title: Correction of residual refractive error in pseudophakic eyes with the use of a secondary piggyback toricImplantable Collamer Lens.
abstract: OBJECTIVE
  To evaluate the feasibility of piggyback insertion with a toric Implantable Collamer Lens (ICL, STAAR Surgical).
  
  
  METHODS
  This study investigated eight pseudophakic eyes of five patients who underwent piggyback insertion of a toric ICL to correct residual refractive error. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and manifest refractive sphere and astigmatism were measured before and 6 months after surgery.
  
  
  RESULTS
  Pre- and 6-month postoperative logMAR UDVA were 0.759±0.430 and 0.201±0.458, respectively. All eyes were corrected within ±0.50 diopters (D) of intended spherical equivalent refraction. The manifest refractive astigmatism was within ±0.50 D in five (62.5%) eyes and ±1.00 D in seven (87.5%) eyes. No eyes lost more than one line of CDVA. Pupillary block occurred in one eye on postoperative day 1.
  
  
  CONCLUSIONS
  Piggyback insertion of a toric ICL appears to be effective and predictable in correcting refractive error in pseudophakic eyes.
authors.affiliation: Department of Ophthalmology, Social Insurance Chukyo Hospital, Aichi, Japan. tkojkoj@mac.com
authors.forename: Takashi
authors.initials: T
authors.lastname: Kojima
authors.forename: Rie
authors.initials: R
authors.lastname: Horai
authors.forename: Shuya
authors.initials: S
authors.lastname: Hara
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakamura
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Nakamura
authors.forename: Yuya
authors.initials: Y
authors.lastname: Satoh
authors.forename: Kazuo
authors.initials: K
authors.lastname: Ichikawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction; D002452:Cell Count; D004728:Endothelium, Corneal / Q000473:pathology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000209:etiology / Q000601:surgery*; D054120:Phakic Intraocular Lenses; D019591:Pseudophakia / Q000150:complications*; D012029:Refraction, Ocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology