

Ophthalmologists have to make a living too.

 

[keppelbay]

Do you know which brand and model of trifocal lenses you got?

I think they are PanOptix, but I'm not 100% certain.

 

[Mulligan]

With these advances in lens types and improved results (and ability to shed glasses) are people opting for the eye surgeries before cataract symptoms occur? Or is it still a wait until you know you need new lens's game?

I didnt have cataracts yet, and I got it done. I had near perfect vision most of my life and it quite frankly sucked getting “old eyes”. I wasn't waiting around for the cataracts, I wanted my good vision back, so I sucked it up and paid for it.