Piggyback multifocal IOLs for a hyperopic-presbyopic surprise after cataract surgery in high myopic patients.

Purpose: To demonstrate the utility of piggyback multifocal intraocular lenses (IOLs) for a hyperopic-presbyopic surprise after cataract surgery in highly myopic patients.

Methods: Case report.

Results: A 43-year-old woman with high myopia presented with dense subcapsular cataracts. The IOL power calculated with the Haigis formula gave a lens of -7D for emmetropia in the right eye. The refractive result was a spherical equivalent refractive error of +2.25. To overcome refractive surprise, a refractive multifocal +3D Sulcoflex 653F with an additional 3.5D for near vision was implanted, achieving a best-corrected visual acuity of 20/40. The lens offered her good intermediate vision for computer work.

Conclusions: With a Sulcoflex IOL, it is possible to achieve good near-intermediate visual acuity and spectacle independence, especially in highly myopic eyes with good near visual acuity. In addition, the implantation of these IOLs might correct residual refractive errors following previous implantation of a monofocal IOL.