title: Piggyback foldable intraocular lens implantation in patients with microphthalmos.
abstract: OBJECTIVE
  To evaluate the clinical results of phacoemulsification and implantation of 2 foldable acrylic intraocular lenses (IOLs) in microphthalmic eyes.
  
  
  METHODS
  University of Tokyo School of Medicine, Tokyo, Eguchi Eye Hospital, Hakodate, and Osaka Rosai Hospital, Osaka, Japan.
  
  
  METHODS
  This study comprised 5 eyes of 3 patients whose manifest spherical equivalent was +10.5 to +18.0 diopters (D) and axial length was 15.79 to 16.82 mm. After phacoemulsification, 2 foldable acrylic IOLs with a mean power of +43.0 D +/- 9.5 (SD) (range +32.0 to +55.0 D) were implanted in the capsular bag.
  
  
  RESULTS
  There were no significant intraoperative complications, and there was significant improvement in uncorrected and best corrected visual acuities after surgery. The spherical equivalent decreased significantly; however, the postoperative refraction was considerably more hyperopic than predicted in all eyes. Except for posterior synechias in 2 eyes and slight interlenticular opacification in 2 eyes, no major postoperative complications occurred during the mean follow-up of 14.8 months.
  
  
  CONCLUSIONS
  Implanting 2 piggyback IOLs was beneficial in eyes with an extremely short axial length. However, the current system of lens power calculation markedly underestimates the required lens power, resulting in a hyperopic refractive error after surgery. The benefits of in-the-bag placement of 2 foldable lenses are questionable.
authors.affiliation: Department of Ophthalmology, University of Tokyo School of Medicine, Tokyo, Japan. oshika-tky@umin.ac.jp
authors.forename: T
authors.initials: T
authors.lastname: Oshika
authors.forename: A
authors.initials: A
authors.lastname: Imamura
authors.forename: S
authors.initials: S
authors.lastname: Amano
authors.forename: S
authors.initials: S
authors.lastname: Eguchi
authors.forename: M
authors.initials: M
authors.lastname: Nakayama
authors.forename: K
authors.initials: K
authors.lastname: Emi
mesh_terms: D000180:Acrylic Resins; D000368:Aged; D002386:Cataract / Q000150:complications*; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007910:Lenses, Intraocular; D008850:Microphthalmos / Q000150:complications*; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods; D016896:Treatment Outcome; D014792:Visual Acuity
chemical_list: D000180:Acrylic Resins