The piggyback method of implanting two intraocular lenses in one eye has been successfully expanded to address pseudophakic refractive error in normal eyes and eyes that have undergone post-penetrating keratoplasty. Piggyback implantation has been combined with the use of newly available minus-power lenses to provide appropriate power for a cataract patient with keratoconus, as well as to correct pseudophakic myopia. The phenomenon of increased depth of focus in piggybacks may be explained by a contact zone between the lenses. The late complication of inter-lenticular cellular growth with resultant hyperopic shift, opacification, and loss of vision has recently become a concern.
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Purpose: To evaluate residual refractive errors after intraocular lens (IOL) extraction and the safety and effectiveness of refractive correction procedures.
Methods: The eligibility criteria for this systematic review were patients who had undergone cataract or clear lens extraction and had experienced residual refractive error. All study designs were considered for inclusion and non-English publications, non-peer reviewed articles, books, and systematic reviews were excluded.
Hyperopia shift in the long term after cataract surgery: a case report.
BMC Ophthalmol
December 2024
Shanghai Eye Diseases Prevention &Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, Shanghai, China.
Background: Long-term hyperopia shift is a rare complication following cataract surgery, presenting significant clinical challenges in analysis and management.
Case Presentation: A 52-year-old female with a history of high myopia and laser-assisted in-situ keratomileusis (LASIK) surgery presented with decreased vision in her left eye at the very fifth year after cataract surgery. The spherical equivalent in her left eye had increased to + 6.
Polypseudophakia: from "Piggyback" to supplementary sulcus-fixated IOLs.
Graefes Arch Clin Exp Ophthalmol
September 2024
Department of Ophthalmology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Polypseudophakia, the concept of using a second intraocular lens (IOL) to supplement an IOL that has already been placed in the capsular bag, was first used as a corrective measure where the power requirement was higher than that of available single IOLs. Subsequently, the technique was modified to compensate for post-operative residual refractive errors. In these early cases, an IOL designed for the capsular bag would be implanted in the sulcus.
View Article and Find Full Text PDFRotational stability of two different piggyback toric intraocular lenses for correction of high post-keratoplasty pseudophakic ametropia.
Digit J Ophthalmol
July 2024
Corneoplastic Unit, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, United Kingdom.
We present the case of a 65-year-old man with bilateral keratoconus and history of bilateral penetrating keratoplasty (PK) who developed gradual visual decline in the left eye due to cataract formation. Following successful left eye cataract surgery and monofocal, non-toric intraocular lens (IOL) in-the-bag implantation, the patient experienced persistently low uncorrected distance visual acuity (UDVA) due to high residual refractive error and intolerance to contact lenses. A supplementary toric IOL was placed in the ciliary sulcus, but subsequent rotational instability of the lens required repeated realignment.
View Article and Find Full Text PDFApplication of Femtosecond Laser + Piggyback Multifocal Intraocular Lens Implantation in Patients with Super-High Myopia Complicated with Cataract.
Semin Ophthalmol
April 2024
Department of Cataract, Aier Eye Hospital of Wuhan University, Wuhan, China.
Objective: To observe the clinical effect of piggyback multifocal intraocular lens (IOL) implantation in treating patients with high myopia complicated with cataract.
Methods: This was a prospective controlled study. We compared 32 eyes of 32 patients who underwent femtosecond laser-assisted cataract surgery with piggyback IOL implantation (two IOLs were implanted into the capsule) with 32 eyes of 32 patients who also underwent the same surgery (one IOL implanted into the capsule) due to high myopia complicated with cataract at the Wuhan Aier Eye Expert Hospital between January 2019 and October 2020.
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