title: Secondary piggyback implantation versus IOL exchange for symptomatic pseudophakic residual ametropia.
abstract: BACKGROUND
  To evaluate the safety and efficacy of implanting a secondary IOL in comparison with IOL exchange to correct residual spherical refractive error after cataract surgery.
  
  
  METHODS
  This prospective case series included 23 pseudophakic eyes of 23 patients. They were divided into two groups: group I included 12 eyes for whom secondary piggyback IOL implantation in the ciliary sulcus was done, and group II included 11 eyes for whom IOL exchange was done. The mean follow up was 18 ± 4.2 months and 20 ± 3.6 months in groups I and II respectively. The visual and refractive outcomes were evaluated, and any intraoperative or postoperative complications was recorded.
  
  
  RESULTS
  The mean spherical equivalent in group I (secondary piggyback implantation), was reduced from -6.2 ± 2.2 diopters preoperatively to -0.28 ± 0.59D postoperatively in myopic eyes and from 4.79 ± 1.02D to 0.03 ± 0.74D in hyperopic eyes. Ninety-two percent of eyes were within ±0.5D of intended correction. In group II (IOL exchange), the mean SE was reduced from -5.88 ± 3.1D preoperatively to 0.16 ± 1.09 D postoperatively in myopic eyes and from 5.05 ± 0.93D preoperatively to 0.11 ± 0.69D postoperatively in hyperopic eyes. Eighty-two percent of eyes had postoperative SE within ± 0.5D of the intended correction. UCVA improved significantly in both groups. Rupture of the posterior capsule occurred in one eye in group II. Only one eye in group II lost one line of BCVA.
  
  
  CONCLUSIONS
  Secondary piggyback implantation in the ciliary sulcus is an effective, safe, and easy treatment for a pseudophakic ametropia.
authors: Mansoura Ophthalmic Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
authors: Hatem E
authors: HE
authors: El Awady
authors: Asaad A
authors: AA
authors: Ghanem
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006956:Hyperopia / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D007431:Intraoperative Complications; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D018918:Phacoemulsification / Q000009:adverse effects*; D011183:Postoperative Complications; D011446:Prospective Studies; D019591:Pseudophakia / Q000209:etiology / Q000601:surgery*; D012029:Refraction, Ocular / Q000502:physiology; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology