Long-Term Observation After Piggyback Multifocal Iol Implantation For A Monofocal Pseudophakic Eye: A Case Report

Few reports have been published on the long-term observation of piggyback multifocal intraocular lenses (IOLs) for pseudophakic eyes. The purpose of this study is to report a case 6 years after piggyback multifocal IOL implantation.

Keio University Hospital, Tokyo, Japan

A 42-year-old woman who underwent multifocal IOL implantation 6 years previously was referred to our hospital with near visual disturbance. The patient previously underwent cataract surgery with monofocal IOL implantation for emmetropia in her right eye and she had a cataract in her left eye.  Because she strongly requested spectacle independence, treatment options were proposed that included a multifocal contact lens or IOL exchange to a multifocal IOL in her right eye following cataract surgery with multifocal IOL implantation for her left eye. Ultimately, a piggyback multifocal IOL (Add-On Diff-sPB, HumanOptics) was implanted in the right eye and cataract surgery with multifocal IOL implantation was performed.

Her preoperative uncorrected distance visual acuities were 0.1 (20/200) that improved to 1.2 (20/17) with -2.50 diopter (D): -1.00 D Ax160 in the right eye; and 0.08 (20/250) that improved to 0.5 (20/40) with -4.25 D: -1.50 D Ax10 in the left eye.Six years postoperatively, her uncorrected visual acuities at distance (5 m) were 1.2 (20/17) that improved to 1.5 (20/13) with -0.25 D: -0.75 D Ax140 in the right eye; 1.2 (20/17) that improved to 1.5(20/13) with +0.25 D: -1.00 D Ax180 in the left eye; and 1.0 (20/20) at near (30 cm) with distance correction. No postoperative complication has been observed for 6 years. She has been satisfied with the results.

This case demonstrates the possibility of long-term safety and stability of piggyback IOL implantation for a pseudophakic eye. It might be a good option to reduce spectacle dependence for patients after monofocal IOL implantation.