Refractive results with secondary piggyback implantation to correct pseudophakic refractive errors

Purpose: To assess the efficacy and safety of implanting a second intraocular lens (IOL) to correct pseudophakic refractive errors. Setting: Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel. Methods: This prospective noncomparative case series included 10 pseudophakic eyes, 5 with a myopic residual refractive error and 5 with a hyperopic residual refractive error. All eyes had secondary piggyback IOL implantation with the IOL placed in the ciliary sulcus. Five types of IOLs were used to correct the residual refractive error. Results: The mean preoperative myopia was -6.6 diopters +/- 3.3 (SD), and the refractive outcome was within 0.5 +/- 0.7 D of the desired refraction (range -1.5 [undercorrected] and +/- 1.0 D [overcorrected]). The mean preoperative hyperopia was +3.8 +/- 0.8 D, and the refractive outcome was within 0.46 +/- 0.4 D of the desired refraction (range 0 and 1.0 D overcorrected). All patients showed visual acuity improvement. Best spectacle-corrected visual acuity improved from 20/44 to 20/30 (P<.05). Conclusion: An IOL type that is appropriate for implantation in the ciliary sulcus is a viable option for correcting pseudophakic refractive error using the piggyback technique.