Secondary Piggyback Implantation Versus Iol Exchange For Symptomatic Pseudophakic Residual Ametropia

To evaluate the safety and efficacy of implanting a secondary IOL in comparison with IOL exchange to correct residual spherical refractive error after cataract surgery.

Mansoura Ophthalmic Center, Faculty of Medicine, Mansoura University, Egypt

This retrospective comparative study included twenty-three pseudophakic eyes of 23 patients. They were divided into two groups: group I included 12 eyes for whom, secondary piggyback IOL implantation in the ciliary sulcus was done and group II included 11 eyes  for whom, IOL exchange was done. The mean follow up was 18±4.2 months and 20±3.6 months in group I and II respectively. The visual and refractive outcomes were evaluated and any intraoperative or postoperative complications was recorded.

The mean spherical equivalent in group I was reduced from -6.2±2.2 diopter preoperatively to -0.28±0.59D postoperatively in myopic eyes and from 4.79±1.02D to 0.03±0.74D in hyperopic eyes. Ninety two percent of  eyes were within ±0.5D of intended correction. While in group II(IOL exchange), the mean SE was reduced from -5.88±3.1D preoperatively to 0.16±1.09 D postoperatively in myopic eyes and from 5.05±0.93D preoperatively to 0.11±0.69D postoperatively in hyperopic eyes. Eighty two percent of eyes had postoperative SE within ±0.5D of the intended correction. UCVA improved significantly in both groups. Rupture of the posterior capsule occurred one  in group II. Only one eye in group II lost one line of BCVA.

Secondary piggyback implantation in the ciliary sulcus is an effective, safe, and easy treatment for a pseudo­phakic ametropia.