Piggyback intraocular lens implantation to correct myopic pseudophakic refractive error after penetrating keratoplasty

PURPOSE: To determine the safety and efficacy of implanting a second intraocular lens (IOL) to correct myopic pseudophakic refractive error after penetrating keratoplasty (PKP). SETTING: Department of Ophthalmology, Toronto Western Hospital, Toronto, Ontario, Canada. METHODS: In this retrospective case series, 6 eyes of 6 post-PKP pseudophakic patients had a second piggyback IOL implantation to correct a residual myopic refractive error. The uncorrected visual acuity (UCVA) and the best corrected visual acuity (BCVA) were measured at regular intervals during a 7-month follow-up. Efficacy was determined by the achieved refractive correction and Snellen UCVA measurements. Safety was measured by loss of BCVA and complications (intraoperative and postoperative). RESULTS: The UCVA improved in all cases. Five patients achieved a BCVA of 20/40 or better postoperatively. Before surgery, the mean spherical equivalent (SE) was -8.08 diopters (D) (range -6.13 to -12.00 D). After surgery, the mean SE was -0.94 D (range -2.38 to +0.25 D). Four patients were within +/-1.50 D of emmetropia. There were no intraoperative or postoperative complications. CONCLUSION: Implanting a piggyback IOL was a safe and effective means of correcting myopic pseudophakic refractive error post PKP.