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Visual quality and anterior chamber biometry in eyes with piggyback IOL

Poster Details

First Author: ArnaldoSantos PORTUGAL

Co Author(s):    Joana Ferreira   Duarte Amado   João Paulo Cunha        

Abstract Details


Cataract surgery has evolved from a visual rehabilitating procedure to become a refractive surgery in which the independence of corrective lenses is seen as a criterion of quality and satisfaction. However, despite all technological advances, achieving predictable refractive results is still a challenging task, particularly for extreme values of axial length. In face of an ametropic surprise, piggyback intraocular lens (IOL) implantation is a therapeutic option with proven refractive results. This work aims to evaluate the visual quality and anterior chamber biometry in patients with secondary monofocal piggyback IOL implantation and to compare these parameters with the contralateral pseudophakic eye.


: Cross-sectional study conducted in the Refractive Surgery Department of Central Lisbon Hospital Center.


Cross sectional study in eleven eyes of eleven patients who underwent monofocal piggyback IOL implantation in the ciliary sulcus to correct residual ametropia following cataract surgery with capsular bag IOL. Three pieces acrylic IOLs and implantable collamer lenses were implanted in the ciliary sulcus. Modulation transfer function (MTF), Strehl ratio, objective index of scattering and pupil diameter were measured using the Optical Quality Analysis System II double-pass system (OQAS II, Visiometrics, S.L., Castelldefels, Spain). Anterior chamber depth, volume and angle were evaluated using the Pentacam Rotating Scheimpflug Camera (Pentacam HR, Oculus, Germany). The results were compared with the contralateral eye of the same patients, which had undergone phacoemulsification with in-the-bag IOL implantation.


There were no post-operative complications following add-on IOL implantation and the mean spherical equivalent was 0.85 diopters. The mean spherical equivalent in the contralateral eye was -0.19 diopters (p > 0.05). Statistical analysis did not reveal any significant differences in the MTF, Strehl ratio, objective index of scattering and pupil diameter between the eyes with piggyback IOL and the eyes with in-the-bag IOL (p > 0.05). There were also no statistically significant differences between both groups in the anterior chamber depth, angle and volume (p > 0.05).


The implantation of a secondary piggyback IOL in the ciliary sulcus, leaving the original IOL in place, is a safe, predictable and effective treatment for a pseudophakic refractive surprise. Anterior chamber morphology is preserved and the optical quality is similar to that of the pseudophakic contralateral eye. FINANCIAL INTEREST: NONE

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