PURPOSE: To present our experience with a pseudophakic piggyback intraocular lens (IOL) (Sulcoflex; Rayner Intraocular Lenses Ltd) in five eyes of four patients. One patient desired increased spectacle independence after bilateral LASIK and refractive lens exchange with an accommodating IOL. The remaining three patients with residual refractive error desired increased spectacle independence following cataract surgery with a monofocal IOL. METHODS: Four eyes received a multifocal Sulcoflex IOL and one eye received a toric Sulcoflex IOL. RESULTS: All patients achieved uncorrected distance visual acuity (UDVA) of 0.1 logMAR (Snellen 20/25) or better and those who received the multifocal Sulcoflex achieved uncorrected near visual acuity (UNVA) of N6 (Jaeger 4) or better. CONCLUSIONS: The Sulcoflex IOL may be a safe and effective method for enhancing the refractive outcome in pseudophakic eyes, providing good UDVA and UNVA when using the multifocal platform. [J Refract Surg. 2011;27(9):693-696.] doi:10.3928/1081597X-20110512-01