Stability Of Toric Piggyback Intraocular Lenses For Correction Of Residual Astigmatism

To determine the anatomical and refractive stability of toric piggyback intraocular lens (IOL) stability for correction of residual astigmatism. 

Patients with residual corneal astigmatism after crystalline lens extraction presenting to our department for surgical corrections. Spherocylindrical correction would be attempted first, but might prove challenging, either due to anisometropia or due to high degrees of astigmatic correction needed. The cause might be due to ectatic corneal pathology. or post corneal grafts.

In the last 2 years, we have been treating those patients with a piggygback option IOL, in the form of a sulcus lens placement. Three lenses were used in this context; Rayner Sulcoflex Aspheric Pseudophakic Supplementary IOL, 1stQ Add-on IOL, and Staar-surgical ICL. We retrospectively analysed 15 eyes implanted with those lenses in the last 2 years in terms on background, anatomical and refractive stability, and visual potential. Quality of life questionnaire as well was conducted on those patients. In addition, multimodal imaging was performed on all patients.

Visual potentials, refractive and anatomical stability and quality of life results are reported and analysed and correlated with background pathology of the astigmatism.

The 3 types of IOLS discussed in our cohort were safe, and effective in treating residual corneal astigmatism. The nature and aetiology of the astigmatism, and the regularity of astigmatism on the corneal level, may affect the visual prognosis and patient satisfaction.