Piggyback Iols For Extreme High Myopic Cataract Surgery

When implanting multifocal lenses into eyes with high myopia and an extremely long axial length, the lowest available power for these lenses is only +5.0D. This may leave residual myopia. Previously, LASIK was used to correct this residual myopia. However, by implanting a monofocal negative lens on top of this, good uncorrected visual acuity can be achieved. This method is examined and introduced.

All cases were operated on by a single, experienced ophthalmic surgeon at Fukasaku Eye Hospital Yokohama and Fukasaku Eye Institute Tokyo Roppongi.

A representative case is described. A 72-year-old male patient had an axial length of 30.81 mm and severe myopia of -22.5 D. He desired a multifocal lens, but calculations indicated the minimum power would be +5.0D, leaving residual myopia of -3.34D. Therefore, after removing the cataract, the capsule was polished. A multifocal lens with +5.0D power and a monofocal minus lens with -6.0D power were then implanted within the same capsule.

Preoperative visual acuity was 20/2000 without correction but dramatically improved to 20/20. Corrected visual acuity also improved from 20/40 to 20/16. Intraocular pressure decreased from 19 mmHg to 13 mmHg. The patient's satisfaction was extremely high, expressing delight at being able to see clearly at all distances without correction.