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PanOptix IOL vibration or wobble, unilaterial performend 3mos ago

I had a PanOptix multifocal IOL implanted in my right eye three months ago. I saw two doctors and both recommended the lens due to my age and only doing the one eye at this time. I use a contact lens for the other eye. Everything has gone well and I am generally pleased with the results as my other eye picks up the slack while I adapt. But over the past two weeks I have noticed a vibration of the image on movement, as if the lens wobbles when I shift gaze. I also notice my iris moves as if rippling or flapping slightly.

I saw the surgeon this morning and he stated everything looks good. At the time of the exam I noticed that with my pupil dilated I didn't observe the vibration effect. But as the dilating has worn off I am now here again seeing everything around me quiver as I look around. "Rim effect" has been mentioned but I do not believe this to be the case. From day one I noticed a bit of vibration but assumed it would improve with time. Instead, it has worsened.

I'm making an appointment with another eye doc for another opinion, but is this a common phenomenon or complication? I'm not finding quite the same thing in my searching. Thank you.
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233488 tn?1310693103
MEDICAL PROFESSIONAL
It would be important to be sure that the IOL is stable and not dislocated or firmly anchored.  Yes such problems have been described, more with multifocal than monofocal or toric IOLs.  Pupil size and mobility may have a role.  You are wise to get a second opinion.
Helpful - 1
6 Comments
Thanks Dr. Hagan. It's odd that when my pupil is dilated, even just to the degree it is at night, the effect is present but much less apparent. And funny to have found this forum and yourself. I had actually sought a second opinion prior to surgery from Discover (I'm in KC) but unfortunately it would've been out-of-network. I have an appointment with my regular eye doc (I went with a different practice for the surgery as the doc is more experienced) in two weeks.
If you change your mind. Discover Vision Centers  have a national/world class consultant for difficult post eye surgery problems in John Doane, MD. He is referred patients from all across the US, South America, Europe and Asia. Far and away the most experiences with problems like this.
I just changed health insurance providers. You're now both in-network. I'll be making an appointment when the card arrives. Thank you.
Okay, when you schedule with Dr. Doane tell the scheduler the problem you are having and referral from Dr. Hagan
Hi Dr. Hagan. I met with Doane and I have to say thank you. I wish he had been my doctor from the start. My symptoms seem to have him stumped but he ruled out mechanical issues with the IOL and clearly explained why that is his conclusion. Piecing things together myself, I believe I am seeing the billowing in my iris. Again while dilated I did not observe the phenomenon. Testing this conclusion I note I do not see the effect when staring directly at a light source. Only when the light is entering at an angle. Perhaps the effect is magnified by the optical properties of the multifocal IOL.

Doane has suggested going with LAL for my other eye when the time comes. I am considering it as my profession is not compatible with doing the PanOptix in both eyes. Cost is the primary constraint but based on progression thus far I think I have enough time before my remaining cataract requires surgery.

Thank you again. I am very happy with the consult.
Thank you. Dr. Doane is one of the most gifted minds and surgeon that I have worked with. He is referred problem cases from all across the US and even Europe and Middle East.  The Light adjusted lens has been wonderful expecially for problem cases like post RK surgery.  Some of our surgeons have had the LAL put in their own eye by Dr. Doane who did the pionering research in USA.  
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