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Primary piggyback intraocular lens implantation in a nanophthalmic eye

Poster Details

First Author: V.Arjun INDIA

Co Author(s):    K. Narendran                    

Abstract Details

Purpose:

Nanophthalmos presents an array of challenges even to seasoned cataract surgeons.Extreme axial hyperopia, high dioptric IOL requirements, shallow anterior chamber and severe positive pressure may complicate lens implantation. We demonstrate a 71 year old patient with bilateral nanophthalmos who had uneventful cataract extraction in the right eye with primary implantation of 2 intraocular lenses (IOLs) of 2 different materials

Setting:

Aravind Eye Hospital, Coimbatore

Methods:

We report a case of primary piggyback intraocular lens implantation in the right eye of a 71 year old male with bilateral nanophthalmos. Patient had an axial length of 16.56mm, lens thickness of 5.66mm and a calculated IOL power of 50.50D. Patient underwent a combined clear corneal phacoemulsification and superior sclerocorneal tunnel approach to implant a foldable acrylic and a rigid PMMA intraocular lens into the capsular bag. Calculated IOL power being higher than the available highest power for a single intraocular lens by 10D a piggyback implantation was done.

Results:

Patient preoperatively had an uncorrected vision of 2/60 (1.4 LogMAR) improving to 6/60 (1 LogMAR) with sphere of 흀� and cylinder of � in his right eye. Immediate post operative period patient had an uncorrected vision of 5/60 (1.1 LogMAR) and a pinhole vision of 6/60 (1 LogMAR).

Conclusions:

Primary piggyback intraocular lens implantation gives better visual acuity in very high IOL power patients especially in a scenario where a custom intraocular lens is unavailable. Piggyback surgery gives the patient better uncorrected visual acuity than implantation of single IOL of maximum available power.

Financial Disclosure:

NONE

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