Piggybacking intraocular implants to correct pseudophakic refractive error

To determine the safety and efficacy of implanting a second intraocular lens (IOL) to correct pseudophakic refractive error. Noncomparative, prospective, consecutive case series. Eight eyes of eight normal pseudophakes and seven eyes of seven postpenetrating keratoplasty (PK) pseudophakes were included in the study. A second intraocular lens (IOL) was implanted anterior to the first in each eye in the study. Efficacy was determined based on the achieved refractive correction and Snellen uncorrected visual acuity measurements. Safety was determined based on loss of best-corrected visual acuity and operative and postoperative complications. Before surgery, spherical equivalents ranged from −5.12 diopters (D) to 7.5 D, with a mean absolute deviation from emmetropia of 3.38 D (1.62). After surgery, spherical equivalents ranged from −2.75 D to 0.5 D, with a mean absolute deviation from emmetropia of 1.21 D (0.90). Before surgery, only 7% of patients had 20/40 or better uncorrected vision, whereas after surgery, 50% had that level of vision. Implanting a second IOL is a viable option for correcting pseudophakic refractive error.