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Secondary piggyback Sulcoflex® as alternative in refractive surprise

Poster Details

First Author: S.Gálvez Carvajal SPAIN

Co Author(s):    N. Uzcategui Rodriguez   A. Munoz Morales   M. Caro   R. Luchena Lopez   F. Molina Socola        

Abstract Details


To evaluate the use of secondary piggy back SULCOFLEX® as alternative in refractive surprise.


A 56 year old woman who attends our service with progressive right eye visual acuity decrease. Her ocular history included bilateral myopia and astigmatism, with prior refractive in RE -5.25, -0.75 x 30 ° LE -2,5, -0,25 x 160 °.Patient was successfully operated both eyes by LASIK in 2005.


Initial exploration CDVA in right eye was 0.5 and biomicroscopy showed nuclear sclerosis with posterior polar lens opacity. We calculate lens power to implant in right eye cataract surgery using keratometry prior LASIK, pre and postoperative refraction. Then, surgery was carried out successfully with implantation of AcrySof® monofocal lens of 17.00 D. Four weeks later, UDVA was 0.6 and refractometry showed a refractive surprise of +2.75, -0.75 x 133º. Due to the low endothelial cell count (1418 cells/mm2) the replacement of the IOL was discouraged. Alternatively, secondary piggy back lens implantation in sulcus was performed with Sulcoflex® of +3.5 D.


The initial four weeks after surgery we followed up and treated with topical steroid and antibiotic. The patient did not present complications. Finally, UDVA was 0.8 (decimal scale) and refraction +0.25, -1 x 122º.


In myopic eyes that have previously undergone corneal refractive surgery, hyperopic refractive error in the calculation of the lens power may occur and even promoted by posterior subcapsular opacity despite the use of optimized formulas. In cases of refractive surprise after cataract surgery, the implant lens Sulcoflex® is a safe, effective and predictable alternative to achieve emmetropia.

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