Piggyback Intraocular Lens (Poly-Pseudophakia): Expanding Indications of an Under Utilized Technique

Residual refractive surprise remains one of the common indication of intraocular lens (IOL) explantation.Surgical technique to correct residual refractive error after cataract -IOL surgery include IOL explantation and exchange, piggyback IOL implantation, excimer laser refractive surgery.IOL explantation is technically challenging procedure and may be associated with corneal endothelial cell loss, trauma to capsular bag; iris and it may be difficult to perform due to IOL-capsular adhesion.Excimer laser assisted refractive surgery may not be feasible for all ophthalmologist due to lack of access to equipment, dry eye syndrome.The Piggyback Intraocular Lens (IOL) is a rather underutilized method which can actually provide good results by enhancing the refractive outcome after a cataract surgery.In this technique both secondary and primary IOL are implanted in the capsular bag-ciliary sulcus to minimize interlenticular opacity (ILO).Primary piggyback IOL implantation method was initially described by Sanders and Gayton in 1993 in case of microphthalmos and cataract, with IOL power of +46 diopters (D).Eventually, this technique started being utilized for correcting postoperative refractive issues [1].