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Implantation of piggyback IOLs guided by intraoperative aberrometry

Session Details

Session Title: Intraoperative Biometry and Correction of Astigmatism

Session Date/Time: Monday 07/10/2013 | 08:00-10:00

Paper Time: 08:41

Venue: Main Lecture Hall (Ground Floor)

First Author: : W.Wiley USA

Co Author(s): :    S. Bafna              

Abstract Details


To determine the utility of intraoperative wavefront aberrometry to guide selection of IOLs for piggyback implantation in cases of high refractive error or high residual error after primary IOL implantation.


Private clinical practice – Cleveland Eye Clinic


In this series of 14 consecutive cases of piggyback IOL implantation, either planned or unplanned, intraoperative wavefront aberrometry (ORA System, WaveTec Vision) was used. Aphakic measurements were performed to optimize sphere and cylinder power for the primary IOL. After implantation of the primary IOL, pseudophakic measurements were used to adjust IOL positioning (in the case of toric IOLs) and to analyze residual sphere to determine secondary IOL selection. The secondary or piggyback IOL was placed in the sulcus. A final pseudophakic measurement was performed and predicted error was evaluated.


Eight of the eyes were hyperopic; 6 were myopic. Eleven procedures were planned piggyback IOLs due to high refractive error. Three were post-refractive surgery eyes that underwent unplanned piggyback IOL surgery due to higher-than-expected residual error after primary IOL implantation. Mean prediction error was 0.39 ± 0.26 D.


Intraoperative aberrometry yields useful information that can help guide the selection and placement of primary and secondary IOLs in a piggyback formation in order to achieve the target refractive outcomes.

Financial Interest:

... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, ... research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented

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